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2TIBBIY DISKURSGA XOS BO'LGAN KASBIY VA KOMMUNIKATIV KOMPETENSIYA
Yorova Sayyora Karimovna Samarqand Davlat Tibbiyot Universiteti Tillar Kafedrasi mudiri, PhD Hasanova Fariza Olimovna Samarqand Davlat Tibbiyot Universiteti Tibbiy pedagogika, Oliy hamshiralik va xalq tabobati fakulteti, 503-guruh talabasi https://doi.org/10.5281/zenodo.11235994
ARTICLE INFO
Received: 18th April 2024 Accepted: 20th May 2024 Published: 21st May 2024 KEYWORDS
diskurs, kompetensiya,
tibbiy nutq, kasbiy,
komminikativ, munozara.
ABSTRACT
Tibbiy diskursning keyingi lingvistik talqinlarida tibbiyot xodimining kommunikativ madaniyatini, bemorlar bilan yaqin munosabatini rivojlantirishga e'tibor qaratish lozimligi uqtirilmoqda. Albatta, bunday shartlarning ijrosi tibbiyot xodimlarining ijodiy fikrlashi, nutq vositalaridan samarali foydalanishi, vaziyatni to'g'ri baholash va moslashishi, bemorni rag'batlantiruvchi kommunikativ amaliyot tajribasi, ijobiy ta'sir etuvchi vositalar singari oZ-oZini nazorat qilish imkonini yaratadigan muloqot modellarini ishlab chiqishni talab qiladi.
Shifokor va bemor o'rtasida axborot almashish ikki tomonlama jarayon bo'lib, bunda bemor yetkazayotgan axborot tahlil qilinadi, o'rganiladi, mulohaza qilinadi, shifokorning vaziyatga oid mushohadalariga aniqlik kiritadi yoki bevosita qabul qilinadi. Muloqot jarayonida shifokorlar tashxis qo'yish uchun bemorlaridan qancha ko'p ma'lumot olishsa, uning aniqlik darajasi shuncha yuqori bo'ladi. Buning uchun bemorlar ham qayd etilganidek o'z tibbiy bilimiga tayangan holda, muloqot qilish tajribasiga ega bo'lishi talab qilinadi. Manbalarda diskursning:
1) yuqori malakali ekspertlar hamjamiyatining xulosasiga asoslanuvchi diskurs (diskurs ekspertnogo soobshestva - DES),
2) fikrlar xilma-xilligiga asoslanadigan diskurs (diskurs razlichiy - DR),
3) muayyan ijtimoiy kelishuvga asoslanuvchi diskurs (diskur soglasovaniya - DS) singari tasnifiy turlari ajratiladi.
Bunday ichki tafovut tibbiy diskursga ham xos bo'lib, kasbiy va kommunikativ kompetensiya darajasi yuqori bo'lgan mutaxassislar (yoki ekspertlar) tomonidan ishlab chiqilgan yozma va og'izaki janrlar (diskurs ekspertnogo soobshestva - DES), tibbiyotning u yoki bu masalalari bo'yicha shifokorlar o'tasida bo'ladigan bahs va munozaralar o'z ifodasini (diskurs razlichiy -DR) topgan janrlar, shifokor-bemor o'rtasida bo'ladigan muloqot janrlari (diskur soglasovaniya - DS) shular jumlasidandir. Asil mohiyati "sog'liqni saqlash" tushunchasi bilan bog'liq bo'lgan ushbu janrlar o'rtasidagi ichki tafovvutning vujudga kelish sababi esa kommunikatorning o'z nutqini muloqot vaziyati, muhiti va o'rniga monand holda qo'llagan holda, fikrini tinglovchiga tez va oson yetkazishga intilishini taqozo etadigan relevantlikka borib taqaladi.
Kasb va kommunikativ kompetensiyasi yuqori darajada bo'lgan mutaxassislar (yoki ekspertlar) hamjamiyati tomonidan yaratilgan (diskurs ekspertnogo soobshestva - DES) yozma va og'zaki janrlar o'zining tor doirada ixtisoslashgan mutaxassislar muloqotiga
mo'ljallangan tibbiy terminlar talqiniga asoslangani, ularga xos murakkab ilmiy va rasmiy ifodalarni ta'lim jarayonida tajribali ustozlar ko'magida o'zlashtirishga mo'ljallangani bilan xarakterlanadi. Shularga ko'ra, ekspertlar hamjamiyati tomonidan yaratilgan (diskurs ekspertnogo soobshestva - DES) yozma va og'izaki, rasmiy va norasmiy diskursiv janrlarni relevantlilik darajasi yuqori bo'lgan tur sifatida ajratish mumkin. Ushbu janrlarni ingliz va o'zbek tillaridagi quyidagi parchalar misolida kuzatish mumkin:
Hemorrhoids, or piles, are a common problem. These swollen veins inside the rectum or outside the anus can cause pain, anal itching and rectal bleeding. Symptoms often improve with at-home treatments but on occasion people need medical procedures. Eating more fiber can help prevent hemorrhoids. Hemorrhoids are swollen, inflamed veins around your anus or the lower part of your restum. There are two types: External hemorrhoids, which form under the skin around your anus. Internal hemorrhoids, which form in the lining of your anus and lower rectum. Buyraklar polikistozi autosom dominant tipda nasliy o'tuvchi kasallik bo'lib, unda ikkala buyrakda ko'p sonli suyuqlik tutuvchi kistalar paydo bo'ladi. Kistalar xisobiga buyrak o'lchami kattalashadi, ammo uning ish bajaradigan parenxima qismi kichrayadi. Sonografiyada buyrak kapsula (giperexogen), pustloq (gipoexogen), mag'iz (gipoexogen) qavatlari va kosa jomlari (giperexogen) ko'rinadi.
Tibbiy janrlarning ikkinchi turi, ya'ni munozarali diskurslar (diskurs razlichiy - DR) esa tibbiy muloqotda muayyan bir kasallikka tashxis qo'yish va muolaja qilish usullariga oid shifokorlar o'rtasida bo'lib turadigan munozaralar misolida kuzga tashlanadi. Ushbu diskurslar ham o'ziga xos ilmiy va og'zaki bayon uslublariga egaligi, tibbiy terminlar tavsifiga asoslanishi, suhbatdoshlarning bir-birlarini tushinish darajalarining professional va kommunikativ kompetensiyalar tengligiga asoslanishi bilan xarakterlanadi. Xususan, "New England Journal of Medicine" jurnalidan olingan quyidagi parchada tananing
kuyish darajasi yuqori bo'lgan bemorlarni davolash bo'yicha olib borilgan tajriba-sinovning amaldagi davolash pratakollaridan samaraliroq ekani haqida bahs qilingan: Our results were unexpected given the magnitude of the signal from previous trials of supplemental glutamine in burn-injured patients.15 Our trial differed from the previous trials in several important ways. First, the previous randomized, controlled trials were small, singlecenter trials ranging from 30 to 48 patients each. Our multicenter trial with a much larger sample showed no combined effect of reduced mortality and shorter hospital stay (the 95% confidence interval for the subdistribution hazard ratio for discharge alive [0.80 to 1.04] ruled out a clinically meaning benefit). Previous research has shown that the effect of intravenous glutamine was also subject to a single-center bias in which all the positive effects were seen in single-center, randomized, controlled trials, whereas larger, multicenter, randomized, controlled trials did not confirm a positive treatment effect.
Munozarali diskurs haqida tasavvurga ega bo'lishda quyidagi hajviy hikoyaga ham manba bo'lib xizmat qilishi mumkin:
Sigaret tutunga to'la katta xonada oq xalat kiygan bir necha o'ta jiddiy qiyofadagi kishilar ertalabdan beri munozora qilishadi.
- Yo'q, yo'q. Men ololmayman. Bemorning dardi jarrohlik emas. Uni terapevt olsin, - dedi sakkizinchi marta so'z olgan jarroxJovliev.
- Ye, nega endi? Bemor chisto infeksionniy-ku?! Tag'in izidan hech kimi yo'q ekan. Uni yuqumli kasalliklar bo'limigayotqizish kerak. Tamom-vassalom, e'tiroz bildirdi terapiya bo'limi boshlig'ixo'ppasemiz Qorbosdiev.
- Hech qachonda. Bemorning barcha dardi o'pkasida-ku. Uni sil kasallar bo'limiga yotqizish kerak. - dedi infeksionist pashsha qo'riyotgandek qo'lsiltab.
- Rentgentda sil belgisi ko'rmadim. Dardi jigarida. U terapevtniki, - dedi o'ninchi marta to'ng'illab To'ng'izboev.
- Hechamda. Asli hamma gap yurakdan. Uni kardiolog olaqolsin. Palatasi bo'shab yotibdi, - dedi Qorbosdiev boshqalarga ko'z qisib.
- Prichyom buyerdayurak. Bemorning qorni taranglashgan-ku?! Yasno. Uj'arroxlarniki, -dedi qoshini suzib kardiolog Kurraev.
- Ha, aytgancha, yaxshisi bemorni reanimasiyaga yotqizsak-chi?! - dedi nihoyat jarrox Jovliev. - Hammamiz navbat bilan borib ko'rib turardik...
- Bekorlarning beshtasini aytibsiz. Hisobot-chi?! - dedi mudrab o'tirgan reanimatolog birdan chiyillab. - O'limning hisoboti yana mening bo'ynimga tushadimi? Yo'q, yo'q, bo'lmaydi. Sil bo'lsa, ftiziatr olsin-da-e...
[https://ziyouz.uz/ozbek-nasri/safar-kokilov/safar-kokilov-konsilium-azhviya]. Tibbiy diskursning ijtimoiy kelishuvga asoslangan (diskurs soglasovaniya - DS) turini esa shifokor - bemor muloqotiga oid "tibbiy maslahat" janri misolida kuzatish mumkin. Diskursning ushbu turi asos e'tiboriga ko'ra, institusional xarakterli bo'lsa ham, unda muloqotning boshqa vosita va usullariga asoslanadigan intertekstual ko'rsatkichlarning aks etishi ushbu diskursni ijtimoiy kelishuvga asoslanuvchi tur ekanliginidan darak beradi. Masalan:
Shifokor: Sizning o'txaltangizda tosh bor ekan.
Bemor: Ha, men buni avvalroq boshqa bir duxtirdan so'rab bilgandim... Shifokor: Xronicheskiy pankreatit ekanmi? Bemor: Bu nima degani?
Shifokor: Bu - o't xaltangizda surunkali shamollash bor, degani. Bemor: Tushundim, duxtir.
Keltirilgan suhbatdan ko'rinadiki, shifokor bemor bilan muloqotda imkon qadar tushinarli qilib so'zlashga intilsa ham, suhbat jarayonida uning kasbiy kompetensiyasi bilan bog'liq institusionallik uning "Xronicheskiy pankreatit ekanmi?" savolida beixtiyor yuzaga chiqqan. Ushbu tushunarsiz vaziyatni bartaraf etish maqsadida shifokor "Bu - o't xaltangizda surunkali shamollash" tarzida qo'shimcha izoh berishga majbur bo'lgan.
Shifokor va bemor o'rtasidagi muloqotning o'rinli va jo'yali bo'lishiga olib keluvchi relevantlikni ta'minlashda eng avvalo shifokor mas'ul bo'lsa ham, bemorning tibbiy savodxonligi, o'z salomatligi bilan bog'liq muammolarni tahlil qilib, o'rganib borishi ham muayyan darajada ahamiyatga ega bo'ladi.
Ushbu tadqiqotlarning e'tiborli jihati ularda tibbiy diskurs ishtirokchilari bo'lgan shifokor va bemorning muloqot jarayonida tutgan o'rni, ularning muloqot olib borish ko'nikma va tajribalari, maqsad va manfaatlari muhokamasiga alohida e'tibor berilganida namyon bo'ladi. Binobarin, sohaga oid aksariyat manbalarda shifokorning kommunikativ kompetensiyasi muhokama markazida turgani holda, bemorning ushbu muloqotdan ko'zlagan maqsad va manfaatlari, uning samarali kechishidagi hissasi, tibbiy muloqotga tayyorlik darajasi kabilar e'tibordan chetda qoladi.
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