Delivery of patient-centered care in complementary medicine: Insights and evidence from the Chinese medical practitioners and patients in primary care consultations in Hong Kong

被引:7
作者
Pun, Jack [1 ]
Chor, Winnie [2 ]
Zhong, Linda [3 ]
机构
[1] City Univ Hong Kong, Dept English, Hong Kong, Peoples R China
[2] Hong Kong Baptist Univ, Dept English Language & Literature, Hong Kong, Peoples R China
[3] Hong Kong Baptist Univ, Sch Chinese Med, Hong Kong, Peoples R China
关键词
Traditional Chinese medicine (TCM); Patient-centred care; Primary care; Hong Kong; Discourse analysis; Shared decision making; EMERGENCY COMMUNICATION; HEALTH; PROFESSIONALS; CHALLENGES; CLINICIAN;
D O I
10.1016/j.ctim.2019.06.013
中图分类号
R [医药、卫生];
学科分类号
10 ;
摘要
Introduction: Traditional Chinese Medicine (TCM) has become increasingly popular around the world, and has been accepted by people not only in China and Southeast Asia, but also in Western countries. Despite its historic role in the Chinese society, there has been limited research on exploring the nature of TCM practitioner-patient interactions in the Chinese context. As indicated by a major study regarding the Hong Kong context(1), there is a need to investigate the role of TCM practitioner and promote interdisciplinary research to ensure safety and synergy of TCM and Western medicine in primary care. This study aims to address this gap by investigating the nature of TCM consultations and their communication patterns in Hong Kong. Methods: Based on 10 h of conversations (in Cantonese) between TCM practitioners and their patients in the diagnostic interviews, the study explored how the doctor-patient relationship was negotiated in the course of the consultation, while both the TCM practitioners and the patients were constantly trying to manage and maintain common ground. Particular attention had been paid to the identification of specific linguistic and discourse strategies that TCM practitioners had employed to establish doctor-patient rapport, so that a better understanding of patient-centred care in the TCM context could be obtained. The participants were recruited from a local university operated clinic which shared the characteristic of TCM practitioners in Hong Kong. Results: A range of linguistic strategies that TCM practitioners used to deliver patient-centred care have been identified. These strategies are also helpful in shaping a joint decision-making process that will lead to better patient understanding and compliance with the doctors' treatments. Conclusions: This study demonstrates empirically how TCM practitioners utilize a range of linguistic resources and communication strategies to shape the ongoing discourse so that their patients can have a better understanding of their illnesses. For an example, it is found that TCM practitioners and their patients were constantly trying to manage and maintain common ground by using a range of grammatical markers, including sentence-final particles (SFPs) and discourse markers (DMs), to negotiate the epistemic commitment so that the patient would have good compliance with the practitioner's suggested treatment. It is also observed that various types of interrogatives have been used by the TCM practitioners to elicit information from the patients as well as to encourage them to talk and make a response. Furthermore, it is found that TCM practitioners would deliberately enquire about the patients' everyday experiences because what they eat, do, and encounter all have an important impact on their body conditions. By exploring into the patients' daily routines in the social talk, the practitioner can help maintain and promote the overall balance of the patient's body, and help them monitor and enhance their health conditions by modifying their daily habits and behaviours. With the adoption of these linguistic and communication strategies, the TCM practitioners are shown to have placed the patients' needs as their top priority. Previous studies in the field have already proved that co-construction of the treatment plan between the doctor and the patient is extremely important, and that a patient-centred approach can largely reduce adverse events leading to avoidable patient harm. The specific strategies identified in the current study can enhance the TCM practitioners' communication with patients, creating an environment that will surely optimise safety for both patients and clinicians.
引用
收藏
页码:198 / 204
页数:7
相关论文
共 32 条
  • [1] PROGRESS IN TRADITIONAL CHINESE MEDICINE
    CHAN, K
    [J]. TRENDS IN PHARMACOLOGICAL SCIENCES, 1995, 16 (06) : 182 - 187
  • [2] Communication in Hong Kong Accident and Emergency Departments: The Clinicians' Perspectives
    Chandler, Eloise
    Slade, Diana
    Pun, Jack
    Lock, Graham
    Matthiessen, Christian M. I. M.
    Espindola, Elaine
    Ng, Carman
    [J]. GLOBAL QUALITATIVE NURSING RESEARCH, 2015, 2 : 1 - 11
  • [3] Perceived quality of communication amongst outpatients in western and traditional Chinese medicine clinics in a Chinese population
    Chung, Vincent Chi Ho
    Lau, Chun Hong
    Wong, Eric Ming Chung
    Yeoh, Eng Kiong
    Griffiths, Sian Meryl
    [J]. HEALTH POLICY, 2009, 90 (01) : 66 - 72
  • [4] Dowsett SM, 2000, PSYCHO-ONCOL, V9, P147, DOI 10.1002/(SICI)1099-1611(200003/04)9:2<147::AID-PON443>3.0.CO
  • [5] 2-X
  • [6] Gu Y., 1996, J ASIAN PAC COMMUN, V7, P156
  • [7] Gu YG, 1999, HEALTH COMMUN, V11, P203
  • [8] The importance of physician listening from the patients' perspective: Enhancing diagnosis, healing, and the doctor-patient relationship
    Jagosh, Justin
    Boudreau, Joseph Donald
    Steinert, Yvonne
    MacDonald, Mary Ellen
    Ingram, Lois
    [J]. PATIENT EDUCATION AND COUNSELING, 2011, 85 (03) : 369 - 374
  • [9] Small talk in medical conversations: Data from China
    Jin, Ying
    [J]. JOURNAL OF PRAGMATICS, 2018, 134 : 31 - 44
  • [10] Jin Ying, 2017, Commun Med, V14, P121, DOI 10.1558/cam.31872