Conversational Discourse Structure between Psychiatrists and Out-Patients in Primary Psychiatric Consultation

Abstract

This research aims to study the conversational discourse between psychiatrists and out-patients in primary psychiatric consultation. The results showed that primary psychiatric consultation two kinds of discourse between psychiatrists and new patients, and between psychiatrists and old patients. The conversational discourse between psychiatrists and new patients consist of ten steps included, start the conversation, asking for purpose, inquire to symptoms and medical records, inquire to related information on symptoms or metal checking, inquire to factors of cause disease, disease diagnosis, treatment and medicine planning, let a patient make an inquiry, appointment making, and end the conversation. For the conversational discourse between psychiatrists and old patients consists of two situations: 1) the conversational discourse between psychiatrists and old patients(better), and 2) the conversational discourse between psychiatrists and old patients(non-better). The conversational discourse between psychiatrists and old patients(better) shown nine steps included start the conversation, mention to the purpose, inquire to symptoms and medical records, inquire to major symptoms related information or metal checking, patient make a self-evaluation and inquire to medicine side-effect, treatment review and medicine adjustment, let a patient make an inquiry, appointment making, and end the conversation. However, the conversational discourse between psychiatrists and old patients(non-better) shown nine steps that differences from the conversational discourse between psychiatrists and old patients(better) is inquire to the cause of the non-better symptom, and inquire to daily life of patients. Some old patients started and ended in some context, indicate the power of the out-patient and accepted.