O discurso do autocuidado em saúde: uma descrição de gêneros na covariação experto-leigo

Abstract

This thesis presents the description of genres realized by the discourse of self-care in Diabetes Mellitus in co-variation with expert and lay variables, showing how they are linguistically developed to build the culture of self-care. This work is located within the framework of research developed at the intersection between Appliable Linguistics (MAHBOOB; KNIGHT, 2008) and Multilingual Studies (MATTHIESSEN et al., 2008) from the systemic-functional approach to language (HALLIDAY; MATTHIESSEN, 2014), as it uses theoretical knowledge of Systemic-Functional Linguistics (SFL) to solve problems in health sciences through a multilingual approach. For Martin and Rose (2008), culture consists of a large and definable set of genres that are understood and recognized by members of the culture, and an understanding of how genres interact with each other. Martin (2014) shows that genre description is not simple, as it requires an extensive analysis across linguistic strata and metafunctions. Recent studies of scientific discourse have shown the need to figure out the linguistic issues that arise from the relationship between specialists (expert) and patients (lay) (CANDLIN; CANDLIN, 2003; MATTHIESSEN, 2013; 2015). Funnell et al. (2004, 1991) point out that patients need to develop self-care initiatives to live with diabetes, and the self-care is built and learned through language (TORRES et al., 2015). Based on gaps described in previous studies, corpora composed of genres realized by the discourse of self-care in Diabetes Mellitus in co-variation with the variables expert/expert, expert/lay and lay/lay were compiled, analyzed, and described to examine (i) how the genres are situated in the culture of self-care; (ii) how they are realized along stratification and metafunction, and how their stages and phases are configured and organized; and (iii) how they differ from each other, showing how expert and lay are linguistically constructed. For this study, two subcorpora were compiled, one to describe the culture of self-care and the other to describe the genres of self-care, consisting of three subcorpora of articles, booklets, and statements corresponding to the variables expert/expert, expert/lay and lay/lay, respectively. The results showed that the culture of self-care in co-variation with expert and lay variables is performed by nine genres types, three of which corresponded to expert/expert, four to expert/lay, and two to lay/lay. The most frequent types of genres were EXPOSITION, PROCEDURE and NARRATIVE, each performed by key systems in their stages and phases. The results also showed that the meanings constructed in the genres are organized in a semiotic fractal configuration. Moreover, the genres use five types of organization for their stages and phases namely obligatoriness, stability, exclusivity, transitionality and recursion. Regarding expert and lay, analyzes have indicated that the genres realized by the expert/expert variable build a stable and predictable text structure, so that they can accumulate more meanings in each clause, which promotes a strong semantic density; the genres realized by expert/lay variable opt for a marked and predictable structure, so that the focus of the text is on information rather than on textual organization, which is developed through a medium semantic density; and the genres realized by lay/lay perform a more diverse and less predictable genre structure due to a low semantic density, allowing more variation in systems selections along text progression as well as more evaluative features throughout the text. Concerning the interdisciplinarity between Systemic-Functional Linguistics and Health Sciences, this thesis contributes with the description of the linguistic configuration of the self-care discourse in Diabetes Mellitus carried out by specialists and patients, which can be applied in the creation of materials to popularize science in order to ensure effective communication between expert and lay, so that patients will have tools to promote self-care and achieve their empowerment.