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21
Interdisciplinary perspectives on im/politeness
Terkourafi, Marina; Defibaugh, Staci. - Amsterdam : Benjamins, 2015
MPI für Psycholinguistik
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22
The "how" and the "what" of (im)politeness
Culpeper, Jonathan Vaughan. - : John Benjamins, 2015
BASE
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23
Identity construction in nurse practitioner-patient interactions
Abstract: This dissertation explores interactions between Nurse Practitioners (NPs) and patients during both inpatient and outpatient visits. Through an analysis of interactional data coupled with ethnographic observations and interviews, I focus on the ways that both patients and providers construct particular identities, that is, how they inhabit the institutional role of patient or provider through particular linguistic moves and stylistic choices. A great deal of scholarly effort has been devoted to understanding language use in medical visits; however, these studies have focused almost exclusively on medical doctors (MDs) and have primarily taken a Conversation Analytic (CA) approach. This study departs from both of these traditions by examining interactions involving an understudied yet growing provider-type: Nurse Practitioners, and by employing an ethnographic discourse analytic methodology. Although they have not been a focus on linguistic study, Nurse Practitioners are recognized in the field of health communication as employing a ‘patient-centered’ approach, which seeks, among other things, to create positive, long-term relationships with patients. Additionally, NPs are recognized as providing a high quality of care measured in terms of patient satisfaction and health outcomes (i.e. improved health). However, what contributes to NPs’ positive evaluations has not been examined in depth, particularly in terms of language use in medical visits. In this dissertation, I address this gap in the literature by employing ethnographic discourse analysis that draws on multiple data sources. The analysis primarily focuses on audio-recordings of 48 medical visits with five different NPs: one working in an inpatient setting; four working in an outpatient setting. In addition to the audio recordings of medical visits, the study also includes interviews with providers and patients, focusing on ethnographic and bio data with the former and overall satisfaction with the latter. Drawing on both emic and etic categories of types of providers and patients, I argue that NPs, through their ability to balance both instrumental and interactional goals, are able to construct the identity of the ‘caring and competent’ provider. Using Agha’s (2007) theory of figures of personhood, I outline the ways in which NPs align with the ‘caring provider’ through linguistic moves of solidarity such as engaging in small talk, using inclusive first person plural pronouns and mitigating medical advice through the use of hedging and indirect speech. Employing these linguistic features allows the NPs to highlight and address the interpersonal goals of the medical visit, enabling them to create positive patient-provider relationships. Similarly, NPs balance the focus on the interpersonal with addressing the instrumental goals of the visit in their alignment with the ‘competent provider.’ This is accomplished through attending to their occupational and professional responsibilities including following the required medical checklist, recognizing their epistemic responsibility to patients, and creating alignments to their organizations and professional institutions. Additionally, NPs also highlight their own medical competency through the use of knowledge sharing and use of singular first person pronouns. Patients, in their enactment of the patient role, align with a number of different identities. Some align with the ‘deferent patient,’ likely a reflection of the older, provider-centered approach; however, this identity is never sanctioned by the NPs. Instead, NPs actively encourage patients to be more proactive in their own health and encourage this; those who do so, I argue, enact the ‘good patient.’ Other patient identities also seem to derive from the new patient-centered model of health care as well as the medical neoliberal ideology, which places patients in the role of ‘patient-consumer’ and requires them to take an active part in improving their health. Although not all patients are able to enact the medically compliant and ‘good patient’ identity, attempts that fall short of doing so are still viewed somewhat positively by the NPs, thereby aligning these patients with a number of other identities. Support for the NP identity of the ‘caring and competent’ provider, comes from interview data with both NPs and patients. NPs construct their own professional identity as teacher and information provider. Almost all NPs interviewed make it clear that they do not ‘push’ patients but simply focus on educating patients so that they can make the best decision for themselves. In doing this, they illustrate how avoidance of giving medical directives, among other things, allows them to create positive relationships with patients and, hopefully, encourage medical adherence. Patients’ responses to satisfaction questions in post-visit interviews also support this identity. Patients overwhelmingly indicate positive impressions of the NPs in the study and report on specific aspects such as showing concern for patients and being knowledgeable. This dissertation illustrates the ways in which employing an ethnographic discourse analytic framework allows for an analysis of identity construction in medical settings. The extent to which the identities that NPs align with are unique to NPs is a question that cannot be answered with this research alone since prior research focused on different goals and utilized different analytic and methodological frameworks. Future research should attempt more accurate and equitable comparisons of various provider types by exploring the ways in which linguistic choices aid in the construction of medical providers’ professional identities.
Keyword: discourse analysis; figure of personhood; identity; institutional discourse; medical visits; Nurse Practitioner
URL: http://hdl.handle.net/2142/88988
BASE
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24
The interplay of pragmatic inference, face and emotion
BASE
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25
Discourse Markers of clarification and causality in Maghrebi and Egyptian dialects: a socio-pragmatic perspective
BASE
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26
First-order politeness in rapprochement and distancing cultures: understandings and uses of politeness by Spanish native speakers from Spain and Spanish nonnative speakers from the U.S.
In: Pragmatics. - Amsterdam : John Benjamins Publishing Company 24 (2014) 1, 1-34
BLLDB
OLC Linguistik
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27
The importance of being indirect: A new nomenclature for indirect speech
In: Belgian journal of linguistics. - Amsterdam [u.a.] : Benjamins 28 (2014) 1, 45-70
OLC Linguistik
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28
First-order politeness in rapprochement and distancing cultures: Understanding and uses of politeness by Spanish native speakers from Spain and Spanish non-native speakers from the U.S.
In: Pragmatics 24 (2014) 1, 1-34
IDS Bibliografie zur Gesprächsforschung
29
Disentangling politeness theory and the strategic speaker approach: theoretical considerations and empirical predictions
In: Intercultural pragmatics. - Berlin ; New York, NY : Mouton de Gruyter 11 (2014) 1, 31-56
BLLDB
OLC Linguistik
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30
Jonathan Culpeper (ed.). Historical Sociopragmatics (Benjamins Current Topics 31). Amsterdam, The Netherlands: John Benjamins. 2011. vii + 135 pp. Hb (9789027202505) €80.00/ 20.00
In: Journal of sociolinguistics. - Oxford [u.a.] : Blackwell 17 (2013) 1, 130-133
OLC Linguistik
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31
From deference to face: the evolution of usted in Costa Rican Spanish
BASE
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32
The languages of global hip hop
Terkourafi, Marina (Hrsg). - London [u.a.] : Continuum, 2012
UB Frankfurt Linguistik
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33
BOOK NOTES
In: Language in society. - London [u.a.] : Cambridge Univ. Press 41 (2012) 3, 408-409
OLC Linguistik
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34
Politeness and pragmatics
In: The Cambridge handbook of pragmatics (Cambridge, 2012), p. 617-637
MPI für Psycholinguistik
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35
Rhoticization and gender stereotyping in a rural community in Crete ...
Vergis, Nikos; Terkourafi, Marina. - : Modern Greek Dialects and Linguistics Theory, 2012
BASE
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36
Corpus study of tense, aspect, and modality in diglossic speech in Cairene Arabic
Moshref, Ola. - 2012
BASE
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37
Crossing the lexicon: Anglicisms in the German hip hop community
BASE
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38
From politeness1 to politeness2: tracking norms of im/politeness across time and space
In: Journal of politeness research. - Berlin [u.a.] : Mouton de Gruyter 7 (2011) 2, 159-185
BLLDB
OLC Linguistik
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39
"thank you", "sorry" and "please" in Cypriot Greek: what happens to politeness markers when they are borrowed across languages?
In: Journal of pragmatics. - Amsterdam [u.a.] : Elsevier 43 (2011) 1, 218-235
BLLDB
OLC Linguistik
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40
The languages of global hip hop
Terkourafi, Marina (Herausgeber). - London : Continuum, 2010
BLLDB
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