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Tsing Hua Journal of Chinese Studies
ISSN 0577-9170; DOI 10.6503/THJCS


The Relationship between Greeting Expressions and Patient Participation in Doctor -Elderly Patient Interaction

Vol. 38 No. 3   9/2008    


The Relationship between Greeting Expressions and Patient Participation in Doctor-Elderly Patient Interaction


Shen-ying Huang/I-ling Chen/Mei-hui Tsai  Feng-fu Tsao









Key words

doctor-patient communication, discourse analysis, greetings, geriatric triads


   As in most social interactions, affective and referential goals are essential in doctor-patient communication: doctors need to establish a trusting relationship with patients so that they can collect holistic health information from them. Although good rapport should be established early in the greeting stage of the medical interview, exactly how doctors' greetings facilitate patient participation has not yet been fully explored. By examining 44 triadic medical encounters among doctors, elderly patients, and patient companions collected in a teaching hospital in southern Taiwan, we examine three research questions. First of all, what greeting topics are commonly observed? Among these topics, which ones encourage more verbal participation from patients? And, how do they achieve this goal in terms of discourse structure and under the context of Taiwanese geriatric interaction? Three categories of doctors' greeting topics were identified according to the average number of syllables they elicited in response from patients' response: greetings with low response (eliciting 0.46 syllables), mid-response greetings (eliciting 4.8 syllables), and high-response greetings (eliciting 41.1 syllables). We find that low-and mid-response greetings dealing mainly with topics related to the preparatory sequences of the interview, such as seating arrangements and name exchanges (low-response), and the patients' hearing ability or language background (mid-response). High-response greetings, such as those touching on a patient's occupation or medical history, are social-relational (Coupland 1994). These topics extend the conversation structure by developing subtopics and establishing ‘grounding' (Paek and Horvitz 2000), i.e., background knowledge between doctors and patients. The patient is the expert on, and has exclusive access to, his/her social-relational aspects. We argue that it is the patient who holds the key to high participation and extensibility of topics. Other high-response greeting topics, such as the patient's age and the patient's companions, reflect the unique and complicated relationships between age and health status (Coupland et al. 1991, Giles et al. 1994) and between patients and caregivers. Since social-relational information is as important as biophysical information in evaluating a patient's health, we suggest that doctors facilitate the use of social-relational topics at the greeting stage. This will help doctors establish rapport with patients and encourage patient participation during the medical interview.



Author: Shen-ying Huang/I-ling Chen/Mei-hui Tsai Feng-fu Tsao
Genre: Article
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