Exploring discursive strategies in rehabilitation from Foucault’s discourse theory: language, interaction, and outcomes
摘要
This study investigates the discursive strategies employed by physiotherapists (i.e., rehabilitation practitioners) in their interactions with patients during the rehabilitation process, with a focus on how these strategies affect patient engagement, adherence, and recovery outcomes. Based on Foucault’s theory of discourse, the study analyzed 52 sets of physiotherapist–patient conversations involving six physiotherapists from three Class A tertiary hospitals. The data were organized and managed in ATLAS.ti 22 to facilitate the retrieval and comparison of discursive elements across sessions. Following an analytic approach informed by Foucault’s theory of discourse, the study examined how power, knowledge, and subject positions were constructed and negotiated through language and non-verbal interaction, leading to the identification of four recurrent discursive strategies observed across different treatment stages: rapport-building through endearing language and family input before and at the end of treatment, narrative-based reflection to enhance patient engagement during transitional stages, empathy-driven encouragement for patient recovery, and motivational exaggeration in therapeutic communication, particularly through the use of hyperbole (magnification, minimization, and anticipation) during ongoing treatment. Additionally, the research also highlighted how physiotherapists gradually assert authority and power, contributing to a structured, physiotherapist-led rehabilitation process. By fostering patient engagement and creating a supportive environment, the study highlights the role of physiotherapist-led treatment in shaping patient experiences during rehabilitation. The results offer theoretical and practical insights for enhancing physiotherapist–patient interactions and advancing rehabilitation care practices.