Cover not available

Article published In: Pragmatics and Society
Vol. 16:3 (2025) ► pp.380–400

Get fulltext from our e-platform
JBE logo with link
PDF logo with download linkDownload PDF
EPUB logo with download linkDownload EPUB
authorization required

I am a doctor in your shoes

The empathic strategies employed by Chinese doctors during text-based online medical consultations

 | Nanjing University
ORCiD logo with link | Harbin Engineering University
 | Harbin Engineering University
Published online: 25 July 2024
DOI logo with link
https://doi.org/10.1075/ps.22101.zha
Abstract
The ability to be empathic with the emotionally-charged personal accounts of patients in a medical consultation is an essential attribute of a qualified doctor. However, there is a lack of empirical research on how empathy is interactionally achieved by Chinese doctors in text-based online medical consultations (OMC). Based on 600 records of text-type online consultations retrieved from https://​www​.120ask​.com, this paper aims to explore how empathy is pragmatically constructed for doctor-patient rapport management in online medical consultations. The findings of this analysis reveal that the types of empathy are in the form of cognitive empathy, affective empathy, sharing empathy, and nurturing empathy. By showing how doctors discursively used these four types of empathic strategies, the study contributes to the limited but growing body of research on Chinese doctors’ empathic strategies in online medical consultations.
Article outline
  • 1.Introduction
  • 2.Background
    • 2.1Defining empathy
    • 2.2Empathy in medical consultations
  • 3.Data and method
    • 3.1Data collection
    • 3.2Data coding and data analysis
  • 4.Results
    • 4.1Cognitive empathy
    • 4.2Affective empathy
    • 4.3Sharing empathy
    • 4.4Nurturant empathy
  • 5.Discussion
  • 6.Concluding remarks
  • Notes
  • References
References (43)
References
Ameka, Felix K. and Marina Terkourafi. 2019. “What If…? Imagining Non-Western Perspectives on Pragmatic Theory and Practice.” Journal of Pragmatics 1451: 72–82. Google Scholar logo with link to Google Scholar
Argaman, Einav. 2007. “With or Without ‘it’: The Role of Empathetic Deixis in Mediating Educational Change.” Journal of Pragmatics 39 (9): 1591–1607. Google Scholar logo with link to Google Scholar
Bachelor, Alexandra. 1988. “How Clients Perceive Therapist Empathy: A Content Analysis of “Received” Empathy.” Psychotherapy Theory Research & Practice 25 (2): 227–240. Google Scholar logo with link to Google Scholar
Baumeister, Roy F. and Kathleen D. Vohs. 2007. “Empathy.” In Encyclopedia of Social Psychology, ed. by Roy F. Baumeister and Kathleen D. Vohs, 297–298. Thousand Oaks, CA: SAGE Publications. Google Scholar logo with link to Google Scholar
Beckman, Howard B. and Richard M. Frankel. 1984. “The Effect of Physician Behavior on the Collection of Data.” Annals of Internal Medicine 101 (5): 692–696. Google Scholar logo with link to Google Scholar
Charmaz, Kathy C. 2006. Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Thousand Oaks, CA: SAGE Publications.Google Scholar logo with link to Google Scholar
2008. “Constructionism and the Grounded Theory.” In Handbook of Constructionist Research, ed. by J. A. Holstein and J. F. Gubrium, 397–412. New York: The Guilford Press.Google Scholar logo with link to Google Scholar
Chen, Xinren. 2022. Exploring Identity Work in Chinese Communication. London: Bloomsbury Publishing Plc. Google Scholar logo with link to Google Scholar
Corbin, Juliet and Anselm Strauss. 1990. “Grounded Theory Research: Procedures, Canons, and Evaluative Criteria.” Qualitative Sociology 131: 1–21. Google Scholar logo with link to Google Scholar
Davis, Mark H. 1994. Empathy: A Social Psychological Approach. Madison: Brown and Benchmark.Google Scholar logo with link to Google Scholar
Fukushima, Saeko. 2020. “Motives of Attentiveness and Their Interactional Manifestations.” East Asian Pragmatics 5(2): 223–246. Google Scholar logo with link to Google Scholar
Goffman, Ervin. 1981. Forms of Talk. Philadelphia: University of Pennsylvania Press.Google Scholar logo with link to Google Scholar
Hackney, Harold. 1978. “The Evolution of Empathy.” Personal and Guidance Journal 571: 35–38. Google Scholar logo with link to Google Scholar
Healey, Meghan L. and Murray Grossman. 2018. “Cognitive and Affective Perspective-Taking: Evidence for Shared and Dissociable Anatomical Substrates”. Frontiers in Neurology 91: 491. Google Scholar logo with link to Google Scholar
Hu, Chang-ai, Mei-yuan Xing, Chun-wei, Yang, Min Zhang and Da-gan Yang. 2014. “Function Assessment of APP Software in China for Seeking Medical Advice.” Chinese Journal of Medical Library and Information Science 23 (2): 7–10.Google Scholar logo with link to Google Scholar
Jefferson, Gail and John R. E. Lee. 1981. “The Rejection of Advice: Managing the Problematic Convergence of a ‘Troubles-telling’ and a ‘Service encounter’.” Journal of Pragmatics 5 (5): 399–322. Google Scholar logo with link to Google Scholar
Jing-Schmidt, Zhuo and Ting Jing. 2011. “Embodied Semantics and Pragmatics: Empathy, Sympathy and Two Passive Constructions in Chinese Media Discourse.” Journal of Pragmatics 43 (11): 2826–2844. Google Scholar logo with link to Google Scholar
Li, Hai-hui. 2018. “The Mechanism of Pragmatic Empathy in Mitigation.” Academic Research 61: 167–171.Google Scholar logo with link to Google Scholar
Longmire, Natalie H. and David A. Harrison. 2018. “Seeing Their Side Versus Feeling Their Pain: Differential Consequences of Perspective-taking and Empathy at Work.” Journal of Applied Psychology 103 (8): 894–915. Google Scholar logo with link to Google Scholar
MacFarlane, Peter, Timothy Anderson and Andrew S. McClintock. 2017. “Empathy from the Client’s Perspective: A Grounded Theory Analysis.” Psychotherapy Research 27 (2): 227–238. Google Scholar logo with link to Google Scholar
Mao, Yansheng, and Xin Zhao. 2019. “I Am a Doctor, and Here Is My Proof: Chinese Doctors’ Identity Constructed on the Online Medical Consultation Websites.” Health Communication 341: 1645–1652. Google Scholar logo with link to Google Scholar
. 2020. “By the Mitigation One Knows the Doctor: Mitigation Strategies by Chinese Doctors in Online Medical Consultation.” Health Communication 35 (6): 667–674. Google Scholar logo with link to Google Scholar
Markham, Annette and Elizabeth Buchanan. 2012. “Ethical Decision-making and Internet Research: Recommendations from the AOIR Ethics Working Committee (Version 2.0).” Available at [URL]
Mehrabian, Albert and Norman Epstein. 1972. “A Measure of Emotional Empathy.” Journal of Personality 40 (4): 525–543. Google Scholar logo with link to Google Scholar
Mercer, Stewart W. and William J. Reynolds. 2002. “Empathy and Quality of Care.” British Journal of General Practice 521: 9–13.Google Scholar logo with link to Google Scholar
Norfolk, Tim, Kamal Birdi and Deirdre Walsh. 2007. “The Role of Empathy in Establishing Rapport in the Consultation: A New Model.” Medical Education 41 (7): 690–697. Google Scholar logo with link to Google Scholar
Northouse, Peter G. and Laurel Northouse. 1997. Health Communication: Strategies for Health Professionals. Connecticut: Appleton and Lange.Google Scholar logo with link to Google Scholar
Rogers, Carl R. 1957. “The Necessary and Sufficient Conditions of Therapeutic Personality Change.” Journal of Consulting Psychology 211: 95–103. Google Scholar logo with link to Google Scholar
1964. “Toward a Modern Approach to Values: The Valuing Process in the Mature Person.” Journal of Abnormal Psychology 68 (2): 160–169. Google Scholar logo with link to Google Scholar
Schrooten, Iete and Menno D. T. de Jong. 2017. “If You Could Read My Mind: The Role of Healthcare Providers’ Empathic and Communicative Competencies in Clients’ Satisfaction with Consultations.” Health Communication 321: 111–118. Google Scholar logo with link to Google Scholar
Shih, Fu-Jin. 1996. “Concepts Related to Chinese Patients’ Perceptions of Health, Illness and Person: Issues of Conceptual Clarity.” Accident and Emergency Nursing 4 (4): 208–215. Google Scholar logo with link to Google Scholar
Tannen, Deborah. 1981. “The Machine-gun Question: An Example of Conversational Style.” Journal of Pragmatics 5 (5): 383–397. Google Scholar logo with link to Google Scholar
Toussaint, Loren and John R. Webb. 2005. “Gender Differences in the Relationship Between Empathy and Forgiveness.” Journal of Social Psychology 145 (6): 673–685. Google Scholar logo with link to Google Scholar
Versteeg, Wytske and Hedwig Te Molder. 2016. “What My Body Tells Me About Your Experience: “My Side” Empathy Formulations in ADHD Coaching Sessions.” Journal of Pragmatics 1051: 74–86. Google Scholar logo with link to Google Scholar
Wan, Quan-fang, Jiang Li, Yi-hua Zeng and Xiao-ling Wu. 2019. “A Big-five Personality Model-based Study of Empathy Behaviors in Clinical Nurses.” Nurse Education in Practice 381: 66–71. Google Scholar logo with link to Google Scholar
Wang, Xiaojiang, Yansheng Mao and Qian Yu. 2021. “From Conditions to Strategies: Dominance Implemented by Chinese Doctors During Online Medical Consultations.” Journal of Pragmatics 1821: 76–85. Google Scholar logo with link to Google Scholar
Wampold, Bruce E. 2001. The Great Psychotherapy Debate: Models, Methods and Findings. Mahwah: Lawrence Erlbaum Publishers.Google Scholar logo with link to Google Scholar
Washer, Peter. 2009. Clinical Communication Skills. Oxford: Oxford University Press. Google Scholar logo with link to Google Scholar
Wynn, Rolf and Michael Wynn. 2006. “Empathy as an Interactionally Achieved Phenomenon in Psychotherapy: Characteristics of Some Conversational Resources.” Journal of Pragmatics 38 (9): 1385–1397. Google Scholar logo with link to Google Scholar
Xie, Xiaolin and Yan Xia. 2005. “Attitudes Toward the Elderly in China: Comparison of College Students and Baby Boomers”. International Journal of Sociology of the Family 31 (2): 145–158.Google Scholar logo with link to Google Scholar
Zhang, Xin, Linzi Li, Quan Zhang, Long Hoang Le and Yijin Wu. 2024. “Physician Empathy in Doctor-Patient Communication: A Systematic Review.” Health Communication 39 (5): 1027–1037. Google Scholar logo with link to Google Scholar
Zhang, Yu. 2021. “How Doctors Do Things with Empathy in Text-based Online Medical Consultations in China: A Discourse-analytic Approach.” Health Communication 36 (7): 816–825. Google Scholar logo with link to Google Scholar
Zhao, Xin, and Yansheng Mao. 2021. “Trust Me, I Am a Doctor: Discourse of Trustworthiness by Chinese Doctors in Online Medical Consultation.” Health Communication 36 (3): 372–380. Google Scholar logo with link to Google Scholar
Cited by (2)

Cited by two other publications

Lei, Rong
2025. “Hug you tightly”: Displaying warm affectivity in online advice about family trauma. Discourse & Society DOI logo
Ping, Wanlin & Ayeshah Syed
2025. Emoji types and functions in online medical consultations on a Chinese medical platform. Journal of World Languages 11:2 ► pp. 343 ff. DOI logo

This list is based on CrossRef data as of 30 november 2025. Please note that it may not be complete. Sources presented here have been supplied by the respective publishers. Any errors therein should be reported to them.

Mobile Menu Logo with link to supplementary files background Layer 1 prag Twitter_Logo_Blue