「你敢有聽過糖尿病？」：台語衛生教育演講中透過探索年長者觀點以創造知識需求感之言談技巧

“Have you heard of diabetes?”— The Use of Perspective-Checking Questions in Creating Knowledge Needs in Taiwanese Health Education Talks for Elderly Lay People

針對常民的衛生教育對醫療人員而言是挑戰，因為他們不同於門診 病人有強烈的健康知識需求，因此創造常民的醫療知識需求是有效衛 教的重要基礎。雖然學者對於其他溝通情境中強化參與者動機之言談 分析有諸多探討，甚少針對衛教情境，因此我們缺乏對於各種互動情 境或類型中創造需求之言談模式的深入了解。本文以言談分析為方 法，檢視 169 個大學生以台語為年長者介紹常見慢性病相關知識的衛 教互動對話，主要論點如下：（1）大多數涉及行銷或促進某目標的互 動類型中，激發訊息接收者的需求感是共通的語用策略；（2）衛生教 育演說之屬性為參與者間的即時對話，主題涉及重要健康議題，因而 可見豐富之知識感需求類型與引發需求感浮現之言談機制；（3）衛教 知識傳遞者使用的「探索觀點問句」（例如「你敢有聽過糖尿病？」 「身邊敢有人有糖尿病？」）是促使知識需求感浮現的必要機制；（4） 知識需求類型與浮現機制與參與者的認識論角色和互動地位相關。

Health education for lay people, in contrast to that for clinical patients, is an important but challenging task since lay people may not feel the need to acquire this knowledge. Creating a sense of knowledge need in the lay people is thus crucial to achieving effective education. While great attention has been devoted to how participants' knowledge needs are created in various communication media (such as academic writing, commercial advertising, and education in general), less has been directed to what and how such needs are created via health education talks. Likewise, how such studies could enrich our understanding of creating a sense of need across different media remains unexplored. Based on the discourse analysis of 169 Taiwanese health education sessions where college students delivered geriatric disease knowledge to elderly people, this study argues the following: 1) creating a sense of need is a prevalent pragmatic strategy in most communication media that involve a promotional goal; 2) events such as health education talks, having spontaneous interactions and on topics of high-stake consequences, allow a wide variety of needs and needs-invoking mechanisms to emerge; 3) knowledge deliverers' use of perspective-checking questions (such as “Have you heard of diabetes?” or “Does anyone around you have diabetes?”) plays an indispensable role in enabling the recipients' knowledge needs to surface; and 4) the distribution patterns of what and how knowledge needs emerge are related to the epistemological and interactional roles of the participants.