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首页> 外文期刊>Family practice. >Explanations, explanations, explanations: how do patients with limited English construct narrative accounts in multi-lingual, multi-ethnic settings, and how can GPs interpret them?
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Explanations, explanations, explanations: how do patients with limited English construct narrative accounts in multi-lingual, multi-ethnic settings, and how can GPs interpret them?

机译：解释，解释和解释：英语水平有限的患者如何在多语言，多种族的环境中构建叙述性叙述，全科医生如何解释它们？

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BACKGROUND: The gap is widening between understanding the subtle ways patients and GPs manage their talk, and superficial discussion of the 'language barrier' among linguistic minority patients. All patients have to explain themselves, not just those for whom English is their first or main language. Patients' explanations reflect how they want the doctor to perceive them as a patient and as a person: they reveal patients' identities. Yet interpretations are not easy when patients' style of talking English is influenced by their first language and cultural background. OBJECTIVE: To explore in detail how patients with limited English and GPs jointly overcome misunderstandings in explanations. METHODS: Using discourse analysis and conversation analysis, we examine how GPs and their patients with limited English negotiate explanations and collaborate to manage, repair or prevent understanding problems. RESULTS: 31% of patients said English was not their first language. Misunderstandings arise owing to a range of linguistic and cultural factors, including stress and intonation patterns, vocabulary, the way a patient sequences their narrative, and patient and GP pursuing different agendas. CONCLUSION: When talk itself is the problem, patients' explanations can lead to misunderstandings, which GPs have to repair if they cannot prevent. Careful interpretation by skillful GPs can reveal patients' knowledge, experience and perspective.
机译：背景：在理解患者和全科医生的微妙方式之间的分歧，以及对语言少数群体患者的“语言障碍”的肤浅讨论之间，差距正在扩大。所有患者都必须自我解释，而不仅仅是以英语为主要或主要语言的患者。患者的解释反映了他们希望医生如何将他们视为患者和一个人：他们揭示了患者的身份。然而，当患者的英语口语风格受其母语和文化背景的影响时，解释起来并不容易。目的：详细探讨英语水平有限和全科医生不足的患者如何共同克服解释方面的误解。方法：使用话语分析和对话分析，我们检查了全科医生及其英语水平有限的患者如何协商解释并进行协作以管理，修复或防止理解问题。结果：31％的患者说英语不是他们的第一语言。造成误解的原因是多种语言和文化因素，包括压力和语调模式，词汇，患者叙述顺序的方式以及患者和全科医生遵循不同的议程。结论：当谈话本身就是问题时，患者的解释可能会引起误解，如果GP不能预防，则必须修复。熟练的GP会仔细解释患者的知识，经验和观点。

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