Práticas conversacionais na tomada do histórico em uma entrevista psiquiátrica

Abstract

The current study forms an interface between language and mental health. Embedded in methodological and theoretical assumptions from the Ethnomethodological Conversation Analysis (SACKS, SCHEGLOFF e JEFFERSON (2003 [1974]) and, is supported by theoretical milestones of Applied Linguistics on Professions (SARANGI, 2006), this essay aimed, firstly, at mapping, through an interactional standpoint, the stages which compose a first-time psychiatric interview from a medical psychosocial ambulatory that works on a Psychosocial Attention Center (Centro de AtençãoPsicossocial – CAPS), linked to the University Hospital of the Federal University of Juiz de Fora. Regarding the chosen research method, we made use of the case study, aiming at, in a second moment, performing an exploratory-oriented investigation through which we try to understand the conversational practices undertaken by a psychiatric resident doctor on level 1 – R1 – for taking the patient history. The data analysis showed that, initially, the stages mapped during this discursive event moved away from the initiative proposed by the specialized literature, as a higher number of relations when compared to the manuals were found, which is, opening – problem display – history taking – case evaluation and forwarding – negotiation and drug prescription – treatment advisory – report fulfillment – closing. Furthermore, the results showed that the doctor used several practices, such as the use of formulation, the production of continuators (SCHEGLOFF, 1982), the patient speech repetition and elaboration of new questions (HERITAGE, 2007), which encourage patient report, seemingly more oriented to the goal of the stage. It is believed that when engaging this practice, the doctor gets closer to an active hearing (HUTCHBY, 2005). In this direction, regarding the importance of doctor-patient relation for the development of diagnosed hypothesis and the therapy addressing, we consider this research extremely relevant, as it helps understanding the interactive dynamics of the duo, implying a new perspective for the understanding of language use within this context, what, consequently, may improve quality of living of offered services.