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"How are you doing?" - "Great" : Opening sequences in HIV consultations in Germany and Nigeria

Title data

Groß, Alexandra ; Boluwaduro, Eniola Olamide:
"How are you doing?" - "Great" : Opening sequences in HIV consultations in Germany and Nigeria.
2017
Event: 15th International Pragmatics Conference (IPrA) , 16.-21. Juli 2017 , Belfast/Nordirland.
(Conference item: Conference , Speech )

Abstract in another language

The paper contributes to an understanding of openings in regularly occurring doctor/patients encounters with HIV positive patients within HIV specialized outpatients’ clinics in Germany (71 doctor/patient-talks) and Southwestern Nigeria (70 doctor/patient-talks). Medical Conversation Analysis research about doctor/patient- encounters in primary care has shown that the way physicians open the consultation affect the manner in which problems are presented (e. g. Heritage & Robinson, 2006; Spranz-Fogasy, 2005) and correlate with patients’ satisfaction with the encounter (e. g. Menz, et al., 2008). It was found that opening questions in doctor/patient- encounters in primary care provide for their overall goal: diagnosing and treating relatively new medical problems. This is contextualized by questions like “What is the problem?” (e. g. Robinson, 2006). Conversely, encounters between HIV positive patients and doctors take place irrespective of patients’ current well-being: The patients are advised to attend at regular intervals for routine assessments of their HIV status in both the Nigerian and German clinical context. Analyses of opening sequences show that the question on general well- being “Wie geht’s Ihnen?” (“How are you (doing)?”) is the most commonly used opening practice in German HIV consultations. Encounters in the Nigerian context also frequently feature “How are you?” questions such as a typical Yoruba expression “Bawo lara yin?” (“How is your body?” / “How are you?”). However, “How are you”- questions constitute about two third of doctors’ opening initiatives in the German context and one third in the Nigerian context.
Our presentation focuses on the interactional meaning of this opening practice. By scrutinizing the turn design of the opening question itself (in terms of intonational patterns and lexical variations) and analyzing its sequential consequences it will be shown that “How are you”-opening questions “do different things” in German vs. Nigerian HIV consultations. In German HIV consultations by using “How are you? ” - opening questions doctors predominantly orient to ‘routine reasons’ for the visit and construct a well visit (Heritage and Clayman, 2010), thereby contextualizing the medical goals of the antiretroviral treatment to enable patients to live a normal life in spite of their HIV infection: In their responses patients orient to doctor’s expectations of them feeling well, firstly by frequently highlighting an outstanding well-being. In responses in which patients present acute problems they secondly do so by designing them as dispreferred responses, using interactional strategies of foreshadowing and/or contrasting specific medical problems against the background of a good general well- being. In Nigerian HIV consultations both patients and doctors orient to ‘How are you?’ opening questions more in the sense of a phatic communion as constituted in mundane interactional greeting sequences. Patients’ positive responses to this opening question suggest that it is a preferred second pair part of a greeting sequence, which is supported by the finding that ‘How are you’ questions often acts as a precursor to the first topic slot, which initiates the start of the main business of the encounters. In contrast to the German data, ‘great’, ‘fine’ or ‘good’ responses from patients for instance, does not necessarily refer to a medically relevant state of well-being though it denotatively suggests so. Patients habitually report problems in proceeding sequences. And in contrast to German HIV consultations, d-p encounters in the Nigerian context are structured towards ‘problem purpose’ (Webb et al., 2013) consultations rather than for routine purposes.

Further data

Item Type: Conference item (Speech)
Refereed: No
Institutions of the University: Faculties > Faculty of Languages and Literature > Lehrstuhl Germanistische Linguistik > Lehrstuhl Germanistische Linguistik - Univ.-Prof. Dr. Karin Birkner
Faculties
Faculties > Faculty of Languages and Literature
Faculties > Faculty of Languages and Literature > Lehrstuhl Germanistische Linguistik
Result of work at the UBT: Yes
DDC Subjects: 300 Social sciences > 300 Social sciences, sociology and anthropology
400 Language > 400 Language
400 Language > 410 Linguistics
Date Deposited: 24 Jul 2017 08:38
Last Modified: 15 Aug 2018 08:29
URI: https://eref.uni-bayreuth.de/id/eprint/38743