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

Each text can be considered as the case of the educational speech messages entering into its structure. We will consider their essence and specificity.

The educational text contains a complex of "smaller" speech educational messages, specific statements of the doctor, each of which represents certain «atom of educational sense» and bears in itself the information about zdorovesoobraznom behaviour.

Each of such messages can include one or several offers united by uniform sense. For example, some offers on how it is important to keep to a diet in the conditions of the specific disease, one of which will be the core on sense, and the others - concretising or illustrating, will represent one educational speech message. We will try to make working definition to such message.

The educational speech message is the statement penetrated by the uniform purpose or set of the statements bearing in ability to influence, capable to change the relation, vision, understanding of, another, the world in whole (in the given work it is a question of change of understanding by the person of the educational information, concerning features of a physical condition and the recommended model of behaviour connected with health).

Educational pedagogical texts and speech educational messages containing in them should not be created spontaneously by the doctor in the course of interaction with the person who has addressed for the help. They should be thought carefully over, in appropriate way are structured and substantially filled. Such speech messages,
Entering into the educational text, should be built on the certain, specially developed algorithm on the relevant theoretical bases.

Unfortunately, doctors, as a rule, are not trained in such work with texts that leads to problems during realisation of educational function. Despite active enough studying of various aspects of teaching of language and a standard of speech for students of medical high schools (Bashkueva, Etc., ZHiljaeva, A.V.Korobkova, the Island And, the Queen of Island L, A.S.Hehtel, etc.) [18, 65, 98, 99, 234, etc.], the problematics connected with search of the theoretical bases of rendering of speech influence on the patient in the course of realisation of educational activity for today did not become a subject of detailed scientific and pedagogical studying. There are no doubts that without it it is impossible to carry out effective influence on intellectual and behavioural spheres of the patient. It causes an urgency of vocational training of the doctors connected with questions of speech influence on the patient in the course of realisation of educational activity.

It is necessary to understand, that the educational activity realised by the doctor - difficult process, it is not reduced exclusively to mechanical to "scoring of principles of a healthy way of life». The doctor should make the whole complex of actions: beginning dialogue, definitely to come into contact to the trained patient, to answer questions arising at the patient, to supervise level of knowledge of interaction trained at different stages etc. However the basic educational function will carry out actually educational text which should affect consciousness of patients, and further - on their behaviour. Such text can include various kinds of messages: some of them can inform the patient, give to it necessary for conducting zdorovesoobraznogo a knowledge way of life.

A number of other messages can be focused on
Motivation formation zdorovesoobraznogo a way of life, belief of the patient to follow to recommendations of the doctor, suggestion of principles zdorovesoobraznogo behaviour.

Necessity of such complex influence is caused by that fact, that the people addressing for medical aid, are often enough far from conducting zdorovesoobraznogo a way of life. They can not have the knowledge necessary for maintenance of the health at optimum high level, corresponding installations and motivation. Therefore before the doctor there is not simply a problem connected with "broadcasting" of bases of regulations zdorovesoobraznogo of behaviour, but also a problem connected with rendering of speech influence on the patient. The importance of similar influence is in many respects caused by complexities of formation at patients komplaensa.

Komplaens - the concept having set of definitions. Most often it is understood as: adherence to treatment [104]; therapeutic cooperation [55]; cooperation of the patient with the doctor and acceptance of its recommendations; [232]; the consent with treatment [164]. According to definition of the World organisation of public health services, komplaens represents degree of following of the patient to medical instructions and recommendations [251]. Komplaentnyj the patient regularly fulfils requirements of the ordered therapy: accepts necessary medicines, the Pedagogical activity directed on formation komplaensa at patients observes recommendations about a diet, impellent activity, refusal of bad habits etc., assumes the account of set of factors: kliniko-psychological, socially-psychological,

Cultural, gender [251]. Certainly, at it is and lingvodidakticheskoe measurement: the doctors who are engaged in educational activity, should be able to apply language as the tool of educational influence.

Lingvodidaktika traditionally it is understood as the scientific pedagogical branch investigating questions of mastering by language in the course of training.
There are following variants of interpretation of this term: as general theory of training to language (studying theoretical and methodological bases of this process); as complex of the theoretical and practical questions connected with teaching of language; as the applied linguistic discipline connected with training to a foreign language [4]. In a context of actual work professional language of the doctor is considered as language distinct from language of the patient and frequently not clear to the last. As a matter of fact, in work questions of training of doctors to interaction with patients by means of language are brought up. Thus, the term "lingvodidaktika" is used in wider understanding - primenitelno to process of pedagogical interaction of subjects of medical process (the experts using strict, regular medical language and patients, having not regular fragmental representations).

The problematics described above does especially actual search of the relevant theoretical bases for working out of pedagogical educational speech messages which would allow to change consciousness and behaviour of the patient. Practically, in this case questions of speech influence are mentioned. For today, despite interest of researchers to a phenomenon of speech influence, it is difficult to reveal a certain uniform approach to its analysis. The given phenomenon is investigated in various areas of knowledge: sociology, political science, the theory of communications, psychology, linguistics. Thus scientists notice, that speech influence can find the application in various areas of a life, including - in pedagogics [239]. At the same time lingvodidakticheskie aspects of speech influence of the doctor on the patient for today remain not opened.

In modern linguistic researches exists following points of view on a phenomenon of speech influence:

- It is represented identical to any speech dialogue, or is considered more narrowly - as propaganda influence, including, in mass media [219];

- Speech influence is understood as the socially-focused kind of speech contacts between people (first of all, connected with a mass communication, propagation etc.) [117];

- It is defined as the sphere of communicative activity realised by the person including both oral and written speech, and possible elements autokommunikatsii; such activity assumes influence on reorganisation of consciousness of the addressee, change of its relations, a psychological condition; [162, 163];

- It appears as influence on individual or collective consciousness, which is realised by means of addressing of messages in a natural language (or by means of other semiotics codes) [154];

-It is considered as directed on achievement of definite purposes influence on retsepienta (or group retsepientov) by means of speech and nonverbal means of dialogue; the purpose of such influence is the belief meaningly to accept the certain point of view [215];

-It is defined as influence on the addressee, focused on change of its personal senses, kategorialnyh konstruktov, behaviour and a psychological spirit (possibility of influence both by means of linguistic thus admits, and by means of paralinguistic and not linguistic means) [239].

Having analysed these definitions of speech influence, we offer following working definition of the given phenomenon (in a context of the educational activity realised by the doctor). Educational speech influence of the doctor on the patient - the influence which purpose is change kognitivnoj and behavioural spheres of the patient by means of addressing to it of specially developed educational speech messages. The essence of such influence consists in understanding change

The questions connected with preservation of health and the further change of a format of behaviour of the patient.

In the course of educational work it is necessary for doctor to invest speech messages with certain sense with such form which would allow to influence consciousness and behaviour of the addressee of the message. How it can be made by means of language? After all, in essence, in this case attempt definitely is undertaken to change separately taken element of a reality connected with the person, having (really or potentially) problems with health.

It puts before us, as a matter of fact, philosophical questions. Whether speech by simply process of pronouncing of sounds, process of ascertaining of any facts, or speech - a way of transfer of senses is? Whether it can change the validity? If yes, these changes occur through any time piece, or already statement at the moment of the pronouncing can change an existing state of affairs? How by means of speech it is possible to affect the person?

Search of answers on these, as a matter of fact, philosophical questions, became a subject of research attention of the scientists who have created the theory of speech certificates. Within the limits of the theory of speech certificates the question on, how by means of speech certificates (speech acts - J was considered. Austen; speech acts, linguistic acts language acts - J. Searle) it is possible to influence both people, and on a reality in a more comprehensive sense. Founders of this theory are philosophers John Ostin (John Austen) and John Serl (John Searle), their followers shined various aspects of the given theory, created own classifications of speech certificates.

The thought, that is represented quite natural, and even ordinary, having said the certain statement, it is possible to surprise, please, frighten, warn, threaten etc. In effect, at realisation of all aforesaid, the person makes a certain speech certificate - «the purposeful speech action made according to

Principles and the rules of the speech behaviour accepted in the given society »[247, with. 412]. Speech certificates, according to the researchers who are engaged in philosophy of language, also make a basis of language dialogue [254, 298]. The basic sign of the speech certificate is it

Purposefulness: the speech certificate has the purpose for the sake of which execution it is made [50].

Whether initially the founder of the theory of speech certificates John Ostin has asked a question «probably to create a reality by means of words?» . Its book «the Word as action» (How to do things with words [254]), the abstract of its lectures which was published in 1962 became the answer to this question. Noticing, that research of statements only from positions of the validity or lozhnosti narrows a circle of research problems of philosophy of language, the scientist has assumed, that there are statements with which help actions can be made. According to J. To Austin, the part of speech certificates can change a reality directly at the moment of their pronouncing. For example, in the course of wedding, "Yes", told by both participants of ceremony, and also «I Declare you the husband and the wife» transfers people to a new civil condition and changes their status. That is in a situation considered by us pronouncing of several statements changes a reality. Such statements the researcher named performativnymi statements or performativami - the statements which pronouncing carries out not description function, and function actually action performance (from English to perform - to execute, carry out - a verb used in a combination to a word action [254]).

That some statement became performativom, it is necessary not only pronouncing of specific words, but also special conditions of course of the speech certificate. Important not only observance of conditions of the certain communicative situation, corresponding desire and intentions, and also the status of participants of a situation; procedure should be executed correctly and completely. Otherwise, at
Non-observance of the listed conditions, performance performativa will turn back communicative failure - "misfire" or "abusing". Hardly the offer «I Declare you the husband and the wife», said by the seller of shop and addressed to buyers, will change the matrimonial status of the last, after all neither a situation, nor the social status speaking, desire of buyers - mismatch the said. At the same time, this statement said in a registry office, the person allocated with powers, after corresponding statements of the groom and the bride, come there for the purpose of wedding, - will change. Thus, as marks J. Austin, as a rule, cannot be made performativ exclusively by means of words, for this purpose certain additional actions also can be demanded. The scientist results following examples: at gift donation, it is necessary not only to tell: « I give », but also, actually, to hand over a gift, and, for example, at the vessel name - to break about his nose a bottle [254]. And in an example considered by us earlier with wedding, besides pronouncing of actually necessary phrases, in territory of the Russian Federation it is necessary to make corresponding papers.

That it was possible to name the statement performativom, it is necessary to observe one more condition. Performativ assumes action realisation by a certain actor directly at the moment of statement pronouncing. That is, it is possible to conclude, that for performativa the figurative formula «I - you - here and now» [184 is characteristic, with. 107, 229], otherwise, the statement will be konstativom. We will compare, for example, statements «I Name this ship« Eagle »(said by the emperor) and« It has named the ship "Eagle" (said by the historian). The difference between performativami and konstativami as a matter of fact is identical to a difference between making and govoreniem [30]. In the first case observance of the offered scheme and necessary conditions conducts to change of a reality by means of statement pronouncing. In the second case we can observe only the event description.

To solve problems which can arise at attempts to differentiate performativy from other statements, John Ostin has offered the following. The scientist has suggested to consider the speech certificate in the structural relation as certain whole, including three components: lokutivnyj (from an armour. locutio-govorenie), illokutivnyj (from an armour. inlocutio - in process govorenija), perlokutivnyj (from an armour. perlocutio - means govorenija). Lokutivnym the certificate Austin has suggested to name direct the certificate govorenija, pronouncing of the certain statement with a certain sense, value, in traditional understanding. Thus statement pronouncing, as a rule, is accompanied by certain force which the author names conventional (speaking, we inform, we warn, we advise, we convince etc.) . Thus, as a rule, fulfilment lokutivnogo the certificate simultaneously is also fulfilment illokutivnogo - assuming giving lokutivnomu to the purposefulness certificate. Illokutivnyj the certificate always has a definite purpose, it is distinguished by special effect. Successful such certificate will be only in the event that leads to certain result. At the same time illokutivnye certificates should be distinguished from perlokutivnyh certificates which are connected directly with reception of results by means of speech influence. In the event that the person to whom a certain speech message has been addressed, has changed the behaviour, it is possible to speak about perlokutivnom aspect of the speech certificate. [254]. As a matter of fact, perlokuktivnyj the certificate is connected with statement consequences, with reaction of the addressee to speech influence [133].

Interpretation of the uniform speech certificate as «trehurovnego formations» [133, with. 57] it is possible to consider on a following example. Offer pronouncing: «You should descend to the doctor» - actually, lokutivnoe the statement. That fact, that I convince the friend to address to the doctor, allows to consider the statement as illokutivnoe: in this case, it represents belief attempt. The assumption, that
My friend will address to the doctor (that is prospective consequences of the statement said by me) represent it perlokutivnuju a component. Perlokutivnyj the aspect of any speech certificate means its comparison to result (for example, whether the addressee of the message has made to what it induced) [133].

Certainly, the researcher considered so-called «ideal designs","pure types» various speech certificates. Austin noticed, that in an "ideal", "pure" kind illokutivnye designs in itself do not change the world (though, at successful performance, they have certain effect). However it is important to understand, that in a life the side between the described kinds of speech certificates can be rather conditional. As underlined Austin, illokutivnye certificates are often connected with effects, and in it their difference from effect product that is the characteristic perlokutivnogo the certificate. Therefore the scientist considered, that it is necessary to distinguish the statements having perlokutivnuju the purpose from statements, having perlokutivnye consequences: illokutivnyj the certificate, unlike perlokutivnogo changes something in a natural order. Austin also noticed, that some perlokutivnye statements have illokutivnoj no formula. For example, having told something, it is possible to upset or surprise the person, but it is impossible to tell: « I upset you "," I surprise you »etc. [254]

Thus, it is important to understand, that division into the specified three components has nevertheless conditional enough character as these components of the speech certificate inseparably linked with each other, and the analysis of each concrete statement represents an original philosophical problem.

In attempt to solve a classification question illokuktivnyh certificates as Austin, and the further followers, developed own taxonomy illokutivnyh certificates. Following classes enter into the taxonomy developed by Austin: verdiktivy, ekzersitivy, komissivy, ex-positives, behabetativy [254].

Verbs by means of which a certain verdict (for example, in speech of judges, arbitrators) is taken out enter into a class verdiktivov. Thus such certificate is not executive («executive»), and is faster, judicial («juridic). To a class verdiktivov, the philosopher, for example, carries such verbs how to recognise as innocent, to estimate, accuse, regard etc. [254].

Ekzersitivy are connected with realisation of force, the right, the power, influence: with their help the decision that something should be made can be sounded. The author notices, that judges and arbitrators, for example, actively use ekzersitivy along with verdikativami. As examples, following verbs can be considered: to appoint, discharge, demand, declare opened, to authorise etc. [254].

Komissivy - a class illokutivnyh the certificates, bound with by promise or the agreement, acceptance of certain obligations. With the help komissiva the speaking undertakes to execute a certain course of actions. As an example used in komissivah verbs the following can serve: to promise, accept obligations, to be going (to make something), to swear, plan (to make something), to intend to make something etc. [254].

Behabetativy - rather diverse group connected with mutual relations of people and social behaviour (apologies, congratulations, a praise, prokljatja, threats etc.). They mean reaction to behaviour of other people or the relation to behaviour of any person (group of people). For example, to express gratitude it is possible to use a verb I "thank" to ask pardons, to use accordingly I am sorry", etc. [254].

Ex-positives - rather difficult group in the definition, connected with a statement of opinion or a relation designation (for example to "recognise,"assume, "demand,"doubt, "confirm" etc.). According to Austin, the most difficult classes in respect of differentiation are behabetativy and ex-positives as they are diverse enough and diverse. [254].

J. Serl (J. Searle) has acted, on the one hand, as the continuer of the theory of speech certificates of Austin, with another - the critic of some positions of the predecessor. The philosopher assumed, that basic unit of human dialogue is the speech certificate, instead of symbols, words or offers [298]. According to Serlja as soon as we mention a question on language dialogue, we speak not simply about pronouncing of sounds or a writing of symbols, namely about fulfilment of the certain certificate [298]. The philosopher suggests to consider any statement from the point of view of intention of the person, its saying: the word, in itself, contains sense (meaning) while the person means the speech certificate, that, making something has it in a kind (meant) (J. Searle). We will notice, that, as well as Austin, Serl paid essential attention and to a context of the speech certificate [298].

According to J. Serlju, basic, minimum unit of dialogue by means of language is illokutivnyj the certificate. The researcher has offered the changed model of structure of the speech certificate, including following components:

- Lokutivnyj the certificate (that is actually pronouncing of a certain statement);

- propozitsionalnyj the certificate, that is the judgement statement (which can be divided into the certificate referentsii and the certificate predikatsii);

- Illokutivnyj the certificate (that is giving to the statement of a certain intention);

- Perlokutivnyj the certificate [133, 298].

The researcher has suggested to distinguish actually illokutivnye certificates and propozitsionalnoe the maintenance illokutivnyh certificates. Carrying out illokutivnyj the certificate, it agree Serlju, speaking makes the certificate referentsii (that is names a certain phenomenon, carries this phenomenon to the world) and the certificate predikatsii (that is a number of certain properties attributes to this phenomenon). In offer Serl allocated propozitsionalnyj an indicator and an indicator
illokutivnoj forces. The first - is a judgement indicator, he says that a certain subject «is entered in the world» and can be characterised words. The second gives the chance to define, how it is necessary to perceive a certain judgement (whether it is, for example, the request or the order), that is gives the chance to define, what illokutivnuju force has the statement which illokutivnyj the certificate makes speaking [298].

In article «That such the speech certificate» (What is a speech act) the researcher has directed the attention to the description of the conditions necessary for fulfilment of certain kinds illokutivnyh of certificates, and also rules which would allow to mark them [298]. Serl believed, that success of the speech certificate is possible only in the event that all components of the speech certificate are successful. At level lokutsii the statement should be correctly issued from the point of view of grammar and syntax; at level propozitsionalnogo the certificate - to be true or false; at level illokutsii - to be successful or unsuccessful; at level perlokutsii - successful or unsuccessful [133].

The active research attention of the philosopher has been turned on taxonomy working out illokutivnyh certificates. Basis for creation of such taxonomy of a steel: illokutivnaja aim (sense) (illocutionary point), a conformity direction (direction of fit), and an expressed psychological condition (expressed psychological state). As a whole, the philosopher has offered 12 measurements on which illokutivnye certificates can differ from each other [297]:

1. Distinctions in the purpose (or sense) the certificate. For example, the order purpose - attempt to achieve that the one to whom the message is turned, has made something; the description purpose - reprezentatsija a certain state of affairs; the promise purpose - to take the obligation before listening to make something. The author marks, what not everyone illokutivnoe the statement has perlokutivnye the purposes, and at many illokutivnyh its certificates are not present, for example, the promise or the statement not
Contain perlokutivnyh intentions. As a whole, as marked J. Serl, the purpose - one of components illokutivnoj forces of the statement.

2. Distinctions in an adaptation direction (a conformity establishment) between words and the world. One illokutivnye statements comprise attempt to correspond to the world, others are directed on that the world has started to correspond to the certain statement. For the purpose of an explanation of this position, the author cites as an example a situation when a certain man, goes behind purchases with the list made by the wife. In this case, the buyer brings the world into accord with statements (we will assume, in conformity with the message «to buy bread»). In the event that in the statement there is a certain change or an error (for example, instead of "bread" it it is written "tea") the reality will change, and he will buy tea. If after this man to start up a certain detective who would write down actions of this man the detective would bring the statements into accord with a reality. And if he has written down "tea" instead of "bread", (while bread has been bought) it would become an error which could be corrected, having corrected records of supervision.

3. Distinctions in expressed psychological conditions. As marks

John Serl, the person whom something explains, declares or confirms - expresses certain belief; the person who promises, swears, threatens, etc. - expresses intention something to make; the person,

Ordering, the commander asking - expresses desire that somebody has made something; the person who has made something bad, expresses a regret, that it has committed it. Thus the philosopher notices, that attempt to construct a certain classification exclusively on the basis of a spectrum of expressed psychological conditions is difficult and labour-consuming.

(illokutivnuju the purpose, a direction of conformity and sincerity of an expressed psychological condition) Serl pawns the specified three measurements in a basis of the taxonomy. He marks also some more the important measurements necessary for its creation:

4. Distinctions in force (intensity) with which it is presented illokutivnaja the statement purpose (its sense). For example, «I offer» and «I insist» specify in different intensity of how in the statement it is presented illokutivnaja the purpose.

5. Distinctions in the status or a position speaking and listening, in relation to illokutivnoj to force of the statement. For example, the person who is above on a rank, will issue the order, and the person equal on a rank, social position etc. - the request more likely (an example the same phrase turned to the soldier by other soldier or the general) can serve.

6. Distinction in how the statement corresponds with interests speaking and listening (for example, distinctions between the complaint and boasting).

7. Distinctions in relation to other discourse. Some performativnye statements correlate the statement to other discourse and a context surrounding it. Following them "however", "thus" etc. carry out function of correlation with a discourse.

8. Distinctions in propozitsionalnom the maintenance, caused by indicators illokutivnoj forces (for example, the prediction is a certain statement about the future, and the message or the report - the statement already about the last event).

9. Distinctions between certificates which necessarily should be speech certificates, and those certificates which can be, but unessentially should be speech. As marks J. Serl, it is possible to estimate something, to conclude something or even to make the diagnosis, not saying words.

10. Distinctions between certificates which demand presence of additional extralinguistic attributes, and those certificates which do not demand them. For example, that war has been declared, the person, its declaring should have the corresponding status (as well as in the example considered some earlier, war cannot be declared the seller of ice-cream).

11. Distinctions between certificates in which illokutivnyj the verb is used in performativnoj to the form, and certificates where a similar picture it is not observed. As the most part of verbs performativna marks Serl, in illokutivnyh statements, thus, having told them, it is impossible for that to execute a certain action. Thus, not all illokutivnye verbs are performativnymi.

12. Distinctions in style of performance illokutivnogo the certificate. For example, «to declare publicly» and «to inform on a secret» - differ on style of realisation illokutivnogo the certificate [297].

Thus, J. Serl describes various kinds illokutivnyh certificates: questions, predictions, requests, orders, expressions of intentions, desires. The indicator ilokutivnoj functions gives the chance to do conclusions concerning treatment of certain judgement: for example, whether is it the order, the statement, the request, the assumption. In a natural language as an indicator illokutivnoj functions the list of used verbs acts, first of all. Besides it, to them verb inclinations, the intonational form, a word order in the offer, punctuation registration [30] can be carried also.

Criticism Serlem of the taxonomy developed by Austin, is connected by that last offered lists of verbs while Serl has passed to the list illokutivnyh certificates within the limits of the taxonomy. Following classes have entered into classification Serlja illokutivnyh certificates: reprezentativy, instructions, komissivy, express willows, declarations.

Reprezentativy - the separate class which is based on concept illokutivnoj the purposes. Illokutivnye certificates from this class allow to fix responsibility speaking concerning some state of affairs, in particular its validity or lozhnosti. The elementary test for definition reprezentativov is possibility of an estimation of the statement as true or false.

Instructions - a class, propozitsionalnoe which maintenance is connected with fulfilment by the addressee of a certain action. In this class such verbs are used how to "order,"ask, "order,"beg"etc.

Komissivy consist in putting on by the author of the statement of obligations concerning certain behaviour in the future - for example, a characteristic verb in such statement the verb will "promise".

Express willows are focused on the illokutivnoj to force on expression of a certain psychological condition. At creation ekspressivov such verbs are used how to "thank,"regret, "welcome". Express willows are not connected with attempt to adapt world around under themselves or will adapt to it.

Declarations (as a matter of fact, that Serl names declarations, at Austin it has been included in a class performativov) make changes to the status speaking or definitely change the validity at the expense of success of the fact of declaring. As examples Serl offers following statements: «you are dismissed», «I declare war» etc. [297].

There are also other attempts of classification of the speech certificates, undertaken by followers of the given theory (D.Vunderlih, J. Lich, by N.I.Formanovsky, etc.), however, uniform taxonomy of speech certificates to this day it is not created [132, 133].

Following the results of the short characteristic of substantive provisions of the theory of speech certificates, it is possible to come to conclusion, that, saying certain statements, we can influence the addressee of the message in a special way. Within the limits of the given research we will stop on questions of applied use of the theory of speech certificates for increase of efficiency of educational pedagogical activity of the doctor. We will consider the above described positions of the theory of speech certificates in a context of problems of our work. The central question which us interests how by means of words and statements to change a reality? In practical application to our work: as by means of certain statements
To change consciousness and behaviour of the people having problems with health, and to direct its vector towards observance zdorovesoobraznogo a way of life, that is to solve lingvodidakticheskuju a problem?

Our basic idea consists that definitely issued statements of the doctor can change a reality in a following key: to influence change of consciousness of the patient which can lead further to behaviour change. These statements we name educational speech messages, they possess ability to influence the patient, capable to change the relation, vision, understanding of, another, the world as a whole. We will try to characterise in more details educational speech messages in a context of the considered theory of speech certificates.

As «the central moment» speech certificate is illokutsija (V.I.Karasik) [85, with. 49], it is important to define, what aim this or that educational message. Educational messages can influence on - a miscellaneous the patient and the validity surrounding it: to inform, convince, stimulate to performance of certain actions; on occasion the fact of their pronouncing can change definitely the validity (for example, the treatment schedule). It is important, that the author educational messages (doctor) understood, for what purpose he says this or that statement, accurately realised, that he wishes to achieve, addressing to the patient this or that message.

In that case, when the patient will receive competently made (from the grammatical, syntactic point of view) the message at which drawing up the doctor was guided by definite purpose achievement (for example to inform the patient to convince it etc.), we can say that educational interaction corresponds with lokutivnoj and illokutivnoj components of the speech certificate. In the course of realisation of educational activity the doctor wants, that the patient has understood something about regulations zdorovesoobraznogo behaviour; in the event that the patient
Has acquired necessary knowledge and has changed a format of the behaviour, we can speak about correlation of educational interaction with perlokutivnoj to a component of the speech certificate. Thus, at realisation of educational interaction of the doctor and the patient the structure of the speech certificate offered in J is completely considered. Austin.

Let's characterise it in more details. Hereinafter we suggest to consider educational activity and educational speech messages on an example of work with the people receiving replaceable therapy by a hemodialysis - the difficult, exhausting treatment demanding from the patient change of style of a life. By working out of educational speech messages for people with other problems with health in the substantial plan, certainly, it is necessary to consider features of their disease.

Chronic illness of kidneys of V stage (HBP V stages) - the chronic disease characterised by terminal nephritic insufficiency and necessity of constant treatment. Such disease causes necessity of replaceable therapy which kidney transplantation concerns, a hemodialysis, peritonealnyj a dialysis [139]. Necessity of treatment by means of a chronic hemodialysis enters the patient into new conditions, conditions of "the special specific form of a life» [33, with. 29], when replaceable therapy by means of a haemofiltration (vnepochechnogo blood clarifications) is one of major factors of maintenance of ability to live of the patient. Treatment by a hemodialysis should occur on the regular basis, not less than three times a week and to last not less than four-five hours [71]. This disease bears vitalnuju threat, that is the life and health of the patient depend on a mode of visiting of sessions of therapy and strict performance of medical recommendations [36, 165].

This disease is connected with necessity of change habitual for a sick way of life [165], efficiency of therapy in many respects depends on the patient and its behaviour [299]. The person having such diagnosis, should keep to strict enough diet, a vodno-drinking mode, a mode
Visitings of medical procedures to accept a significant amount of medicines [32, 36]. In many respects such behaviour is reached thanking komplaentnosti the patient, that is its adherence to treatment. Komplaentnost - the quality depending on a number of social, psychological, medical factors [39], however, is possible also its formation by means of educational and psihologoyopedagogicheskogo influences from the doctor [255, 256, 277, 290].

During educational work with the patients receiving treatment by a hemodialysis, following kinds of educational speech messages can be used. The patient can address the speech message which is focused on informing, or the message more likely connected with the prevention or belief. We will result following examples. «Duration of a dialysis is significant: as separate session, and totally for a week» - here we can observe easier informing of the patient on a principle of action of medical procedure. The same picture will be observed, if the doctor tells: «the Mode of visiting of procedure - three days in a week». In this case notification of the patient about a hemodialysis mode is observed only. But the doctor also can tell: « Ivan Petrovich if you do not go on procedure of a hemodialysis three times a week, will arise risk of your premature death ». Here we observe already the prevention. On force of influence on the patient this statement much more intensively statements in the previous example.

In that case when the patient has listened to this prevention and began to go regularly on a hemodialysis, distsiplinirovanno and without admissions, the prevention of the doctor was conceived by action and a situation has changed. In this case it is possible to speak about perlokutivnom effect of the statement.

Thus we will notice, that any illokutivnoe the statement (it is final if it is heard and understood by the patient) in any (let and tiny) a measure changes a reality as changes consciousness of the patient and certain system of its representations about health and its ways
Preservations. As soon as the patient has heard, has apprehended, has understood and has realised a certain fact about the health and possibilities of its preservation, something has already changed. If the doctor has informed the patient - the patient is informed, if has warned - the patient is warned, if has warned - has caution etc.

Let's consider one more example: «Ivan Petrovich, your dialysis - in morning change, in odd day of week (Tuesday, Thursday, Saturday), in a hall № 7». It is not so simple informing of the patient by the doctor, it is its record in the plan (accompanied by entering of the patient in the schedule of work of branch). The patient who has received this speech message, will come now in due time and in defined dializnyj a hall as understands, that its this official schedule, during other time and in other hall devices «an artificial kidney» are occupied. As a matter of fact, here we speak about type of the statement which Serl would name the declaration, and Austin - performativom. The reality has changed in the sense that henceforth on odd days of week in morning change in a hall № 7 hemodialysis passes at hypothetical Ivan Petrovicha.

Thus, on the basis of the analysis of the theory of speech certificates and features of the educational activity realised by the doctor, we can allocate following kinds of speech messages on an influence orientation for the patient and on the validity:

- The speech messages of the doctor having informative character (apellirovanie to consciousness of the patient). The report of the certain information to the patient, its notification, informing becomes the Main task of such kind of speech messages.

- The speech messages of the doctor having character of rendering of influence on behaviour (apellirovanie to consciousness and behaviour of the patient).

- Also the speech messages, changing the fact of the pronouncing an existing state of affairs can be considered. Here can be carried performativy (on taxonomy of Austin) or declarations (on
Taxonomy Serlja). We will notice, that the given kind of speech messages is used much less often, than previous two. As a subject of our further analysis first two kinds of speech messages will act: having informative character and influences having character on the patient (its behaviour etc.).

In a context educational intentsy the doctor, considered in dissertation chapter 1, we can allocate following types of educational speech messages.

1) the statements describing the validity of a psychosomatic condition of the patient and a situation of its treatment. Such statements can be named by descriptive;

2) the statements, concerning permissions and prohibitions to the patient of those or other formats of behaviour. As these statements establish certain norms of behaviour, they can be named deonticheskimi;

3) the statements connected with achievement perlokutivnogo of effect - the possible influence rendered by the statement on the patient. They can be named perlokutivnymi by statements.

We assume, that for realisation of problems of educational activity it is necessary to consider the specified kinds of speech messages. For us parametres on which we can make statements necessary for us with illokutivnoj force are important and carry them to a certain class (to a class of messages with an informative orientation, or messages with an orientation on behaviour change).

Both at Austin, and at Serlja, as key parametres of reference of the statement to a certain class verbs acted: at the analysis of the certain speech message it is possible to judge it is possible to carry this or that statement to what class of speech certificates on that verb which can be used. Thus, sending in the statement to certain verbal forms becomes the basic criterion of "breakdown" of speech messages of the doctor on kinds interesting us.

It is necessary to note, what not in all educational speech messages directly specific verb can be used. However it always can «be substituted mentally nearby» or to ask a corresponding verifying question. We will result such example. The statement «a pressure Diary allows to watch fluctuations of arterial pressure» is connected with the report to the patient of data on mission of this document. It is possible to ask a verifying question: «That the doctor now does?» And to answer, that he informs the patient. Thus on behaviour of the patient the given speech message will not render intensive influence. However it can influence its consciousness meaning that the patient is informed now, the pressure diary what for is necessary.

It is possible to consider and other example: «Ivan Petrovich, you necessarily should measure pressure every day. It is very important, after all differently we will not see fluctuation of your arterial pressure and we can not pick up correct therapy that is the extremely dangerous to your cardiovascular system». The resulted two offers united by one purpose, are way of belief. We can mentally ask a question: «That the doctor in this case does»? And to answer, that the doctor saying this statement, convinces the patient, resulting corresponding arguments. In that case when after the lapse of time the patient will show to the doctor accurately filled diary of pressure for the long period of time, we can tell, that the statement of the doctor has conceived perlokutivnyj effect.

As a whole, it is possible to conclude, that at drawing up of speech messages it is necessary to pay attention to an originality of lexical structure, in particular, to a choice of "verifying" verbal forms. In the example considered above there is no actually a verb "convince", however, there are such words and phrases as it is obligatory",« it is very important ». Sense of the statement, presence of the arguments explaining danger of non-observance of the recommendation
On filling of a diary of pressure also are aimed at making effect of influence on the patient.

Feature of the majority of the statements, capable to influence on kognitivnuju and behavioural sphere of the patient, that they are marked by following lexemes is: for this reason; considering all aforesaid; because...; taking into consideration that...; because.; thus, etc. as Markers perlokutivnyh statements such words said by the doctor and word-combinations as act: I will especially note, I will underline, further I will explain also a number of others.

Thus, the offer analysis (or several offers) and words used in it, and also use of "a verifying question» allows to draw a conclusion on attempt of belief of the patient. In the speech messages connected with informing of the patient (deksriptivnyh) it is possible to substitute following verifying verbs: to inform, inform, notify, notify etc. For definition of the educational speech messages connected by the permission or prohibition of a certain format of behaviour (deonticheskih statements), can be used such verbs how to resolve, forbid. For the educational speech messages connected with rendering of influence on behaviour of the patient (perlokutivnyh), it is possible to use following verifying verbs: to convince, influence, influence (consciousness and behaviour).

The educational text (containing complex of educational speech messages) should be simple enough, for the easiest mastering on hearing. It is possible to name sequence of communication of speech messages of the educational text offered by us, that is algorithm of forming of educational speech messages figuratively "Short flight of stairs". Such composition includes a complex of messages, each of which "follows" from previous and it is logical with it is connected. The essence of such interrelation can be described as follows. The doctor sounds the first educational speech message. The message following it can or
To concretise previous, or logically from it to follow. If a certain speech message difficult enough as a matter of fact or demands, that the patient has paid to it additional attention, it is possible to address to the patient the message identical on the sense, however invested with other lexical form. For example, if there is a certain moment which represents danger to a life of the patient, it is necessary to repeat the information on it some times (certainly, a little in the different form, but, keeping sense). Important that the patient has precisely heard and has unequivocally understood this information that its attention has been directed to it «atom of sense». Thus, algorithmically messages should look as follows (drawing 1):

Drawing 1

Algorithm of forming of educational speech messages in the educational text

The educational conversation spent by the doctor with the patient, should be under construction taking into account base rules of conducting conversation. Accordingly, at creation of the educational text also it is necessary to consider these rules. For today in pragmalingvistike and theories of speech certificates
Attempts to develop rule which would provide success of speech interaction are undertaken. Working out by Herbert Polom Grajsom (H became one of such attempts. Paul Grice) cases of the postulates raising efficiency of speech interaction. The researcher had been formulated the principle of cooperation postulating the following. The contribution speaking in conversation should correspond to the moment and a situation in which interaction is carried out, to be co-ordinated with the purposes and a direction of conversation [278].

Grajs allocated following significant categories which should be taken into consideration at planning of speech dialogue: categories of quantity, quality, the relation and a way. Each of the specified categories is connected by the author with defined maksimami, postulates, following which promotes increase of efficiency of interaction according to a cooperation principle.

- The quantity category is connected Grajsom with volume of the information which it is necessary to transfer in the course of interaction (the message should be so informative, how much it is required; the message should not contain more information, than it is required).

- The validity category means necessity of observance of the following requirement: it is not necessary to say that can be false or has no sufficient bases.

- The relation category is connected with maksimoj relevance: it is necessary not to depart from those purposes which are pursued during interaction.

- The quality category is connected with how the message (that is not so much with the maintenance, how many with way of its report to the listener) is said. In this case it is necessary to observe following requirements (maksimy): to avoid an ambiguity, an ambiguity, to be short and laconic [278].

According to the considered positions, it is possible to conclude, that the educational text should meet following requirements (maksimam):

1. «Maxim informativnosti, or quantities» (the text should be informative so, how much it is required);

2. «Maxim of the validity, or qualities» (in the text should not not confirmed data);

3. «Maxim of relevance, or relations» (the text should be relevant to the purposes of communication interaction);

4. Maxim of clearness, or a way of a statement »(the text should not contain not clear words and formulations, should not bear in itself a polysemy).

Having analysed theoretical bases of creation of educational texts, we will pass to attempt to create in practice the educational text.

First of all, we will address to a file of senses which should be transferred during educational work. The biomedical component of the educational text is caused by requirements of medical character: in each concrete medical case there is a number of instructions, which the person who has addressed to the doctor, should carry out to support functions of the organism in an optimum condition. For example, at a diabetes of II type it is necessary to observe a mode of reception of insulin and to adhere to a corresponding diet, and at a chronic asthma - to stop to smoke, observe a correct mode of breath etc. Such medical instructions follow from physiological features of an organism and have accurate communication with the treatment standard. Thus, educational biomeditsiskoe the maintenance of the text which should be brought home the patient, reflects medical requirements and is not subject to updating. This information should be given exactly in that volume which will allow the patient to support a life and health as much as possible effectively.

As a whole, the doctor can speak about a food, a vodno-drinking mode, impellent activity, a mode of a dream, work and rest, sequence of a drug intake, visiting of the doctor or certain medical actions, to ways of preventive maintenance of diseases of a various aetiology etc. The maintenance of the text depends on essence of disease and a somatic condition of the person who has addressed to the doctor. It is important, that speech messages addressed to the patient were short enough, but thus capacious that the doctor, during the limited period of time has managed to pay attention not only to educational activity, but also actually clinical work (to diagnostics, realisation of medical manipulations etc.). Such approach is represented to us to the most realistic.

At the same time the doctor should pay attention prognosticheskomu to a maintenance component (to say, that will be if the patient conducts zdoovesoobraznyj a way of life), and also to a bioethical component of the maintenance (shining smyslozhiznennye questions zdorovesoobraznogo a way of life).

As to consider all variety of the maintenance of educational messages it is simply impossible, we suggest to consider further specificity of messages on an example of messages to the patients receiving treatment by a hemodialysis. These people suffer chronic illness of kidneys of V stage accompanied by necessity of replaceable nephritic therapy (as a rule, a hemodialysis - procedures of a haemofiltration by means of the special device) - change of style of the life long, regular, unpleasant and demanding from the patient which non-observance is capable to lead to a lethal outcome [71].

Let's describe process of working out of the educational text for such patients. Text working out occurred as follows.

Commission of experts (2 doctors of the nephrologist and one dietician; all were candidates of medical sciences) has made the list of the most significant recommendations connected with conducting zdorovesoobraznogo of a way of life for
Such patients. The list of these recommendations has been offered the second expert group of doctors (8 persons - 2 doctors of medical sciences, 6 candidates of medical sciences - nephrologists, dieticians, the doctor on medical physical training, the psychotherapist) to which should choose from offered the most relevant statements which it is necessary for the patients receiving treatment by a hemodialysis to give. Data of expert interrogation also have been correlated with recommendations about questions zdorovessobraznogo behaviour on a hemodialysis.

Following the results of the spent procedures, these recommendations have been issued by the author of dissertational research as educational speech messages taking into account base positions pedagogical semiologii, lingvodidaktiki, theories of speech certificates, pragmalingvistiki, communicative linguistics. The case of the developed messages (the educational text) has been offered the focus group consisting of 4 experts - (a commission of experts including of two nephrologists, the dietician, the psychotherapist - 1 doctors of medical sciences and three candidates of medical sciences). Following the results of a positive estimation of the developed text focus group of researchers, the decision on its approbation was accepted. The text looked as follows:

The text of the first educational conversation of the doctor with the patient who begins treatment by a hemodialysis (a complex of speech messages about conducting a new way of life in the conditions of replaceable nephritic therapy)

I. Bioethical section (reflects a bioethical component of the maintenance of the educational text)

1. By means of corresponding treatment and efforts of you we can keep yours a life and health - this invaluable gift.

2. But you should understand, your health is a zone and your responsibility too.

3. You should keep health and a life for the sake of yourselves and the relatives, those people who requires you.

4. Maintenance of health and preservation of a life by means of replaceable nephritic therapy will allow you to continue to be engaged in that is important in your life, that you love.

5. Anybody except you cannot carry out completely all necessary medical instructions appointed the doctor.

II. Prognostichesky section (reflects prognostichesky a component

Maintenances of the educational text)

6. If you observe all necessary instructions and a medical mode, duration of your life will be long, practically same, as well as at healthy people.

7. If you observe a medical mode and to co-operate with the doctor concerning treatment we can support quality of your life at as much as possible accessible high level.

8. That you could continue to conduct an active life and to be engaged in that love, to you will be necessary to reconstruct the way of life definitely.

III. The Basic data on treatment by a hemodialysis (in this section the biomedical component of the maintenance of the text is reflected)

9. Henceforth the hemodialysis is a vital procedure for you.

10. The hemodialysis is the procedure allowing by means of the artificial filter, out of an organism, to clear blood of toxins collecting in it and a superfluous liquid.

11. Procedure of a hemodialysis is carried out by means of connection to the device «an artificial kidney».

12. At you on a hand the fistula - the artery and vein connection, providing possibility of access to system of blood for carrying out of procedure of a hemodialysis is for this purpose generated artiovenoznaja.

13. You necessarily should watch hygiene of a fistula.

14. If with a fistula there will be any problems, necessarily immediately inform your attending physician.

15. When the fistula will come in worthlessness, it will be necessary to make the new. In some cases for treatment continuation statement central venous katetera or implantation of a vascular artificial limb is required.

16. Each session of a hemodialysis lasts a minimum 4 hours.

17. The number of sessions in week and duration of procedure is defined by the doctor individually. We will calculate these medical parametres on the basis of result of your analyses and supervision over your condition.

18. Hemodialysis procedure is spent in special halls, in each of which simultaneously can be some person.

19. At the coordination with the personnel during a session it is possible to sleep, it is possible to have a bite that you took from the house, it is possible to read, listen to music or to look films in ear-phones.

20. Very important during a dialysis to observe a rule: not to stir to other patients.

21. Before and upon termination of a hemodialysis session it is necessary to be weighed.

22. Weighing before a dialysis allows to define, how many a liquid you have typed from the moment of the termination of the previous procedure.

23. Weighing after a hemodialysis allows to define, how many a liquid has been deduced from an organism during a hemodialysis.

24. It is very important, that for each procedure from an organism the necessary quantity of a liquid left. The procedure problem to reach «dry weight»: your individual weight without superfluous water, such which will be specified you by the attending physician.

IV. The Mode of visiting of a hemodialysis (in this section the biomedical component of the maintenance of the text is reflected)

25. Your procedure of a hemodialysis will pass in a hall №... In the first/second/third change with... (Time of the beginning of procedure) is underlined.

26. On a hemodialysis it is necessary for you to come regularly three once a week as only regular sessions, a minimum on 3 times a week, can support your life.

27. If not to visit a hemodialysis a minimum three times a week terms of your life will be short. Remember that the two-single dialysis is inadmissible.

28. If you pass even one session in a month, the risk of your premature death will essentially increase.

29. The admission of several sessions of a hemodialysis will lead to that in your organism harmful substances and a superfluous liquid will collect successively. All it can lead to cardiac arrest or a hypostasis of lungs and death.

30. Sometimes, especially if you break a necessary diet, the admission even one session represents threat for a life. In case of the termination of visiting of a hemodialysis within several days there comes death.

31. For preservation of your health and a life matters not only a total indicator of duration of a dialysis for a week, but also
Duration of each session. For this reason it is important to spend (and to you - to remain in bed) all session of a hemodialysis up to the end.

32. You should not try to reduce a hemodialysis session, as though you would not like to leave sometimes before.

33. It is necessary to remember, that reduction of time of a hemodialysis negatively affects an organism and life expectancy condition.

34. You always should come on a dialysis in due time in the appointed day, whatever were your mood, desire, circumstances and situations.

35. If it is necessary for you to leave, necessarily inform on it to your attending physician.

36. In case of your departure we will make for you the individual schedule.

37. If you leave for a long time, it is necessary to find dialysis possibility in a place of stay and to agree about timely carrying out of procedures.

38. To trace all indicators of an organism, you should hand over analyses regularly.

39. That analyses were in norm, it is necessary to keep to a special diet also.

V. The Diet in the conditions of treatment by a hemodialysis (in this section the biomedical component of the maintenance of the text is reflected)

40. The diet approaching for you taking into account nuances of your organism will be certain by the doctor the dietician or your treating doctor-nephrologist.

41. But it is important to you to remember, that there is a number of principles and rules of a food which to you cannot be broken.

42. You cannot abuse products in which those substances which can put an irreparable harm to your organism (for example, sodium, kaly, phosphorus) contain.

43. Infringement of principles of a food and the excessive use of the products rich with these substances, can lead to a lethal outcome. For example, the use of a considerable quantity of such products as tomatoes, the strawberry, a string bean, a melon, a potato, bananas, dried fruits, grapes, will cause giperkaliemiju which is capable to entail cardiac arrest.

44. As a whole, it is necessary to remember, that daily consumption kalija should not be more than 2 gramme.

45. You also cannot use the food rich with phosphorus (dairy products, cheese, eggs, groats). Consumption of such food leads giperfosfatemii (to accumulation neogranicheskih phosphorus connections in blood), and it involves infringement exchange calcium-phosphoric that becomes the reason of development of a tumour parashchitavidnyh glands, damage of bones, accumulation of connections of calcium and phosphorus in cardiovascular system and increases in risk of a heart attack and a stroke.

46. In day you can use the squirrel about 1,2 grammes on kg of weight of a body. Such quantity of fiber is necessary for your organism as during a hemodialysis many amino acids with which it is necessary to fill can be lost. At the same time, superfluous consumption of fiber leads to formation of a considerable quantity of nitrogenous slag, that in addition loads all systems of an organism.

47. It is necessary to lower quantity of the products containing sodium. The basic supplier of sodium in an organism is a table salt. Accordingly, you should exclude from the food any products containing it in a considerable quantity - half-finished products,
Sausage products, tinned products, cheese etc. In a human body, receiving treatment by a hemodialysis, a kidney cannot remove surplus of sodium and a liquid from a body, in a body water that conducts to occurrence of hypostases and pressure increase collects.

48. It is undesirable to use more than 1-2 gramme of table salt a day.

49. Is better to refuse in general salt use at preparation of dishes as its minimum necessary for an organism already contains naturally in some products (for example, in vegetables, fruit).

50. If necessary salt meal already in a ready kind so on flavouring qualities the food will seem to more salty, but it is desirable to refrain at all from dosalivanija meal.

51. The meal should be correct image prepared (to avoid zharenija better, conservations). The food prepared in these ways, contains many harmful substances, in particular, sodium (at conservation) and kalija (at zharke products with the high maintenance kalija, it all remains in a dish). The meal is recommended to be boiled, such way of preparation allows to reduce concentration in food of harmful substances as the part leaves them in water.

52. To eat it is necessary regularly, 4-5 once a day. It allows to distribute in regular intervals loading on digestive and secretory systems.

53. Please, will pay special attention, that a day you should drink no more than 500 ml of a liquid as bolshee the quantity of a liquid creates excessive loading on all systems of an organism.

54. Pay attention that with meal in an organism water also arrives, the cumulative quantity of a liquid in meal and drink should not exceed 1 litre.

55. With care it is necessary to use the products rich with a liquid, such as water-melons.

56. Totally in an interval between procedures of a hemodialysis you can save up in an organism of a liquid no more than 4 % from weight of a body.

57. In a case if you will break a vodno-drinking mode and to use more liquids, than it is necessary, it will accumulate in an organism in fabrics, the hypostasis will develop, pressure and loading upon heart will raise.

58. Restriction of consumption of water and salt also will allow to normalise arterial pressure, to avoid attacks of a hypertension, a hypotonia, spasms in feet during a hemodialysis.

59. To be quiet concerning a food, it is possible to make the special dietary menu which will consist only of the resolved products and will always help you to supervise the diet. Dishes of such menu are tasty enough. There are even special books of recipes for people who are on a hemodialysis. To concern a food it is thoughtless - it is henceforth inadmissible, as now it is the extremely dangerous to you.

VI. Medicamentous therapy in the conditions of treatment by a hemodialysis (in this section the biomedical component of the maintenance of the text is reflected)

60. To support a condition of various systems of an organism, medicinal therapy also is appointed.

61. For example, to supervise the phosphorus maintenance, it is necessary to accept phosphate-connecting preparations.

62. At your disease besides phosphate-connecting of preparations, it is necessary to accept a number of other medicines also.

63. Many medicines are directed on correction of complications at chronic illness of kidneys of V stage, such, as neurologic, endokrinnye infringements, an anaemia, belkovo-power insufficiency and infringements fosforno-kaltsievogo an exchange.

64. With the list of all necessary medicines we will be defined, as soon as you will hand over all necessary analyses.

65. Not to worry that you can forget to accept medicines, it is possible to get a special box and in it to put tablets for every day weeks. Also you can make for yourselves the drug intake schedule, including, by means of special supplements for smart phones.

66. Remember that a mode of a drug intake it is very serious. Necessarily watch, that all medicines have been accepted. You cannot pass reception of tablets.

67. It is important to limit also the use of medicines which have adverse influence (for example, not steroid anti-inflammatory preparations, some groups of antibiotics) on kidneys.

68. At reception of appointments from doctors of other specialities, inform them, that be on a hemodialysis that they could pick up corresponding therapy, and after these appointments and before reception of these preparations necessarily consult to the treating doctor-nephrologist.

VII. Other aspects of change of a way of life on a hemodialysis (in this section the biomedical component of the maintenance of the text is reflected)

69. As chronic illness of kidneys of V stage and treatment by a hemodialysis leave traces on work of all systems of an organism, it is important to watch the condition as a whole.

70. Necessarily regularly supervise the arterial pressure, there is an interrelation between work of secretory system and arterial pressure.

71. If in work any of organism systems there is a deterioration, you should inform on it to your attending physician immediately.

72. It is important to observe a healthy way of life as a whole. It is established, that patients who keep to the diet recommended above do not abuse smoking, alcohol, strong coffee, feel much better. You can independently be convinced of it, having communicated with «skilled patients».

73. Also conducting zdorovesoobraznogo a way of life will be promoted also by regular employment by physical training in a mode of sparing loading.

74. As a whole, remember, that for you vital to observe the recommended mode.

75. Experts, employees of branch of a hemodialysis, will give you necessary treatment, consultations and the help in the decision of complexities arising with health, and you from its part, should observe all recommendations, treatments concerning parametres, a mode of a life, a diet.

76. Your responsible behaviour, your realised cooperation with the doctor and conducting zdorovesoobraznogo a way of life will allow us with

You long years to support optimum possible quality of your life.

The created educational text reflects specificity of a life of the patients receiving replaceable nephritic therapy. For the most convenient work with the text, it also is taken out in the appendix (the appendix 1). Working out of educational texts for the people having (really or potentially), other problems with health, demands the account of corresponding biomedical recommendations.

Thus, as the theoretical basis of working out of educational speech messages, the theory of speech certificates acts. Possibilities of its applied application in frameworks lingvodidaktiki are connected with rendering of specific influence on the patient: informing and convincing character. The algorithm of forming of educational speech messages in the educational text represents "short flight of stairs": the consecutive arrangement of statements, each of which is logically connected with the previous. In the paragraph the educational pedagogical text developed for patients with chronic illness of kidneys of V stage, receiving replaceable therapy by means of a hemodialysis is presented. The analysis of efficiency of the educational work spent with use of the educational text, will be presented in paragraph 2.3.


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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 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:

  1. approbation of algorithm of educational speech interaction of the doctor and the patient
  2. 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
  3. 2.1. The maintenance and a composition of the educational speech messages addressed to the patient and focused on formation at it of relevant representations about zdorovesoobraznom behaviour
  4. 1.3. Theoretical bases of service interaction in the course of realisation of the goods in retail trade
  5. Chapter 2. Features of realisation of theoretical bases in activity of educational institutions of noble family
  7. § 2. The characteristic of the elements forming criminally-legal me - hanizm protection of the rights and freedom of the patient
  8. a theoretical substantiation of phenomena «pedagogical interaction» and «the polycultural educational environment» in modern Russian pedagogics
  9. Chapter 1. Concept criminally-legal mechanism protection of the rights and svo - bod the patient and the characteristic of elements, its forming
  10. § 2. Konstitutsionno-legal bases of realisation of a freedom of speech in a network the Internet: three levels of regulation
  13. CHAPTER 1. Theoretical bases of interaction of police with institutes of a civil society.
  14. Chapter 1. Theoretical bases of pedagogical maintenance of aesthetic education of children of average school age in nonlearning activity of educational institution
  15. § 1. Realisation of legal responsibility in the general context of realisation of the right
  16. communicative function of language and a problem of speech influence of the sermon
  17. Chapter 2. Theoretical problems of management of competitiveness of a higher educational institution in the regional market of educational services
  19. formation of speech function from the point of view of physiology
  20. Anisimov ALEXEY PAVLOVICH. THEORETICAL BASES of the LEGAL REGIME of the EARTHS of SETTLEMENTS In the RUSSIAN FEDERATION. The dissertation on competition of a scientific degree of the doctor of juridical science. Saratov,