Narratives of illness in a Chinese virtual hospital: From narrating to stance-taking
Abstract
This study explores 60 individual narratives of illness presented in the initiating messages of threads that are posted in a well-known virtual space, ‘Tianya Hospital’ (天涯医院), in China. ‘Tianya Hospital’ is a discussion board where website users discuss their own or their loved ones’ health problems with other participants, who may be either health experts or patients with similar illnesses. Adopting the approach of mediated discourse analysis, the study aims to find out what is narrated (i.e., narrative presentation categories), what stance is taken and what the patterns and functions of the narrative presentation and the stance taking are. Some narrative presentation categories identified in this study are to some degree associated with existing face-to-face medical consultation phases, while others are related to a ‘timescale’ frame and the ‘sick role’ concept. The findings also show that the online narratives present not only the description of health problems, but also epistemic and affective stances. Some features of the narrative presentation organization and the stance taking in narratives can perform particular functions, such as serving to legitimize patients’ or patients’ caregivers’ complaints about healthcare services
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PDFDOI: 10.1558/cam.37444
References
Armstrong, Natalie, Nelya Koteyko and John Powell (2012) ‘Oh dear, should I really be saying that on here?’ Issues of identity and authority in an online diabetes community. Health 16 (4): 347–365. https://doi.org/10.1177/1363459311425514
Atkinson, Paul and Sara Delamont (2006) Rescuing narrative from qualitative research. Narrative Inquiry 16 (1): 164–172. https://doi.org/10.1075/ni.16.1.21atk
Bamberg, Michael and Alexandra Georgakopoulou (2008) Small stories as a new perspective in narrative and identity analysis. Text and Talk 28 (3): 377–396. https://doi.org/10.1515/TEXT.2008.018
Barton, David and Carmen Lee (2013) Language Online: Investigating Digital Texts and Practices. London: Routledge. https://doi.org/10.4324/9780203552308
Beckman, Howard B. and Richard M. Frankel (1984) The effect of physician behavior on the collection of data. Annals of Internal Medicine 101 (5): 692–696. https://doi.org/10.7326/0003-4819-101-5-692
Biber, Douglas and Edward Finegan (1989) Styles of stance in English: Lexical and grammatical marking of evidentiality and affect. Text 9 (1): 93–124. https://doi.org/10.1515/text.1.1989.9.1.93
Cao, Lina and Xijin Tang (2014) Topics and trends of the on-line public concerns based on Tianya forum. Journal of Systems Science and Systems Engineering 23 (2): 212–230. https://doi.org/10.1007/s11518-014-5243-z
Chandran, Sucharita and Geeta Menon (2004) When a day means more than a year: Effects of temporal framing on judgments of health risk. Journal of Consumer Research 31 (2): 375–389. https://doi.org/10.1086/422116
China Internet Network Information Center (2017) China Statistical Report on Internet Development. Available online: http://www.cnnic.cn/gywm/xwzx/rdxw/201708/t20170804_69449.htm
De Fina, Anna and Alexandra Georgakopoulou (2008) Analysing narratives as practices. Qualitative Research 8 (3): 379–387. https://doi.org/10.1177/1468794106093634
De Fina, Anna and Alexandra Georgakopoulou (2012) Analyzing Narratives: Discourse and Sociolinguistic Perspectives. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9781139051255
De Fina, Anna and Alexandra Georgakopoulou (eds) (2015) The Handbook of Narrative Analysis. Hoboken, NJ: John Wiley and Sons. https://doi.org/10.1002/9781118458204
De Fina, Anna and Brittany T. Gore (2017) Online retellings and the viral transformation of a Twitter breakup story. Narrative Inquiry 27 (2): 235–260. https://doi.org/10.1075/ni.27.2.03def
Demjén, Zsofia (2016) Laughing at cancer: Humour, empowerment, solidarity and coping online. Journal of Pragmatics 101: 18–30. https://doi.org/10.1016/j.pragma.2016.05.010
Du Bois, John W. (2007) The stance triangle. In Robert Englebretson (ed.) Stance-Taking in Discourse: Subjectivity, Evaluation, Interaction, 139–182. Amsterdam: John Benjamins. https://doi.org/10.1075/pbns.164.07du
Du Bois, John W. and Elise Kärkkäinen (2012) Taking a stance on emotion: Affect, sequence, and intersubjectivity in dialogic interaction. Text and Talk 32 (4): 433–451. https://doi.org/10.1515/text-2012-0021
Fage-Butler, Antoinette and Patrizia Anesa (2016) Discursive construction and negotiation of laity on an online health forum. Pragmatics and Society 7 (2): 196–216. https://doi.org/10.1075/ps.7.2.02fag
Fahy, Kathleen and Philip Smith (1999) From the sick role to subject positions: A new approach to the medical encounter. Health 3 (1): 71–94. https://doi.org/10.1177/136345939900300101
Fox, Susannah and Deborah Fallows (2003) Internet health resources. Pew Internet & American Life Project. Available online: https://www.pewresearch.org/internet/2003/07/16/internet-health-resources/
Frank, Arthur W. (1993) The rhetoric of self-change: Illness experience as narrative. Sociological Quarterly 34 (1): 39–52. https://doi.org/10.1111/j.1533-8525.1993.tb00129.x
Greenhalgh, Trisha (1999) Narrative based medicine in an evidence-based world. British Medical Journal 318 (7179): 323–325. https://doi.org/10.1136/bmj.318.7179.323
Greenhalgh, Trisha and Brian Hurwitz (1999) Narrative based medicine: Why study narrative? British Medical Journal 318 (7175): 48–50. https://doi.org/10.1136/bmj.318.7175.48
Hall, Brian J., Peng Xiong, Kay Chang, Ming Yin and Xin-ru Sui (2018) Prevalence of medical workplace violence and the shortage of secondary and tertiary interventions among healthcare workers in China. Journal of Epidemiology and Community Health 72 (6): 516–518. https://doi.org/10.1136/jech-2016-208602
Harvey, Kevin and Nelya Koteyko (2013) Exploring Health Communication: Language in Action. London: Routledge. https://doi.org/10.4324/9780203096437
Heritage, John and Steven Clayman (2011) Talk in Action: Interactions, Identities, and Institutions. Hoboken, NJ: John Wiley and Sons. https://doi.org/10.1002/9781444318135
Herring, Susan C. (2002) Computer-mediated communication on the Internet. Annual Review of Information Science and Technology 36 (1): 109–168. https://doi.org/10.1002/aris.1440360104
Herring, Susan C. (2007) A faceted classification scheme for computer-mediated discourse. Language @ Internet 4: 1–37.
Holmes, Janet (1982) Expressing doubt and certainty in English. Regional Language Centre Journal 13 (2): 9–28. https://doi.org/10.1177/003368828201300202
Hu, Peng, Fang Cheng and Jiadong Gu (2014) 上海市某区近五年医患纠纷情况分析与对策研究 [Analysis of situation and strategy of medical disputes in one district of Shanghai in recent five years]. Clinical Misdiagnosis and Mistherapy 27 (4): 87–91.
Jaffe, Alexandra (ed.) (2009) Stance: Sociolinguistic Perspectives. New York: Oxford University Press.
Jones, Rodney (2013) Health and Risk Communication: An Applied Linguistic Perspective. London: Routledge. https://doi.org/10.4324/9780203521410
Jiang, L. Crystal, Natalya N. Bazarova and Jeffrey T. Hancock (2013) From perception to behaviour: Disclosure reciprocity and the intensification of intimacy in computer-mediated communication. Communication Research 40 (1): 125–143. https://doi.org/10.1177/0093650211405313
Kärkkäinen, Elise (2006) Stance taking in conversation: From subjectivity to intersubjectivity. Text and Talk 26 (6): 699–731. https://doi.org/10.1515/TEXT.2006.029
Kiesling, Scott F. (2011) Stance in context: Affect, alignment and investment in the analysis of stance taking. Paper presented at the iMean conference, University of the West of England, Bristol, UK, 15 April.
Kleinman, Arthur (1992) Local worlds of suffering: An interpersonal focus for ethnographies of illness experience. Qualitative Health Research 2 (2): 127–134. https://doi.org/10.1177/104973239200200202
Labov, William (2013) The Language of Life and Death: The Transformation of Experience in Oral Narrative. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9781139519632
Labov, William and Joshua Waletzky (1967) Narrative analysis: Essays on the verbal and visual arts. In June Helm (ed.) Essays on the Verbal and Visual Arts: Proceedings of the 1966 Spring Meeting of the American Ethnological Society, 12–44. Seattle: University of Washington Press.
Langlotz, Andreas and Miriam A. Locher (2012) Ways of communicating emotional stance in online disagreements. Journal of Pragmatics 44 (12): 1591–1606. https://doi.org/10.1016/j.pragma.2012.04.002
Lemke, Jay. L. (2000) Across the scales of time: Artifacts, activities, and meanings in ecosocial systems. Mind, Culture, and Activity 7 (4): 273–290. https://doi.org/10.1207/S15327884MCA0704_03
Lewallen, Andrea (2013) Linguistic Predictors of Peer Responsiveness in an Online Cancer Support Group. Unpublished doctoral dissertation, Loma Linda University, California.
Lundby, Knut (ed.) (2008) Digital Storytelling, Mediatized Stories: Self-Representations in New Media. New York: Peter Lang.
Luo, Yunjuan (2014) The Internet and agenda setting in China: The influence of online public opinion on media coverage and government policy. International Journal of Communication 8: 1289–1312.
Markham, Annette and Elizabeth Buchanan (2012) Ethical Decision-Making and Internet Research 2.0: Recommendations from the AoIR Ethics Working Committee. Association of Internet Researchers (AoIR). Available online: http://www.aoir.org/reports/ethics2.pdf
Masters, Ken, Dick Ng’ambi and Gail Todd (2010) ‘I Found it on the Internet’: Preparing for the e-patient in Oman. Sultan Qaboos University Medical Journal 10 (2): 169–179.
Mazanderani, Fadhila, Braden O’Neill and John Powell (2013) ‘People power’ or ‘pester power’? YouTube as a forum for the generation of evidence and patient advocacy. Patient Education and Counseling 93 (3): 420–425. https://doi.org/10.1016/j.pec.2013.06.006
Moore, Rhonda J. and James Hallenbeck (2010) Narrative empathy and how dealing with stories helps: Creating a space for empathy in culturally diverse care settings. Journal of Pain and Symptom Management 40 (3): 471–476. https://doi.org/10.1016/j.jpainsymman.2010.03.013
Page, Ruth (2012) Stories and Social Media: Identities and Interaction. New York: Routledge. https://doi.org/10.4324/9780203148617
Parsons, Talcott (1951) Illness and the role of the physician: A sociological perspective. American Journal of Orthopsychiatry 21 (3): 452–460. https://doi.org/10.1111/j.1939-0025.1951.tb00003.x
Rudolf von Rohr, Marie-Thérèse (2015) ‘You will be glad you hung onto this quit’: Sharing information and giving support when stopping smoking online. In Catherine A. Smith and Alla Keselman (eds) Meeting Health Information Needs Outside of Healthcare: Opportunities and Challenges, 263–290. Waltham, MA: Chandos/Elsevier. https://doi.org/10.1016/B978-0-08-100248-3.00012-3
Scollon, Ron (2001) Mediated Discourse: The Nexus of Practice. London: Routledge. https://doi.org/10.4324/9780203420065
Seale, Clive, Jonathan Charteris-Black, Aidan MacFarlane and Ann McPherson (2010) Interviews and internet forums: A comparison of two sources of qualitative data. Qualitative Health Research 20 (5): 595–606. https://doi.org/10.1177/1049732309354094
Sillence, Elizabeth (2010) Seeking out very like-minded others: Exploring trust and advice issues in an online health support group. International Journal of Web Based Communities 6 (4): 376–394. https://doi.org/10.1504/IJWBC.2010.035840
Thompson, Riki (2012) Screwed up, but working on it: (Dis)ordering the self through e-stories. Narrative Inquiry 22 (1): 86–104. https://doi.org/10.1075/ni.22.1.06tho
Thurnherr, Franziska, Marie-Thérèse Rudolf von Rohr and Miriam A. Locher (2016) The functions of narrative passages in three written online health contexts. Open Linguistics 2 (1):450–470. https://doi.org/10.5040/9781350057685.0015
Veen, Mario, Hedwig te Molder, Bart Gremmen and Cees van Woerkum (2010) Quitting is not an option: An analysis of online diet talk between celiac disease patients. Health 14 (1): 23–40. https://doi.org/10.1177/1363459309347478
Wu, Yijing and Xiaoyan Wang (2013) 门诊医患会话打断的语用功能研究 [A study on pragmatic functions of conversational interruption between doctor and patient in clinic]. Journal of Hunan University of Technology Social Science Edition 18 (6): 135–140.
Zhang, Jingwen and Huiling Ding (2014) Constructing HIV/AIDS on the Internet: A comparative rhetorical analysis of online narratives in the United States and in China. International Journal of Communication 8: 1415–1436.
Zhou, Yanqiu Rachel (2007) ‘If you get AIDS… You have to endure it alone’: Understanding the social constructions of HIV/AIDS in China. Social Science and Medicine 65 (2): 284–295. https://doi.org/10.1016/j.socscimed.2007.03.031
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