Finally, we discuss how affect to the ideological dimension of such phenomena discourse in health-care system, health beliefs and intra-disciplinary relationship in health-care system. Usually, in scientific research and debates, it is used indiscriminately, without being defined. Without a clear understanding of discourse theory and DA, it is difficult to comprehend important research findings and impossible to use DA as a research strategy. Hence, this paper aims to help health-care practitioner employ DA as an effective research strategy.
This study was a narrative review. Electronic databases such as PubMed, Medline, ProQuest, and science direct were searched using the keywords discourse analysis, methodology, and health-care system. A manual search of various journals and books was also carried out. Not only all the searched articles and books were included, but also highly relevant articles from English literature were considered for the present review. There are many explanations and definitions of discourse and DA. DA is a broad and diverse field, including a variety of approaches to the study of language, which derive from different scientific disciplines and utilize various analytical.
DA examines language in use. DA is both an old and a new discipline. Historically, DA path a way from linguistic approaches to socialistic approaches. Its origins can be traced back to the study of language, public speech, and literature more than years ago. One major historical source is undoubtedly classical rhetoric, the art of good speaking.
Whereas the grammatica, the historical antecedent of linguistics, was concerned with the normative rules of correct language use, its sister discipline of rhetorical dealt with the precepts for the planning, organization, specific operations, and performance of public speech in political and legal settings. After two decades, a new form of DA emerged in the middle decades of the 60s and 70s, following the development of knowledge in the social sciences and humanities.
Formal sentence grammars had been challenged from several sides and were at least complemented with new ideas about language use, linguistic variation, speech acts, conversation, other dialogs, text structures, communicative events, and their cognitive and social contexts. Much formal rigor and theoretical sophistication had to be temporarily bracketed out to formulate completely new approaches. A new cross-discipline of DA began to develop in most of the humanities and social sciences concurrently with and related to, other disciplines, such as anthropology, semiology, psycholinguistic, sociolinguistics, and pragmatics.
Many of these approaches, especially those influenced by the social sciences, favor a more dynamic study of oral talk-in-interaction.
Discourse analysis: A useful methodology for health-care system researches
In this view, DA concerned with how an individual's experience is socially and historically constructed by language and DA assumes that language constructs how we think about and experience ourselves and our relationships with others. Since the s, Foucault's works have had an increasing impact, especially on DA in the social sciences. Now DA as qualitative methods apply in various fields such as anthropology, ethnography, sociology, intellect, cognitive and social psychology, politic science, communication, and critical linguistics, and health-care system.
Mainly DA philosophical base is a social constructionist approach. Discourse analytical approaches take as their starting point the claim of structuralist and poststructuralist linguistic philosophy, which our access to reality is always through language. With language, we create representations of reality that are never mere reflections of a preexisting reality but contribute to constructing reality.
That does not mean that reality itself does not exist. Meanings and representations are real. Physical objects also exist, but they only gain meaning through discourse. Language, then, is not merely a channel through which information about underlying mental states and behavior or facts about the world are communicated.
This also extends to the constitution of social identities and social relations. It means that changes in discourse are a means by which the social world is changed. Rather they gain their status as selves by taking a position within a preexisting form of language. In terms of epistemology, many discourse theorists adopt a relativist view; they assume that there exist no objective grounds on which the truth of claims can be proven and propose that the value of knowledge should be evaluated according to other criteria, such as its applicability, usefulness and clarity.
Burr provided an outline of the general philosophical assumptions that underpin most discourse analytical approaches, drawing on the accounts of social constructionism. A critical approach to taken-for-granted knowledge - Our knowledge of the world should not be treated as objective truth. Historical and cultural specificity; We are fundamentally historical and cultural beings and our views of, and knowledge about, the world are the products of historically situated interchanges among people.
This view match by this view that all knowledge is contingent is an anti-foundationalism and anti-essentialist[ 9 ]. The link between knowledge and social processes — Our ways of understanding the world are created and maintained by social processes. The link between knowledge and social action - Within a particular worldview, some forms of action become natural, others unthinkable. Different social understandings of the world lead to different social actions, and therefore, the social construction of knowledge and truth has social consequences.
DA is composed of two main dimensions, textual, and contextual. Textual dimensions are those which account for the structure of discourses, while contextual dimensions relate these structural descriptions to various properties of the social, political, or cultural context in which they take place.
The contextual form examines the production and reception processes of discourse, with particular attention to the reproduction of ideology and hegemony in such processes, and the links between discourse structures and social interaction and situations. Some DA mixes one or more of these approaches; for example, one kind of critical DA CDA combines linguistic analysis and ideological critique. There are various categorizations of discourse analytical research. The styles are categorized along two axes: 1 between text and context, and 2 between constructivist and critical approaches.
The first axis is about the degree to which research focuses on individual texts or on the surrounding texts. The proximal context is the local context, for example, a discipline or science. The distal context is a broader social context, for example ecological, regional, or cultural settings.
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The second axis describes the degree to which the research focuses on ideology and power, as opposed to processes of social construction. The axes are seen as continua, not as dichotomies. Thus, combinations of elements of both axes are possible and usual. Jansen in his article summarized the four perspectives of DA that described by Phillips; they are as follows. A social linguistic analysis is constructivist and focuses on individual texts. It gives insight into the organization and construction of these texts and how they work to construct and organize other phenomena.
The focus is not on the exploration of the power dynamics in which the texts are implicated.
Similar to social linguistic analysis, these discourse analyses are interested in the way in which broader discursive contexts come into being. They are not directly concerned with power. Individual texts are more important as background material. Critical linguistic analysis shares with social linguistic analysis its focus on individual texts, but its main concern is with the dynamics of power that surround the text.
The examination of individual texts is for understanding how the structures of domination of the proximal context are implicated in the text. The main interest of CDA is in the discursive activity to construct and maintain unequal power relations. The distal context is of interest, that is, the ecological, cultural, or regional setting that surrounds individual texts. It is based on the premise that texts have a constructive effect in shaping how we experience ourselves and others and how we act in relation to this, example, the ability to prescribe medication.
In addition to the above DA types, there are other classifications for DA theoretical approaches. Discursive psychology is part of the general movement of critical psychology, which has been reacting against mainstream social psychology, especially the sort of experimental psychology. Discursive psychology is an approach to social psychology that has developed a type of DA to explore the ways in which people's selves, thoughts, and emotions are formed and transformed through social interaction and to cast light on the role of these processes in social and cultural reproduction and change.
Historical DA is a poststructuralist approach to reading and writing history; a mode of conceptualizing history through a theorized lens of critique.
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Historical DA works against the objectivist fallacy of traditional positivist historical methods in decentering the authority of the historian as a neutral recorder of facts and the claim of historical writings as objective reconstructions of past events. In line with its intent to disrupt taken for granted ways of conceptualizing history, the task of historical DA is not to find truths about past events or to identify the origins or causes of past events, but to expose history as a genre contingent, ambiguous, and interpretive. Historical DA is, therefore, less a set methodology than a set of postmethodological methodologies.
Rules about what is considered to be relevant narration in the courtroom include the degree of detail and presumed objectivity of witness testimony and prohibitions concerning admissible narratives. Assumptions about what makes testimony valid influence the telling and retelling of the events that trials seek to narrate conclusively. Further, as Coombe points out, the contest of narratives begins much earlier than in the dramatic setting of the jury courtroom with the selection of evidence that contributes to the narratives presented in courtrooms : Courtroom exchanges are also subject to generic restrictions.
Due to the traumatic nature of their experiences, victims may testify in an affective, non-linear, and dissociative mode—qualities resembling norms of avant-garde or Modernist texts—hence appearing suspect to those who adjudge these trials : — Other scholars have also conducted genre-based narrative interrogations of law.
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Accordingly, the story of codified law consists of the reconstruction of events and the filling-in of narrative gaps. Since in civil law systems the judge or judges and lay assessors determine the description of previous events on the basis of accumulated evidence, witness questioning, and argument, the meta-narrative of a case has to be reproduced in a written protocol of judgment, which employs persuasive narrative strategies Vismann : 98— Law and Literature interfaces legal protocols with literary narratives to demonstrate the contingent nature of justice. One ethical-rhetorical approach dates from the work of White Legal and literary rhetoric thus intersect with the ethics of interpretation.
Most pertinently, in terms of its potential for narratological research, Goodrich has argued that the basis of law as a science and an autonomous discipline can be found in the medieval philological interpretation and preservation of the Corpus Iuris Civilis : In essence, the establishment of law as a science involved a disregard for the context in which legal texts were created.
Within the US American context, stories that display a high degree of experientiality about being materially disadvantaged and institutionally excluded have provided counter-punctual arguments to the assumption that the legal subject is a white, propertied man. Accordingly, one field of narrative legal scholarship concerns reciting alternative stories to those related in hegemonic legal contexts. Feminist critique uncovers how acts of domestic abuse do not cohere with legal models which assume that violence takes place between men in public places, and how rape complaints are consistently discredited if their stories do not comply with this model—if the assailant was not a stranger, did not use a weapon, and did not attack a woman outside her home.
Personal testimonies to experiences unattended to by legal code and legislation have become vehicles for raising public notice of how rape and sexual slavery are employed as systematic tools of oppression during wartime.
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The rights of indigenous peoples have been rendered tangible through personal narrative; and these narratives have contributed to challenging the legal status quo. Somewhat underrepresented in narrative approaches to legal discourse is research that invokes structuralist work on narration and deals specifically with categories of temporality, tense, internality or externality, and reliability. In German statutes one finds similarly impersonal narration about anonymous agents involved in a sequence of hypothetical actions, e. Depending on how wide or narrow their definition of narrative is, some narratologists will argue that this law does not meet the minimum requirements of experientiality, eventfulness, human-like agency, etc.
This pattern differs considerably in preambles, where allusions are made to political collectives as a strategy of legitimation von Arnauld : Noting the rhetorical differences between impersonally and personally narrated legal texts and their ideological effects can be achieved through attention to the specific narrative qualities of law.
Discourse analysis: A useful methodology for health-care system researches
Most pressingly, the issue of how to deal with narrative arises in legal interpretation. This entails the application of codified law or precedent judgments to the case at hand according to competing rules of application and it raises issues of narrative intentionality. In the US, debate continues about whether the Constitution should be interpreted according to the presumptive original intentions of those who composed it, the exact semantic meanings of the words at the time an act or amendment was enacted, or according to the general purpose of the enactment, which has to be viewed contextually.
This debate has enduring political consequences, as recent US Supreme Court decisions regarding campaign financing and healthcare have amply shown. Legal interpretation concerning European Community law functions differently, as does the application of codified law in civil law systems.
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Thus recent efforts to homogenize European law and rules of application interface with narratological concerns, as methods of interpreting narrative texts may be variously based on intrinsic textual signals, linguistic concerns, extratextual realities, or historical contingencies. The insight that legal discourse is not autonomous but inextricably bound to its historical context can be attributed to many sources including Friedman , who argued that a legal system is indivisible from the legal culture through which it is understood, and Cover On the one hand, law is rendered comprehensible through narrative.
On the other hand, law is embedded in the cultural narratives that frame it. Hence legal prescriptions cannot be separated from the narratives that situate, explain, and legitimize their prerogative.