出版社：Department of General Linguistics, University of Stellenbosch
摘要：It is widely acknowledged that HIV and AIDS infection rates are exceptionally high in South Africa (cf. Whiteside 2005). Although the figures that reflect infection in the Western Cape are slightly lower than in other parts of the country the situation is nevertheless alarming and worrying. The nature of the condition and of currently available medication is such that successful verbal communication is an essential precondition to effective treatment. Against such a background it appears to be even more important than with other pathologies that misunderstanding or lack of understanding between doctors and patients should, as far as possible, be addressed and minimized. However, observation and analysis of a small number of consultations between doctors and patients in an HIV day clinic in the Western Cape has given some impression of the communicative dilemmas and difficulties of doctors and patients in consultations related to anti-retroviral (ARV) treatment. Such communicative problems arise from the variety of disparate matters that need to be attended to, specifically the need to monitor constantly not only the physical condition of patients, but also their understanding of essential aspects of the disease and their ability to follow the rigid treatment procedures in order to take responsibility themselves for managing their condition. This paper will focus on a particular generic feature of medical consultations, namely question-answer sequences. Our interest is particularly in the functions of certain kinds of questions and the interactive demands that arise from them. The method chosen is sequential analysis, which means that we study these sequences not in isolation, but within their discursive and institutional context (Johnstone 2002; Bührig 2005). By doing so we aim to reconstruct the underlying communicative purposes which shape the linguistic actions of physicians in ARV therapies. This may not only help us to better understand why communication is organized as it is in this context, but could also allow us to identify inadequate communicative strategies. Thus, thorough reflection on what actually happens in these interactions may be helpful in deciding what works, what does not work and what may be best practice in the given circumstances.
