بررسی متون توصیه ای در گفتمان پزشکی فارسی

توصیه های پزشکی فارسی، به عنوان یکی از حوزه های گفتمان غیرروایی، تاکنون مورد توجه پژوهشگران قرار نگرفته اند. از این رو، پژوهش حاضر به بررسی و مقایسه کاربرد ابزارهای «پیش فرض»، «تقویت» و «تضعیف»توصیه با درنظر گرفتن شدت نسبی این ابزارها در کتاب های نسخه‌نویسی پزشکی فارسی و مجله‌های برخط پزشکی فارسی می‌پردازد. به این منظور از  الگوی لوینسون (levinsohn, 2015) در بررسی متون غیرروایی بهره گرفته شده‌است. داده های پژوهش،  از 100 متن کتاب های نسخه‌نویسی پزشکی فارسی و 100 متن مجله‌های برخط پزشکی فارسی گردآوری و گزینش شدند. همچنین نرم افزار آماری اس. پی. اس. اس برای تحلیل داده ها به کار برده شد. بر پایه یافته‌های پژوهش، نتایجی به دست آمد. نخست اینکه، «دستورالعمل های بدون فعل» و «صورت های امری» از ابزارهای پیش فرض بودند. همچنین «باید» و «بهتر است» به ترتیب در میان صورت های «تقویت» و «تضعیف» توصیه در کتاب های نسخه نویسی پزشکی فارسی و مجلات برخط پزشکی فارسی به شمار می‌آیند. دوم اینکه، با توجه به توزیع ابزارهای «پیش فرض»، صورت های «تقویت» و «تضعیف» توصیه در دو پیکره پژوهش تفاوت معناداری مشاهده گردید. در نهایت، عواملی مانند «برتری دانش پزشک»، «نوع متون توصیه» و «جایگاه توصیه ها در متن» بر انتخاب نوع توصیه ها در متون پزشکی فارسی تاثیرگذار است.

An Investigation of the Hortatory Texts in Persian Medical Discourse

Longacre (1996) recognizes four major discourse genres including narrative, procedural, behavioral and expository discourse. He considers exhortations to be a subbranch of behavioral discourse, which “deals with how people did or should behave” (Longacre 1996, p. 9, in Dooley & Levinsohn, 2000). Accordingly, this study is going to analyze Persian hortatory texts of two genres: Persian General Practitioners’ Books (GPBs) and Online Medical Journals (OMJs). In particular, it looks at the relative potency of different forms of exhortation and distinguishes between default, highlighted and backgrounded hortatory forms based on Levinsohn (2015). The corpora of this study consisted of 100 texts from two written Persian GPBs and 100 texts from two Persian OMJs. The addressees of the GPBs were general practitioners and students of medical sciences, though writers sometimes directed their exhortations to patients. The addressees of OMJs were the public with some medical knowledge. Our initial step to conduct this research was to classify each sentence as an exhortation or setting it aside as a supportive material; then, 2) listing the different hortatory devices used; 3) counting the frequency of each one; 4) then deciding: a) which one was default, and b) whether using the others had the effect of highlighting or backgrounding the exhortations concerned; and 5) analyzing the statistical significance of the findings through the use of SPSS software version 24. Results of the research indicated that the default devices and the most frequent hortatory devices used in GPBs were “verbless commands” (in the prescription sections of the GPB texts) and “imperatives” (in nonprescription parts of GPBs). Highlighted forms of exhortations found were “must” and “it is necessary” in GPBs. Backgrounded forms of exhortations in GPBs included “it is better”, “it is recommended” and “indirect exhortations”. Example 1, 2 and 3 show the use of the default (verbless command), highlighted (bαyæd “must”) and backgrounded hortatory forms (it is better) in GPBs: 1)      bQrAje           controle                      tQngije                      nQfQs for                   controlingEZ               tightnessEPEZ           breath “For controlling shortness of breath”           Inhaler salbutamol    N=1                                                  2 puffs if necessary           Inhaler beclomethasone   N=1                           2 puffs every 6 hours (Attar, 2016, p. 191, Bronchiectasis, PFP) 2)      kæpsule          /αmperαzolrα bαyæd             betorekαmel     væ        qæbl    capsule                  OmeprazoleOM         must                completely       and      before /æz       qæzα                mæsræf            nemud                         /æz       ʤævidæn         væ from    food                consumption    do.PAST.3SG             from    chewing           and bαz                   kærdæne                   kæpsul             bαjæd              /eʤtenαb         open                do.PASTINFEZ       capsule                        must                avoidance Sævæd SUBJ.become.PRES3SG “Omeprazole capsule must be consumed fully before eating food. Chewing and opening the capsule must be avoided.” (Ayati Firoozabadi and Fallah, 2015: 17, Tennis elbow, DPG)  3)      behtær             /æst                              ʤæhæte         tæzriqe           /epinefrin         /æz better               be.PRES.3SG             forEZ             injectionEZ    epinephrine      from sorænge         /ænsolin           /estefαde          Sævæd syringeEZ       insulin              use                   SUBJ.become.PRES3SG “It is better to use Insulin Syringes for injecting Epinephrine.” (Ayati Firoozabadi & Fallah, 2015. p. 99, Anaphylaxis, DPG) The default device in OMJs was “imperative”. Highlighted hortatory forms found in OMJs were “must” and “it is necessary”, “imperatives used with immediately” and “it is highly recommended” were used, as well. Backgrounded hortatory forms in OMJs included “it is better”, “it is recommended” and “indirect exhortations”, “imperatives directed to 1st person plural”, “(it) is helpful”, “infinitives” and “very indirect exhortations”. Example 4, 5 and 6 illustrate the use of the default (imperatives), highlighted (hætmæn “must”) and backgrounded hortatory forms (infinitive): 4)      dær      suræte            dαStæne                    sαbeqeje                    bimαrije in         formEZ          have.PASTINFEZ    preexistenceEPEZ    diseaseEPEZ xαs                   jα         mæsræfe                     dαru     be        pezeSketαn                special             or         consumptionEZ         drug     to         physicianEZCLIT.3PL                     /etelα/              dæhid information                 IMPER.give.PRES2PL         “If you have a special disease or consume some drugs, inform your physician.”  (Angiography of coronary vessels, DWB, http://www.pezeshk.us/?p=31745) 5)      dær      suræti             ke         sαbeqeje                    bimαrihαje               in         formINDEF   that      preexistenceEPEZ    diseasePLEPEZ /en/eqαdije    xuni                dαrid                          hætmæn         pezeSkrα        coagulationEPEZ     bloodINDEF have.PRES2PL          must                physicianOM motæle/           sαzid informed         IMPER.do.PRES2PL “If you have the preexistence of blood coagulation, you must inform your physician.” (Angiography of coronary vessels, DWB, http://www.pezeshk.us/?p=31745) 6)      kαheSe                       mæsræfe                     qæzαhαje                 hejvαni           decreasingEZ                   consumptionEZ         foodPLEPEZ          animalATTR bexosus           guSte              qermez specially          meatEZ          red “Decreasing the consumption of animal foods especially red meat.” (Prevention from breast cancer, DWB) Chisquare test results of the study confirmed significant differences between the application of the default, highlighted and backgrounded hortatory forms used in GPBs and OMJs. In addition, the results confirmed that the factors mentioned by Levinsohn (2015) affected the choice of hortatory forms in GPBs and OMJs; in this regard, the findings demonstrated that the “physician’s superior knowledge”, “the type of the hortatory texts”, “the position of the exhortations in the text”, “the degree of prominence each exhortation is to receive”, and “its scope” all influenced the form of exhortations chosen by the writers of GPBs and OMJs. Our study, further, reached some results contradictory with the ones obtained by Levinsohn (2015) which may be related to language and culturespecificity and different discourse types studied by the authors of these studies:      using “it is necessary” as a highlighted form of exhortation, not a backgrounding one as mentioned by Levinsohn (2015); using “imperatives” directed to 3rd person with equal potency of “imperatives” directed to second person, despite the assertion stated by Levinsohn (2015) where he claims that “imperatives” directed to second person are more potent than “imperatives” directed to 3rd person; and finally, revealing a different result in Persian medical texts from that of Levinsohn (2015) regarding the arrangement of highlighted forms of exhortations and backgrounded ones.