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Eye Contact as a Nonverbal Strategy in Facilitating Patients' Verbal Participation

促進病人發言的非語言技巧:眼神接觸

摘要


近年來,已有許多言談分析的研究旨在觀察言談互動非語言行為之眼神接觸,且在醫學教科書與文獻亦提及醫師適當的與病人保持眼神接觸,可有效引導出病人的病情資訊,因此建議醫師於詢問病人病史時,應保持適度的眼神接觸。再者,由於醫病溝通過程的醫問病答對話模式,旨在收集病人全面性的病情資訊並作出適當的診斷,因此在問答過程中,醫師與病人間的眼神接觸對病人資訊提供的影響尤其值得重視。已有研究顯示眼神接觸能引發對方回應,本研究更進一步探討當醫師詢問第一個開放式間句(今天來有什麼問題?)之後,醫生給予病人不同時間長度的眼神接觸對病人的回應有何影響(即回應的時間長短與回應量多寡)。本研究於台灣南部某大學醫學院附設醫院家庭醫學部收集23個實際問診的影音檔,病人皆為初診老年人且有一位親友陪伴。結果顯示醫師問問題時,若能投以病人更多的眼神接觸可鼓勵病人提供更詳盡的描述,其中以病人回應時,醫師與病人眼神接觸的時問愈多者能引起病人花較多的時間(19.4秒)提供較多的回應(46.1音節)。因此,本研究建議,當醫師詢問病人病情資訊時,醫師宜投以病人更多的眼神接觸,以鼓勵病人提供更多有關他們的健康資訊。

關鍵字

醫病對話 眼神接觸 發言量

並列摘要


In medical consultations, through the process of doctor questions and patient responses, doctors aim to elicit a comprehensive understanding of patients' health problems in order to establish an accurate diagnosis. Research has demonstrated that eye contact functions as a strategy in eliciting responses from addressees. This paper further explores whether eye contact encourages addressees' verbal participation in the context of medical interviews. We focus on patient responses to doctors' first open questions (e.g., what's your problem today?) since they are often taken as the patients' chief complaints and raised as the topics for discussion during the rest of the consultation. Our analysis is based on 23 videotaped medical consultations collected from a tertiary teaching hospital in southern Taiwan. The participants are doctors from the Department of Family Medicine and their elderly patients, each accompanied by a family member. In terms of three varying degrees of doctor-patient eye contact durations, this paper aims to discover the eye contact effect on patients' verbal participation. The results show that after doctors' first open questions, patients in the more eye contact group verbally participate more and longer (46.1 syllables in 19.4 seconds) in their responses than the less eye contact group (21.9 syllables in 13.5 seconds) and the no eye contact group (0.3 syllables in 14.7 seconds). Based on these results, this paper suggests that doctors' eye contact with patients encourages patients' narration of their health problems.

參考文獻


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