Volume 11, Issue 2 - Special Issue: Language and health: a revisit of language in the medical context; Guest Editors: Yansheng Mao and Shuang Wei

This study examines the metaphorical expressions of anger and sadness in Korean psychological counseling and casual conversation. In counseling contexts, patients frequently use metaphors to articulate abstract emotions or concepts, as metaphors play a pivotal role in shaping cognitive processes that map concrete experiences onto abstract domains. By comparing datasets from psychological counseling sessions and casual conversations provided by South Korea’s AI-HUB, the study found that anger was expressed through a broader range of metaphors in counseling discourse, while casual conversation exhibited comparatively fewer metaphorical expressions of anger . Although similar metaphorical patterns were used to convey sadness in both contexts, counseling discourse demonstrated a more balanced distribution, whereas casual conversation predominantly conceptualized sadness as a form of illness . Furthermore, the analysis of source domains revealed a wider range of conceptualizations in counseling, including liquid in a bowl, insanity, object, plant, enemy, fire, and natural force . In contrast, casual conversation primarily relied on the domains of liquid in a bowl and object . This study contributes to the integration of metaphor research and psychological counseling, offering insights that may inform future investigations into metaphor use in health discourse.

This study examines the use of metaphors in Traditional Chinese Medicine (TCM) within the context of health communication in the United Kingdom (UK). By analyzing the narratives collected through interviews with eleven TCM practitioners in UK clinics, this research investigates how metaphors facilitate the expression of complex medical concepts and bridge cultural gaps between Chinese medicine and Western medicine. The metaphors employed in describing conditions such as pain, emotion, infertility, cancer, and obesity in both Chinese and English are analyzed, and the findings suggest that the use of metaphors can enhance the description of medical conditions and improve health communication. This result is encouraging in that it highlights the importance of metaphorical language in mediating health experiences, improving diagnosis, support, self-management, and overall patient empowerment. The study also underscores the need for healthcare practitioners to be aware of their metaphor use and the cultural implications of their communication strategies. It can also enrich the repertoire of metaphorical language available to Western healthcare professionals and patients, fostering a more holistic and culturally sensitive approach to medical treatment.

Emoji may help overcome the lack of non-verbal cues in text-based online medical consultations enabling doctors to better engage with patients. However, emoji can also be ambiguous and possibly, misinterpreted. Focusing on 87 online medical consultations from a Chinese online medical platform, this study utilizes the emoji categories in Emojipedia to examine types of emoji used by doctors and patients and adapts the emoji illocutionary effect typology to explore their functions. We found that the most prevalent emoji types in online medical consultations were smileys , people, and symbols . Patients’ emoji were mostly negative (67 %) whereas 70 % of emoji used by doctors were positive or neutral. Of 565 instances of emoji use, their primary function was as illocutionary force indicating devices, to modify the tone of the accompanying text. Illocutionary force enhancement was the most frequent function of illocutionary force indicating device emoji, accompanying speech acts such as react , inquire, and inform . Emoji also functioned to perform illocutionary acts, mainly as react acts, where doctors and patients used emoji to acknowledge each other’s texts. This study contributes to the literature on communication in online medical consultations, providing insights into the nuances of emoji use which may be useful for e-health professionals.

Patient questioning plays a pivotal role in medical encounters, especially in Online Medical Consultations (OMCs). This paper attempts to report the speech acts and interactional dynamics of patient questioning in OMCs through the lens of the finite typology of speech acts. The findings indicate that patient questioning is a complex interactional act, realized through a cluster of speech acts, such as Request, Disclose, Tell, and others, presenting different interactional dynamics in the opening, core, and closing phases of OMCs. This study enhances the current understanding of how patient questioning functions within OMCs and underscores the importance of effective communication to facilitate patient-centered care. Furthermore, exploring the speech patterns of patient questioning in OMCs provides valuable insights that can empower patients with effective questioning strategies, thereby contributing to the overall efficiency of OMCs.

As a core concept in Traditional Chinese Medicine (TCM), dampness (湿气, shiqi /damp- qi ) is regarded as the root cause of numerous diseases. This study has analyzed the selected posts of dampness elimination in the Chinese social platform RedNote (小红书, Xiaohongshu ) based on Matthiessen’s social-semiotic processes in the contexts of health and healthcare. Results show that netizens portrayed themselves as symptom identifiers through the “expounding” process and as advice givers through the “recommending” process in their experience-sharing posts. Specifically, netizens used definition, quotation, and categorization to construct dampness with reference to the holistic cycle of nature – body – organ and syndrome differentiation, and discursively constructed as medical experts and peer-like experienced patients through the demonstration of professional medical knowledge with TCM jargons or terms and the frequent use of emoticons and macro-images. Netizens not only act as actively responsible individuals through self-care and self-medicine but also contribute to three levels of the discursive construction of Yangsheng (养生,‘life-nurturing’) practice in social media, both of which will deepen the understanding of TCM from a self-health perspective and reveal how individuals integrate their personal experiences into the holistic treatment of TCM.

This study aims to examine the linguistic features, emotional self-disclosure, and thematic patterns of the online self-disclosure discourse of individuals with depression in China. First, the study findings indicate several key linguistic characteristics in the online self-disclosure discourse of individuals with depression in China. Specifically, regarding the use of personal pronouns, the highest frequency is observed for the singular first-person pronoun “I”, which demonstrates the self-focused narrative mode prevalent in Chinese online depression discourse. Notably, the use of third-person pronouns constructs a state of isolation in terms of both external identity and internal emotions, further highlighting the confrontational nature of the discourse. Besides, in terms of lexical usage features, the online self-disclosure discourse of individuals with depression in China can be categorized into three main types: (i) frequent use of disease-related vocabulary, (ii) frequent use of negative terms such as “no” or “not”, and (iii) frequent use of emotional words. Second, regarding emotional self-disclosure, the use of negative emotional words significantly outweighs the use of positive ones, resulting in an overall dominance of negative sentiment. Additionally, the emotional orientation of the semantic content should be interpreted in the specific contextual meaning. Third, as for topic characteristics, the online self-disclosure on social media reveals five key topics: emotional representation, emotional challenges, life status, pathological manifestations, and emotional needs. In light of these findings, this study aims to enrich the research on emotional health discourse to some extent and provide a comprehensive perspective to enhance social understanding of individuals with depression, with the hope of contributing to the improvement of overall mental health in society.

It is widely believed that the employment of backchannels in conversations contributes to discourse organization as well as positive social management. Despite a multitude of previous research focusing on the role of backchannels in diverse task-oriented discourses, few studies probed into the usage of backchannels during online medical consultation. As such, with the help of both quantitative and qualitative approaches, this study endeavors to explore the role of backchannels through analyzing the forms and functions of backchannels employed by Chinese doctors in online medical consultation. The analysis showed that doctors’ backchannels can be classified into two types: lexical backchannels and non-lexical backchannels. Functionally, backchannels are predominantly used to follow e-patient’s utterances, respond to e-patient’s questions, express unexpected agreement, and introduce empathic moves. To some extent, this paper does not only shed new light on the felicitous use of backchannels for doctors both online and offline in Chinese medical consultation scenarios but also provides insights into rapport management by doctors during Chinese online medical consultation.

Social media networks provide a comfortable space for the hearing-impaired community, becoming an important medium for them to share personal emotions and seek social support. This study collected hearing impairment logs published by the Chinese hearing-impaired community on social media platforms as the corpus. Using qualitative research methods, the study analyzes the trauma-related linguistic features, narrative structures, and emotional expressions characteristic of their discourse on these platforms. The study indicates that the trauma narratives in the online discourse of the Chinese hearing-impaired group exhibit certain linguistic and structural features, including frequent use of psychological vocabulary, pronouns, tense shifts, and negations. In terms of narrative structure, these stories tend to be linear, yet often incoherent and fragmented. Emotionally, the narratives primarily convey negative emotions, although they tend to evolve into more positive sentiments over time. The findings not only incorporate social media discourse into the research scope, contributing to the expansion of health discourse studies, but also reflect the role of humanities and social sciences research in supporting vulnerable groups’ integration into society, aligning with the language strategies of the Healthy China initiative.