Towards A Model Of Narrative-based Patient-Doctor Interaction In TCM

Traditional research on microanalyses of medical interaction has predominantly focused on the doctor's perspective. Now this domain may be shifted to the patient's perspective with the increasingly development of narrative approach in primary medical care. Moreover, the previous research has been mainly limited in Western medical encounters. Little attention is paid to Traditional Chinese medicine interaction. Concerning the four fundamental features "wang", "wen", "wen" and "qie" in TCM, more attention should be paid to the patient's experience of illness, that is the patient's illness narratives. Due to the extreme significance of "wen" in the encounter of TCM, this thesis is limited to the diagnostic aspect, which seeks to explore the interaction model based on illness narrative patterns. Thus, it would be of great value to seek some distinct narrative patterns in primary care of TCM.This thesis briefly reviews the linguistic and narrative approaches to medical interaction model, notes deficiencies and embeds a more narrative-based-process into the dynamics of the physician-patient interaction in TCM. Two representative ways of storytelling as well as the corresponding roles of doctors are described and analyzed according to narrative variables. Finally the systematic descriptions of the narrative interaction model with distinct styles in TCM in terms of complex variables are constructed, which attempt to depict the dynamic interplay between the illness narrative strategies that patients usually adopt and their corresponding responses that doctors behave, which appears to facilitate the mutual understanding of diagnostic process. The expert patient narrative-based medical interaction model in TCM is characterized by expert patient's negotiative narrative process with external and reflexive narrative sequences. More specifically, on the basis of their own perception or experience of illness, the patients tend to focus on descriptions of events and explore the in-depth meaning of illness. By contrast, the co-constructional narrative-based medical interaction model in TCM is distinct for its heuristic narrative process with more internal narrative. That is, more emphatic reassurance is involved.