How Chinese Doctors Do Things With Discursive Strategies in Palliative Care Family Meetings: A Genre Theory Analysis.

Abstract

Palliative care family meetings (PCFMs) can be conceivably endorsed as helpful means for bettering end of life (EOL) communication with terminally ill patients and their families. Relevant scholarship in China remains emerging and youthful, with many avenues left to explore. Few studies have delineated the structure and specified the strategies for conducting PCFMs in the Chinese context. To address this gap, this study gathered data from audio-recorded family meetings held in palliative care wards in China. Within the theoretical framework of genre theory in functional linguistics (FL) that defined genres as staged, goal-oriented social processes, utilizing thematic analysis and discourse analysis, the twofold generic structure of PCFMs was delineated, consisting of four genre stagings in the upper stratum and fourteen elemental genres in the lower stratum, with the identified attributes of elemental genres, their sequence and possibility of iteration. Doctors' discursive strategies in terms of semantics and lexicogrammar were specified as they serve to achieve communicative goals regarding knowledge, identity, and emotion. It is hoped that the results will improve the context for growing palliative care practices and positive clinical outcomes in China and provide insights into the structurization and discursiveness of practices in EOL settings.