评价理论视角下中国在线妇产科医疗咨询话语中的信任建构
Trust Construction in Chinese Online Obstetrics and Gynecology Medical Consultations from the Perspective of Appraisal Theory
摘要: 该研究以丁香医生网站的在线妇产科咨询文本为语料，运用评价理论(Appraisal Theory)和王与姚提出的本土化信任建构话语模型，探讨了中国在线医疗场景中医患信任的建构机制。研究发现，医生主要通过两个维度建构信任：1) 在认知信任(Cognition-based Trust)维度，医生运用介入系统(如自言/借言)和级差系统(如语势弱化/强化)等评价资源，来凸显其专业能力与诚信品质，树立专业可信的形象；2) 在情感信任(Affect-based Trust)维度，医生则多运用态度系统(如情感/判断表达)和介入系统(如唤起共同认知)等资源，以建立与患者的价值观契合和情感联结。研究旨在为理解中国在线医患信任的话语逻辑提供理论视角，并为优化在线医疗服务提供实践参考。
Abstract: Using online obstetrics and gynecology consultation texts from the Dingxiang Doctor website as its corpus, this study employs Appraisal theory and the indigenous trust-building discourse model proposed by Wang & Yao to explore the mechanisms underlying the construction of doctor-patient trust in the Chinese online healthcare context. The study found that doctors primarily build trust through two dimensions: 1) In the Cognition-based Trust dimension, doctors utilize appraisal resources such as the engagement system (e.g., monogloss/heterogloss) and the graduation system (e.g., lowering/raising of speech force) to highlight their professional competence and integrity, thereby establishing a credible professional image; 2) In the Affect-based Trust dimension, doctors primarily employ resources from the attitude system (e.g., expressions of affect or judgment) and the engagement system (e.g., evoking shared cognition) to establish alignment with patients’ values and foster emotional connections. This study aims to provide a theoretical perspective for understanding the discursive logic of doctor-patient trust in China’s online healthcare context and to offer practical guidance for optimizing online medical services.
文章引用：姚开萌. 评价理论视角下中国在线妇产科医疗咨询话语中的信任建构[J]. 现代语言学, 2026, 14(7): 141-149. https://doi.org/10.12677/ml.2026.147629

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