|Budget Amount *help
¥1,900,000 (Direct Cost : ¥1,900,000)
Fiscal Year 1999 : ¥800,000 (Direct Cost : ¥800,000)
Fiscal Year 1998 : ¥1,100,000 (Direct Cost : ¥1,100,000)
The purpose of this research is, in two-year research period, to analyze the discourse in the relationship between the medical staff and the patient (his/her family) in which the paternalistic intervention often arises.
1. In this research, using 17 categories to analyze the recorded discourses of doctors and patients, the quantitative analysis of the medical interview and informed consent was made. The 17categories are as follow. The medical staffs narratives: [A. direct discourse, (1) explanation, (2) correcting the misunderstandings, (3) response, (4) persuasion.] [B. indirect discourse, (5) question, (6) accepting the patient's emotion, (7) recommendation/advise] The patient's narratives: [A. spontaneous narratives, (8) complaining the pain, sufferings, and feelings, (9) request/proposal, (10) question] [B. passive narratives, (11) response, (12) responding to the persuasion, (13) responding to the recommendation] Others: (14) narratives among the patient and family, (15) narratives
among the medical staff, (16) monologue, (17) silence.
2. The analysis of the discourses of 13 cases recorded by 4 medical doctors clarified the following. (1) The average rate of doctor's narratives was 52.2% which was comparatively lower than past data presented by the preceding researches. Such paternalistic medical interviews as explained exclusively by the doctors were less than expected. (2) Through the analysis of the 13 cases, it was made evident to show the correlation in the following relationships between the rate of patient's narratives and the rate of doctor-bring-about-patient's narratives, between the rate of doctor-bring-about-patient's narratives and the rate of continuous patient's narratives, and between the rate of doctor's narratives and the rate of doctor-bring-about-patient's narratives. (3) The medical staff plays the role of giving the information about the patient's disease and the treatment in the medical interview or informed consent. In case that the doctor is conscious of his/her role as information-giver, the doctor tends to take initiative in the discourse between the doctor and the patient, and to explain continuously in order to make the patient understand his/her own conditions of illness. Less