Doctoral Degrees (English)

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Browsing Doctoral Degrees (English) by browse.metadata.advisor "Anthonissen, Christine"

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    Discursive features of health worker-patient discourses in four Western Cape HIV/AIDS clinics where English is the lingua franca
    (Stellenbosch : Stellenbosch University, 2012-12) Njweipi-Kongor, Diana Benyuei; Bangeni, Nwabisa; Anthonissen, Christine; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of English.
    ENGLISH ABSTRACT: This is a qualitative analytical study that investigates the use of English as lingua franca (ELF) between doctors and patients with different L1 at four different HIV/AIDS clinics in the Western Cape. The study addresses a gap in medical research, especially in the field of HIV/AIDS, namely, a lack of sufficient data-driven analytical investigation into the linguistic and conversational nature of doctor-patient communication in ELF in this setting in South Africa. A literature review contextualises ELF, discourse analysis (DA), conversation analysis (CA) and genre theory providing a theoretical framework for the study. The methodology involves audio-recording and transcription of HIV/AIDS consultations conducted in ELF. From the genre perspective, the study investigates the different genres in and determines if HIV/AIDS consultations are a sub-genre of medical discourses. DA investigates what contextual, socio-cultural linguistic features characterise medical interaction in this multilingual context and what ELF linguistic strategies participants use to signal and resolve misunderstanding. CA investigates the turn organisation and turn-taking patterns in the consultations to assess participants’ contributions and identify different types of sequences that characterise them, aiming to understand how they enable the interactants play their roles as doctors and patients. The results reveal that HIV/AIDS consultations exhibit formal features of doctor-patient consultations in general and intertextually revert to other oral genres leading to the conclusion that, considering their purpose, participants and context, HIV/AIDS consultations are like all medical consultations and are a sub-genre of medical discourse. The macro analysis reveals that the interactants’ socio-cultural and multi-linguistic backgrounds do positively influence the nature of the interaction in this context as it highlights characteristic linguistic features of ELF usage like borrowing, linguistic transference from L1, the use of analogy, code-switching and local metaphors all resulting from processes of indigenisation and hybridisation. The results reveal few instances of misunderstanding, concurring with earlier studies that problems of miscommunication may be minimal when two languages and/or cultural groups interact. The micro analysis reveals that the turns in the consultation follow the pre-selection and recurrent speakership patterns and that despite the advocacy for partnership between doctors and patients in their contribution and negotiation of outcomes, the doctor unavoidably remains the dominant partner. S/he determines the course of the consultation by initiating more turns, asking most of the questions and often unilaterally deciding on topic changes. S/he has longer talking time than the patient in the sequences and the physical examination and prescription phases of the consultation while the patient is mostly portrayed almost as a docile participant yielding to the doctor’s requests and taking very little if any initiative of his/her own to communicate his/her views and desires. The study reveals instances of both patient and doctor initiated repair to resolve any misunderstanding, which improves the quality of the interaction and its outcomes such as adherence and treatment follow-up. The study further highlights the challenges faced in the field which impacted on the data, the most crucial being the complicated but necessary ethical procedures required to get participants’ consent to participate in the study.