an originality of speech influence of the doctor on the patient during the decision of an educational problem of formation of representations on regulations zdorovesoobraznogo behaviour

Pedagogical educational activity of the doctor is focused on familiarising of the people who have addressed for the help to the expert, such way of life which would promote maintenance of their health at optimum possible level.

The primary goal of the pedagogical educational activity realised by the doctor - formation at the population of representations about regulations of similar behaviour.

The way of life can be characterised as a complex of the ways of ability to live most typical for the person in certain conditions (cultural, social, ecological) [73], including the social, biological, psychological, spiritual parties of human life (D.A.Izutkin) [74]. The word-combination «a healthy way of life» is often enough used not only in the specialised scientific medical, pedagogical, sociological, philosophical literature, but also in informal conversation that can testify to the importance of the given phenomenon for each person. L.V.Dobroradova suggests to consider it as a complex of such conditions
Abilities to live of the person which promote durable work of systems of its organism, and also a complex of methods of preservation of health and development of the person [57]. As conducting a specific way of life can become the reason enough considerable quantity of diseases, it is obvious, that adherence to a healthy way of life can be connected with their preventive maintenance [75].

In modern researches the term «samosohranitelnoe behaviour» including, according to S.I.Kulikovu, installation on the self-preservation, certain relations of the person to preservation of own health, a complex of skills necessary for it [110] also is actively used. The term samosohranitelnoe behaviour is considered in pedagogics, sociology as the activity focused on preservation of in physical, psychological, social aspects [185].

For today seldom enough it is possible to meet «completely the healthy person». In a context of the modern approach to understanding of the health causing introduction in practice of public health services of the International Classification of Functioning (MKF), the opinion is accepted, that each person, anyhow, gets during a life experience of illness or specific disfunktsionalnyh conditions, and also restrictions, them caused [281]. It is thus noticed, that is necessary aspires to such behaviour which would allow to support health at the greatest possible level for each person. In our opinion, it it is possible to reach in the event that the person will conduct zdorovesoobraznyj a way of life, that is to build the life according to norms and regulations zdorovesoobraznogo behaviour. Under zdorovesoobraznym behaviour we understand such kind of vital activity of the person and system of its mutual relations with world around which promotes the most harmonious life in the tideway of preservation and maintenance of the health on optimum, as much as possible high for
Each concrete person level. In the given research we suggest to consider zdorovesoobraznoe behaviour and conducting zdorovesoobraznogo a way of life as synonymous concepts.

Conducting zdorovesoobraznogo a way of life allows to warn occurrence of diseases, osoznanno to carry out recommendations of the doctor, and in case of presence of chronic diseases allows to lower frequency of occurrence of relapses, that is allows to hold a condition of own health under the control.

Familiarising of the person zdorovesoobraznomu to a way of life occurs thanks to the pedagogical educational activity realised by the doctor by means of speech influence. The basic tool of influence on the patient who is used by the expert, in this case is language.

Interaction of people by means of language - an integral part of human life. Without language development of human thought, culture and society, and also interaction of people in education spheres, sciences, arts would be impossible. Thus language is embodied and realised through speech which allows language to realise communicative function [78]. Language corresponds with speech as social corresponds with the individual: the first - is abstract, formal, stable, reflects a picture of the world of the people which uses it and does not depend on a situation in which it is applied. Speech - a phenomenon individual: it reflects experience of the concrete person and is caused by a situation in which there is a dialogue [78]. Realising pedagogical educational activity, the doctor, as a matter of fact, carries out specific speech influence on the patient, thus a role of basic "tool" of such influence carries out language.

The question on occurrence of language and has not received the definitive answer, despite the fact that what various aspects of its occurrence and functioning are considered in philosophy, linguistics, ethnography, cultural science [233, 254, 304, etc.]. There is a set of the theories assuming various ways of formation of language, each of
Which, anyhow, faces from a certain sort criticism of the positions. For example, it agree logosicheskoj theories - one of the first theories of occurrence of language, it has been given people by divine will. We will notice, that the given question has found the reflexion already at mythology level. Myths of the various people mention questions of occurrence of language in conformity with the picture of the world [304]. According to representations of various religions (Christianity, a Judaism, konfutsianstva, induizma), the person has received language from a certain Universal Beginning (the God, Logosa, Dao) which has created all world and including the person, and also has allocated the last with possibility to think and speak [128, 188].

Within the limits of the onomatopoeic theory of occurrence of language there was an assumption, that occurrence of the last has been connected with attempts of ancient people to reproduce the world around phenomenon in the sound form and to imitate them. The Further transformation of the words which have arisen thus occurred spontaneously owing to what modern words are frequently far from initial sounding and even initial sense [128]. The criticism of the given theory is connected by that rather small number, actually, onomatopoeic words does not allow to explain occurrence of variety of the lexemes designating phenomena of world around [195].

mezhdometijnaja the theory which has arisen in epikurejskoj to school in the Ancient Greece, assumed, that mechanisms of occurrence of language are connected with occurrence of emotional barrackings owing to the impressions received by primitive people at interaction with phenomena of world around (for example, in connection with emotions of fear or surprise). According to the given theory, the accent becomes on origin of language under the influence of emotional impressions, that is under the influence of private world of the person [128, 195], thus critics of the theory notice, that it does not give an explanation to occurrence of the words which are not possessing emotionally-expressional colouring [195].

ZHestovaja the theory offered by V.Vundtom, is based on the assumption of presence at the first people of two systems of interaction with each other - sound and zhestovoj, first of which the second has been intended for expression of the emotional sphere, - veshchestvenno-subject. According to the researchers adhering to this theory, the sound system which began to get gradually lines of language what we know it now [128] has appeared more functional.

The theory of the public contract (T.Gobbs, ZH.ZH.Russo, E.Kodiljak), started with the assumption that language was osoznanno and is purposefully created by ancient people who tried to give names to those phenomena which faced, and, thanks to it to keep the thoughts and to share them with each other [128, 188].

The hypothesis of labour barrackings takes away sistemoobrazujushchuju in occurrence of language a role to barrackings which accompanied labour activity of ancient people. It is important to notice, that within the limits of the given theory it is supposed, that it were the barrackings caused not by emotional impressions, and muscular efforts of the working person [195]. According to the scientists adhering to the given theory, in process of complication of labour activity, necessity of management to it increased, that became possible thanks to simultaneous exclamations which then have played the role in occurrence first of all verbs of action [128].

The theory labour (or social) the language origins, the developed F.Engelsom, connects its occurrence with development of collective work in which process primitive people needed to co-ordinate plans of joint actions to communicate concerning subjects and the phenomena which they faced. Then words began to arise and at interaction of people out of work processes. According to the given theory, the further complication of work, complication of tools applied by the person, promoted development not only speech, but also thinking of the person [128, 188].

As a whole, the question on language occurrence remains till now opened and serves as a subject of research attention of experts. However, whatever has served as stimulus to occurrence and development in the person of language and speech, it is important to understand, that during any moment he could not live thus what there live other live beings on the Earth, the showing various behavioural patterns connected with instincts of preservation of and the kind. The person, as a matter of fact, became the being which has "dropped out" of space of the natural nature, thus the requirement for protection of and some kind of remained for it essential (M.A.Lukatsky) [129]. For this reason before the person there was a problem to create such world in which it could be in safety and could provide realisation of the requirements, find a certain way of adaptation in it (E.Kassirer) [88]. This world - the world inoprirodnogo lives in something is artificial, artefakten. It is the culture world. Occurrence in this world of each born person to master and become connected with necessity this world its part [129].

It is important to understand, that development by the person of the world of culture cannot occur "in itself", "instinctively", without presence of certain conditions [304] (histories so-called «children - Maugli» [233] become an example to that). It is necessary for the person will learn to live in it it is artificial the created world that will be impossible without rendering on it influences by other person by means of a word. Thus, language becomes that means which allows the person to enter into a context of culture [126], to establish interrelations with other people and with society as a whole, means which promotes formation of outlook of the person and transfer of knowledge and the experience which has been saved up by generations (P.Berger, T.Lukman, A.A.Leontev) [22, 119]. Language promoted

To occurrence of such forms of public consciousness, as art, a science, religion, philosophy [22, 138, 233].

Language became the basic means of influence of one person for another. Vision of the world inherent in the person is based on that set of knowledge and that information which it receives in the course of speech interaction with native speakers - both with other people, and with texts (M.A.Lukatsky) [127]. As a whole, it is possible to tell, that language is the certain intermediary which functioning allows each separate consciousness to meet consciousness of other person [276]. Thanks to language the person is entered in social [52 environment, language functioning - without what the modern culture [304] is impossible, and possibility to speak for the person is, as a matter of fact, a way not only to learn, but also to change and design a reality [22]. It is possible to tell, that language - a basis of all kinds of human activity [304], and a special role he plays areas of professional formation and development of the person. Such kind of activity, as educational - not an exception: All its components and components are impossible without language oposredovanija (M.A.Lukatsky) [129].

Within the limits of the given research us educational activity of the doctor, as one of directions of educational activity as a whole interests. Its essence, specificity and the philosophical bases has been considered in the first paragraph of the dissertation. In the given work as object of research attention there is its basic tool - language. Use of the given tool - the key factor of realisation of pedagogical educational activity of the doctor. It is obvious, that without it there is simply impossible a rendering of influence on to whom educational activity of the physician is turned: patients, their nearest environment, the people who have addressed for any reason behind the help to the doctor. Most actively in this case pragmatical function of language is realised. Thanks to it, in particular at the expense of speech influence from the doctor, training of people concerning preservation of their health and conducting zdorovesoobraznogo a way of life is carried out.

There is a set of attempts to make definition of such difficult phenomenon as language. There is even a point of view according to which to make it basically it is impossible [194]. As a rule, following possibilities of understanding of language [132] are allocated:

- As any sign system (for example, dance language, music language);

- As specific ethnic language;

- As «a class of sign systems (consisting of phonemes, morphemes, lexemes...), uniform human language, centre of properties of all concrete languages» [132, with. 23].

In an explanatory dictionary of Russian under the editorship of Ozhegova and SHvedovoj, language is defined as «historically developed system of sound, dictionary and grammatical means, obektivirujushchaja thinking work, and being the tool of dialogue, an exchange of thoughts and mutual understanding of people in a society [149, with. 905]. According to V.M.Solntsev, language represents« set of rules on which offers become, and set allocated with sense or value of units which are used in conformity with rules »[207, с.63]. According to M.V.Panovu, language can be presented as a certain complex of" typical elementary units », and also laws according to which they are combined and alternate [153, с.13]. JU.S.Maslov notices, that attempt to make a certain uniform definition to a language phenomenon is difficult and offers the analysis of this phenomenon both from the functional point of view, and from the point of view of its internal structure. In the first case language is considered as «the major means of dialogue, the tool of formation and thought expression» [131, с.7], and its communicative functions in this case are ascertaining, appellative, expressional, kontaktoustanavlivajushchaja, metalanguage, aesthetic functions and function of definition of an accessory to group. In the second case the researcher defines language as «difficult system of signs, and rules of their functioning» [131, with. 31].

From the point of view semiologii (semiotics), language is understood as sign system (P.Berger, N.B.Mechkovsky, F de Sossjur, F.F.Fortunatov) [22, 135, 210, 231], thus languages can be divided on natural and artificial. The similar treatment of language as systems of signs, it is extended enough in modern linguistics [142], however, and at it is the critics noticing, that it does not possess such properties of sign system as unambiguity and konventsionalnost [70, 194].

The natural language is the language covering all spheres of an ordinary human life, that is everything, that enters in the field of human existence [128, 213]. It has arisen spontaneously and developed naturally together with development of the person. As a matter of fact, natural languages are languages of the dialogue, those public national languages which were spontaneously generated in process sotsiogeneza; each such language has the history, was exposed to certain changes during time. Its features - completeness, coverage of all spheres of a life, adaptability, an openness, relative freedom. The natural language represents base sign system over which secondary systems are built on, for example, such as the literature; the natural language thus represents a way of interpretation of these secondary systems [222]. The natural language provides satisfaction of human requirement for interaction, helps people to co-ordinate and co-ordinate joint actions. It is realised in speech of the person - the form of human dialogue possessing more individual character by means of language in various communicative situations [131].

Artificial languages are purposefully created by the person for the decision of definite purposes, for example, professional or scientific. In system of artificial languages its such kinds, as symbolical language (for example, mathematical language, physicists), computer language (the programming language, various formats of granting of computer data) can be allocated; the languages connected with enciphering by the natural

Information (various code systems, such as the Morse alphabet). With artificial language system, as a rule, work either experts, or the people studying a certain science [148]. For example, or physicists everyone has got acquainted with mathematical language at school during corresponding lessons. An artificial language desubektizirovan, it has rigid fixedness of terms and is connected with a scientific picture of the world (M.A.Lukatsky) [127]. Development of a human society has led to occurrence and development of system of trades, occurrence of professional communities, each of which has generated the specific system of interaction by means of language. Especially important this fact is represented in a context of research of the trades connected with scientific activity as everything, that is connected with a scientific picture of the world, should be described by special language [127]. For example, actively enough question on an accessory of language of professional community natural or to an artificial language rises in sphere jurislingvistiki. Trying to define, whether legal language natural or artificial is, C.Fillmor concludes, that in some respects legal language is similar usual, to a natural language, in others - has distinctions [227]. Collective of authors of Institute of the Scientific Information on social studies (A.M. Smiths, h.p. Burdin, N.A.Solntsev), arguing on language of professional legal community, comes to conclusion, that it is to a certain extent conditional in relation to a natural language: traditional linguistic categories

Are developed in it in some other plane that causes necessity of "transfer" from a natural language on language legal [108].

In our opinion, in something the similar situation is observed and in professional medical language: on the one hand, it is based on a natural language and has the same grammatical system, besides special lexicon includes common [2], metaphorical
The world picture in medical language is traditional [151]. On the other hand, such language distinguishes a qualitative originality. As mark A.M.Anokhin and I.e. Vedensky, medicine language is language of a science, hence, on a level with a natural language, the language of science is one of base components sotsiokulturnogo a context in which the medicine functions. Researchers notice, that as semiotics system, language of medical community is based on a natural language, at the same time, essential differences are observed owing to high concentration in it special terminology, thus terms can belong to various sciences and have the various maintenance and degree abstraktnosti [11].

It is possible to tell, that the doctor «exists on a joint» two languages: on the one hand, it is the representative of professional community, the expert having a picture of the world, connected with scientific and medikoyobiologicheskoj the nature of a subject of the work. On the other hand, it works in system "person-person" (E.A.Klimov) [91], and patients with whom it realises educational work, as a rule, are far from medicine. It, in our opinion, causes mixed, partially artificial character of branch medical language.

In a context of the given research language of representatives of medical community interests us, first of all, as the pedagogical tool, the tool with which help the expert can realise educational work. From the point of view of the person who has addressed to the doctor, language of the doctor can be perceived as some kind of «language of the alien». Conversation of two professional physicians frequently can be not clear practically to the person who does not have communications with this area of a life. In the event that the doctor begins to explain to the patient conducting regulations zdorovesoobraznogo a way of life on «faultless medical», the patient, unfortunately, can understand nothing. Accordingly, for the purpose of increase of efficiency of educational pedagogical activity it is necessary
To answer the following question. How the doctor can reach consciousness of the patient and make so that last has understood the expert? In essence, this problem is connected with «transfer from professional language on language accessible». Thus, as one of features of speech influence of the doctor in the course of educational pedagogical influence it is possible to note partially artificial character of professional medical language causing necessity of "transfer" of words of the doctor on language, accessible to the patient.

In view of that distinctive line of medical language is presence original kategorialnogo the device [11] generated within the limits of professional community, in the course of pedagogical educational activity there is a lexical asymmetry: patients, unlike doctors, are not familiar with a considerable quantity of medical concepts.

As a whole, the majority of terms functioning in professional medical language completely is clear only to the experts who have received appropriate preparation. Thus there is a certain communication between medical terms and theoretical conceptual schemes which dominate in a medical science during this or that moment of time: new theories can introduce new terms, or terms from the theories dominating earlier [11]. Exist both the general medical terms, and the specific terms used by representatives of certain medical specialities [151]. For example, "patogenez" - the term which can actively be applied by the therapist, the phthisiatrician, and the surgeon-oncologist, and "aura" - a word actively used mainly by psychiatrists or neurologists in a context of conversation on an epilepsy or a migraine. At medical lexicon in enough considerable quantity there are foreign loans: English, French [44] and, certainly, Latin [145]. Active application not only separate terms, but also word-combinations Thus find and
Phraseological units, for example, «lege artis», «minimum minimorum» which also can be heard from lips of doctors.

It is necessary to notice, that many, used medical terms were included into system of a natural language or became known the wide public thanks to the certain educational activity spent among the population, and also thanks to availability of public health services and popularisation of achievements of a medical science in the XX-th century. Today the inhabitant knows about a number of medical concepts (certainly, most widely used), for example, such, as «a hypertensive crisis», "intoxication", "tachycardia". The mite in popularisations of medical terminology have brought mass-media, and also the film industry, mentioning in the products medical subjects. However dialogue of two professional doctors nevertheless will not be completely clear to the inhabitant. For example, the story about «the stretched liquid sinovialnoj to a bag of the popliteal pole located in its medial department» [235, with. 45] will give to the person far from medicine, rather weak representations that occurs to it, what disease and in what stage he suffers, and also, how it is necessary itself for a message to recover.

Difficult kategorialnyj the device of professional medical language is acquired by the future doctors in the course of professional medical preparation and does not cause complexities at occurrence of the expert in a professional field. In the course of work with colleagues - physicians (doctors, the medical personnel) interaction is carried out in language of professional community that excludes occurrence of the communicative complexities connected with lexical asymmetry. At the same time in the course of work the doctor co-operates with the people who have addressed for the help, that is representatives not medical area. These people represent that audience to which the pedagogical educational should be addressed
Activity of the doctor. It puts experts before necessity of the decision of the pedagogical problem connected with search of ways of adaptation of speech of the doctor, its reduction to as much as possible accessible to understanding of the patient to a kind. Introduction in process of training of the patient of language propaedeutics can become possible way of the decision of the given problem.

The propaedeutics as a whole can be presented as «a preliminary circle of knowledge about something, introduction to a science» [150, with. 617]. She assumes a statement of a certain science in the compressed and elementary kind and precedes deeper studying of a certain subject [228]. The propaedeutics is carried out as a preparatory stage in studying of the phenomena at higher level [172], as the preliminary course stating in the systematised kind of data without which studying of the basic discipline [94] is not obviously possible. The language propaedeutics can be connected with training of children in formation of literacy [240], and also with logopedic work with children having infringements of speech [87]. Most actively the language propaedeutics is applied in frameworks lingvodidaktiki where it is connected with preparation of students for development of new knowledge, within the limits of teaching of a foreign language for the special purposes [5] lingvokulturologicheskoj to preparation at studying of a foreign language [241] etc. the Professional language propaedeutics also can be connected with introduction of the future expert in trade language, including, at a stage previous studying of a foreign language [89].

Within the limits of educational activity at work with patients we define language propaedeutics as the preparatory stage of educational work directed on formation at them of representations about the basic concepts, connected with maintenance of health and conducting an appropriate amount of a life. Such propaedeutics can be carried out as follows. For patients the small dictionary-thesaurus in which in an accessible kind will be can be made
The basic terms with which the patient should face during the further interaction the doctor are presented. Such dictionary can be printed in the form of the booklet and be given for independent studying to the patient. At occurrence of any questions, the patient can receive consultation of the doctor at a meeting and specify not clear moments for it. Following the results of the talks given with the patient the doctor can make the conclusion about, whether representation about terms which will be used further in the course of educational interaction was generated at the patient. If yes, the expert can pass to the basic stage of educational work if is not present - to continue the further propaedeutic work.

In the course of interaction of the doctor and the patient, including at realisation of pedagogical educational activity, presence of statusno-role asymmetry also is observed. Such kind of asymmetry is caused by specificity of a social situation of interaction of the doctor and the patient (V.I.Karasik) [86]. Researchers (V.V. Zhura, B.P.Krasovsky, B.O. Hoftvedt, etc.) notice, that the initiative in the course of communications, as a rule, belongs to the doctor: he solves when to begin and when to finish conversation when and how to set questions to the partner in communications [66, 100, 279]. As a matter of fact, the doctor and the person who has addressed to it, in the conditions of reception are allocated by the different social status which leaves traces including on course of pedagogical educational interaction.

From the point of view of social norms, the patient is offered to agree with recommendations of the doctor and to carry out them, otherwise communications with the doctor will be suspended. At the same time the patient can have opinion distinct from opinion of the doctor concerning ways of maintenance of the health [208]. In this case actual there is a search of ways of an establishment of productive contact between the doctor and the patient, search of such methods of speech influence, which
Would promote formation and maintenance of adherence to recommendations of the doctor and conducting the way of life conformable to preservation of health.

The account of the factor of the addressee. The success of the decision of pedagogical educational problems of the doctor in many respects depends on that, how much the patient is ready to understand those speech educational messages which to it are addressed by the doctor. In linguistics in such cases it is accepted to speak about the factor of the addressee - the factor of communications which assumes the account of features of the one to whom the message (V.I.Sternin) [214] is addressed. As a whole, that speech influence was more effective, it is recommended to consider quantity of people to which a certain speech message is turned, their age and gender features, their cultural-educational level and level of knowledge of language on which there is an interaction [214].

Analyzing features of speech communications of the doctor and the patient, V.V. Solozhenkin specifies in conditionality of speech statements individual culture as the patient, and the physician: both the expert, and the patient perceive words each other through a prism of own person that demands acceptance in attention of its features. The researcher recommends to the doctor to build speech communications with the person who has addressed for the help, taking into account following features: level kognitivnoj safeties of the person; cultural-educational level; language features (whether the patient in that language on which the doctor speaks speaks, or the translator is necessary); possibilities of acceptance by the person of responsibility for the health and a situation; a psychological condition (including presence of mental frustration) and psychological characteristics of the person (for example, uneasiness level) [208].

In the course of speech interaction of the doctor and the patient it is important to consider also, that many situations, phenomena, experiences about which the doctor speaks with the patient, are subjective enough. For example, «strongly is ill» - and «poorly is ill» - subjective categories which can be connected with

Specific features of the person, for example, the lowered or raised threshold of painful sensitivity, propensity to uneasiness or ipohondrichnosti. How much the phrase «strongly is ill» is identical in understanding of the doctor and the patient? As marks I.Hardi, about the phenomena of the physical world to speak much easier, than about experiences or the feelings, after all the first are more objective [232]. It is important to understand, that the language picture of the world of the patient differs an originality connected with its personal, emotionally-strong-willed, mental, kulturnoyoobrazovatelnymi by features that should be accepted in attention the doctor realising educational activity.

In our opinion, it is important to consider also, that the doctor co-operates with patients and their relatives in conditions for patients and them semejnoyorodstvennogo environments unfamiliar, difficult, unpleasant, that leaves the mark. The emotional condition of the person, presence of unpleasant somatic experiences can affect a way of perception of the information received from the doctor: the information part can have no time for the end is understood by the patient, the part - is deformed. According to L.P.Urvantsevu and L.M.Bedrinu, during speech interaction with the patient the doctor can solve following problems: removals at sick pressure, fear, alarm; « Stimulations of the patient »to the story about the condition; settlements of conflict situations; optimism suggestions. Also the doctor can realise empathy function through speech; to specify to the patient in errors in representations available for it about a disease picture; to motivate to observance of instructions; to adjust mutual relations and to regulate a direction of conversation [19].

L.P.Urvantsev and L.M.Bedrin is given by following recommendations for effective language interaction with patients or their representatives: not to interrupt the interlocutor, to spend careful selection of words, to consider specificity of an internal picture of illness, motivation
Persons, features of temperament and character, emotionally-strong-willed sphere of the person, kognitivnyh and speech abilities [19].

In the course of interaction of the doctor and the patient it is important to take also into consideration level of awareness of the patient about a condition of its health or about disease [19] available for it, and also the general level of medical literacy of the patient [208]. For example, on reception to the doctor the person also having the higher either average medical education, or "skilled enough" patient having chronic disease and owing to the condition many knowing about principles of treatment can come. At the same time it is important to consider, that such people not always can have adequate representations about own health or about illness [208]. The account of level of medical literacy of the patient in the course of realisation of educational activity, on the one hand, allows to adapt speech of the doctor for level of readiness of the patient, with another - gives the chance to correct wrong representations available for the patient about zdorovesoobraznom behaviour [19].

As a whole, realising pedagogical educational work, it is important to doctor to understand, that in the course of educational activity there is a meeting with Another, with the person, a meeting with the separate person having own experience, representations and experiences [260]. As M.Fisher and J ironically mark. Iro (M. Fisher, J. Ereaut), to the doctor it would be much easier, if the patient began to think and speak, as the doctor if the patient possessed the same cogitative and language konstruktami, as the physician. As a matter of fact, authors speak about widespread desire of experts to "level" a picture of the world of the doctor and the patient, "having tightened" the patient on level of the doctor [270]. But whether it is possible to the full? In this case the educational pedagogical work spent with the patient, can generate at the patient competent representations about a condition of its health and about how it is necessary itself for a message that it to keep. In too time, it is important to understand, that the patient remains the carrier
"patsientskogo", instead of "professional" consciousness. It should be accepted in attention at realisation by the doctor of educational activity.

The certain organizational restrictions connected with regulations of a medical institution leave traces on realisation of pedagogical educational activity of the doctor. Regulations of reception of patients - a significant organizational condition of functioning of any medical institution, influencing, including, on realisation of pedagogical educational activity of the doctor. The expert for short enough interval of time which has been taken away for work with the patient, should be in time not lead educational discussion, but also carry out diagnostics and define treatment tactics, and also issue reception documentary.

The regulations of reception of the patient can differ depending on a speciality, disease and medical institution type. So, in a polyclinic on primary survey of the doctor-therapist and the pediatrist (taking into account filling of medical documents and, actually, medical interaction - survey, diagnosis statement, etc.) 15 minutes [174] are taken away. The Doctor-cardiologist can accept the patient within 24 minutes, endokrinolog - 19, the stomatologist - 44 minutes [173]. If the doctor works in clinic or in system, where can observe the patient long time (for example, on hemodialysis branch), the time regulations of work with the patient can be another and are defined by internal instructions of medical institution. Thus realisation of educational activity should not be carried out to the detriment of another by duties of the expert. Thus, it is obvious, that the educational speech messages of the doctor addressed to the patient, should be short enough and laconic, thus - capacious on sense. In the given context important there is a search of ways of rendering of educational speech influence,
Which would allow to reach the put pedagogical purposes in short enough time piece.

Bioethical and etiko-deontologicheskaja an orientation of speech influence at realisation of pedagogical educational activity. Besides duty regulations and instructions on time rationing, professional work of the doctor and all system of its interactions with subjects of professional work is regulated by a complex bioethical and deontologicheskih norms. These norms through penetrate each professional function of the expert; not an exception is also the speech aspect of educational work of the doctor.

How the doctor should conduct itself that should not speak - at documentary level all it is regulated by methodical recommendations of Ministry of Health, the ethical code regulating behaviour of the doctor, the arches of rules of labour behaviour. Special attention of professional community and the wide public to necessity of such regulation is connected with those risks and calls about which it was spoken in paragraph 1.1. Also it is directed first of all on preventive maintenance jatrogeny - the conditions caused by incorrect actions of employees of system of public health services, connected with a tresspass to the patient during preventive, diagnostic, medical influences [134].

The researchers, prosecuting the given subjects, notice, that is important not only preventive maintenance jatrogeny in sphere «invazivnogo interventions» (for example, in the form of sterilisation of medical tools), but also in sphere of interaction with the patient, as with the person. According to V.M.Sedovu and V.J.Bibikov, jatrogenii are considered as a consequence not only actions, but also statements of employees of medical institutions in execution of the professional duties by them [196]. S.V.Dyachenko with co-authors, considering classification jatrogeny, allocates in them
Special kind infringement of regulations of mutual relations with the patient, insufficient informing of the person on disease and treatment possibilities is information-deontologicheskih jatrogeny to which carry besides disclosure of medical secret. Also, considering this kind jatrogeny, the author speaks about the importance of the account of specificity of words used by the physician and about possibility of their wrong interpretation [61].

Certainly, one of the base requirements shown to speech behaviour of the doctor, - observance of rules of speech etiquette and the politeness providing success of communications [16]. It is obvious, that the reference to the patient, its representatives should be valid and polite, and familiarity in dialogue is inadmissible [40] as ironicalness or playfulness [86] is inadmissible. At the same time, in spite of the fact that dialogue of the doctor and the patient should be official, it should not be too distantsirovannym. It is caused, first of all, by necessity of maintenance of the emotional atmosphere promoting preservation of trust between participants of medical process [86].

Significant is intentsionalnaja an orientation

Educational interaction with the patient: it should be carried out in the blessing and in interests of the patient, thus not to be manipuljativnym [283, 289]. In this connection important the requirement of observance of confidentiality concerning operating by the information, significant for the patient is represented, that also corresponds with norms of ethics and deontologii [293]. Also does not raise the doubts an interdiction for damage drawing sick of words or their maintenance [40].

Pertinent at carrying out of educational conversation use by the doctor correct and at the same time clear is represented to the patient of terms, especially when everyday words will have negative konnotatsiju. Such speech behaviour will allow to avoid social stigmatizatsii, connected with certain states of health that corresponds with preventive maintenance jatrogeny. For example, A.

Meadows recommends to experts to use a word-combination

"Excess weight" instead of a word "adiposity" [287].

Thus, it is possible to conclude, that the pedagogical educational activity realised by the doctor, and its speech component should correspond with an imperative "do not do much harm". Owing to that speech of the doctor can influence strongly enough the patient, realisation of educational speech influence should be regulated by norms of bioethics and deontologii. Speech influence - the extremely powerful tool which can influence strongly enough consciousness, behaviour, lives of people to which it is turned. For this reason it is important, that educational speech influence which the doctor renders on the people who have addressed for the help, it has been turned by it into the blessing. Therefore the doctor, realising speech influence on the patient, should be guided by such professionally significant personal quality, as ability to bioethical thinking and behaviour.

Described above feature of speech interaction should be considered at planning and realisation by the doctor of pedagogical educational activity. Certainly, the account of all designated by us above laws of interaction of the doctor and the patient, and also the data received by clinical psychology, sociology of medicine and other sciences studying specificity of behaviour of people concerning own health is important. The considered researches shine mainly work directly with patients. But interaction of the doctor with the nearest family-related environment of the patient or its representatives also demands certain educational support [220, 280, etc.]. In our opinion, in case of interaction with the nearest environment of the patient, representatives of group of risk on health and healthy people, within the limits of pedagogical educational activity also it is necessary to consider all features set forth above.

On the basis of the above-stated it is possible to draw a conclusion that educational speech interactions of the doctor and the patient is not reduced to use of set of morphemes, word forms and offers. It is under construction according to norms and regulations of statusno-role relations accepted in public health services sphere. It allows to treat educational speech influence of the doctor as diskursivnoe formation, original «a speech concrete definition» in the specific sphere of human existence connected with medicine (V.I.Karasik) [86, with. 193].

As a whole, the following factors promoting realisation by the doctor of effective educational activity, directed on formation at patients or representatives of their nearest family-related environment of representations about regulations zdorovesoobraznogo behaviour can be allocated. The appropriate communicative behaviour of the doctor should correspond with features of a medical discourse. The expert should possess language competence and communicative literacy which allow it to use properly language and vnerechevye influence forms on the patient. The specified qualities (appropriate communicative behaviour, language competence and language literacy) should be formed at the doctor in the course of it dodiplomnoj (at level spetsialiteta) and poslediplomnoj preparations (at level of internship, improvement of professional skill).

Thus, the doctor within the limits of pedagogical educational work solves a problem of formation at the patient of the representations connected with regulations zdorovesoobraznogo of behaviour. It represents a kind of activity of the person and system of its mutual relations with the world around, promoting the most harmonious life in the tideway of preservation and maintenance of the health at the greatest possible level for the given person. During such activity the doctor broadcasts the actual information for the patient, concerning its psychosomatic condition in the present and the future, ethical aspects of such behaviour; renders
Purposeful influence on intellectual sphere of the patient also changes a format of its behaviour in necessary for preservation of health a channel.

Specificity of speech influence of the doctor on the patient during the decision of this problem consists in the following: partially artificial character of professional medical language, presence lexical and statusnoyorolevoj asymmetries, necessity of the account of the factor of the addressee (personal, socially-psychological and other features trained - the patient), presence of the organizational restrictions connected with regulations of a medical institution, bioethical and etiko-deontologicheskaja an orientation of speech influence of the doctor in the course of realisation of pedagogical educational activity. These features should be taken into consideration in the course of realisation of the pedagogical educational activity focused on formation zdorovesoobraznogo of behaviour of the patient.


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A source: Vatskel Elizabeth Aleksandrovna. the Lingvodidaktichesky component of educational activity of the doctor. The dissertation on competition of a scientific degree of the candidate of pedagogical sciences. Moscow - 2018. 2018

More on topic an originality of speech influence of the doctor on the patient during the decision of an educational problem of formation of representations on regulations zdorovesoobraznogo behaviour:

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  3. approbation of algorithm of educational speech interaction of the doctor and the patient
  4. 2.2. The theoretical bases and algorithm of forming by the doctor of speech interaction with the patient in a context of realisation of educational function
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