대화분석적 관점에서의 한국 의료통역 연구
저자
발행사항
서울 : 한국외국어대학교 통번역대학원, 2015
학위논문사항
학위논문(박사) 한국외국어대학교 통번역대학원 : 통번역학(한노) 2015. 2
발행연도
2015
작성언어
한국어
주제어
DDC
418.02 판사항(22)
발행국(도시)
서울
기타서명
A Conversation-Analytic Study of Medical Communication in Korea with Reference to Interactions between Korean Doctors, Interpreters, and Russian Patients
형태사항
283 p. : 삽도 ; 26cm.
일반주기명
한국외대 논문은 저작권에 의해 보호받습니다.
지도교수: 방교영
참고문헌 : p.266-279
소장기관
A Conversation-Analytic Study of Medical Communication in Korea with Reference to Interactions between Korean Doctors, Interpreters, and Russian Patients
Korea’s global healthcare market is expanding every year. As the number of overseas patients using Korean healthcare facilities grows, so does the importance of medical interpretation and related research. This study analyzes the act of medical interpretation carried out by medical interpreters in the process by which the interaction between patients from Russian-speaking nations and physicians unfold in Korea’s healthcare context. In so doing, the study aims to systematically detail this practice. Materials collected from university and specialized hospitals in Korea were narrowed down to 59 medical interpretation cases, which were subjected to conversation analysis (CA).
Patients from Russian-speaking countries, as with other overseas patients seeking healthcare in Korea, have medical conditions and diseases different from those of patients who reside in Korea. The commercial profit-making goal of Korea’s healthcare environment influences the behavior of physicians, interpreters, and patients as well as each stage of the interpretation process. Interpreters assume their essential interpretation responsibilities while also serving as representatives or undertaking administrative work as medical coordinators.
The conduct of Russian-language medical interpreters is organized in line with the goal of each phase of medical conversation. This is embodied by the ways in which interpreters’ actions are distinctively organized across different stages, through which they demonstrably orient to fulfilling the goal of each stage of medical conversation. For instance, in the opening stage, the medical interpreter recognizes that the communicative initiative rests with the physician while also demonstrating that s/he also has the right to manage the conversation. In the problem presentation stage, s/he assumes the patient's standpoint in conducting the interpretation but also demonstrates that s/he is in a different position (third party) from that of the patient while simultaneously focusing on moving the conversation forward. In the history-taking stage, s/he engages in three undertakings: eliciting information, violating the principle of optimization, and organizing the patient's statement. In the diagnosis stage, s/he uses various means to assume the physician's standpoint to get the patient to accept the diagnosis. In the treatment stage, s/he does his/her utmost in the patient's interest from the physician or patient's standpoint. In the closing stage, s/he also serves as coordinator or representative and his/her conduct varies according to the outcome of the patient visit.
In terms of the stance that the participants take toward each other, the findings suggest that physicians who consult and treat overseas patients in Korea’s healthcare environment are well aware of overseas patients’ distinctive traits, needs, and preferences. They see overseas patients as consumers who have come to Korea to purchase medical services and adopt a consumer-oriented perspective to be as accommodating of patient demands as possible. Physicians bestow on interpreters the mandate to conduct medical interviews and allow interpreters to take patients’ medical history on their behalf. Patients from Russian-speaking nations who visit Korean healthcare facilities, on their part, regard interpreters as their spokespeople/representatives. They also anticipate a particular method of treatment and regard the treatment presented by physicians as a proposal they can accept or reject. It is shown that while physicians lead the opening of a medical conversation, its closing is determined by patients.
Physician-patient interaction, which is very complex and paradoxical to begin with, is further complicated with interpreter involvement. The involvement also decreases the scope of direct physician-patient interaction. Physicians bestow on medical interpreters the mandate to take patients’ medical history when medical interpreters often lack expert medical knowledge. Physicians equate interpreters with patients while also demonstrating excessive dependence on interpreters. These perceptions and practices not only reduce patients’ communication opportunities or even deprive patients of such opportunities altogether but could also negatively impact patient health and medical services.
This study can be a starting point for a wide array of related research, including the analysis of interaction among physicians, interpreters, and patients of other linguistic/cultural spheres. Language-specific studies would be required for generalizations for medical interpreters and patients of other linguistic/cultural spheres. It is hoped that this study will deepen the understanding and social awareness of medical interpretation and the work undertaken by medical interpreters in Korea while serving as the basis of medical interpreter training and education.
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