THE ANALYSIS OF SPEECH ACTS IN MEDICAL CONSULTATIONS
BETWEEN MIDWIVES AND PATIENTS
IN BPS S.MIRANINGSIH, AMD.KEB GELURAN TAMAN SIDOARJO
A THESIS
By :
Rukhoiyah Swandani
St. Number : 121112057
ENGLISH DEPARTMENT
FACULTY OF HUMANITIES
UNIVERSITAS AIRLANGGA
SURABAYA
THE ANALYSIS OF SPEECH ACTS IN MEDICAL CONSULTATIONS
BETWEEN MIDWIVES AND PATIENTS
IN BPS S.MIRANINGSIH, AMD.KEB GELURAN TAMAN SIDOARJO
A THESIS
By :
Rukhoiyah Swandani
St. Number : 121112057
ENGLISH DEPARTEMENT
FACULTY OF HUMANITIES
UNIVERSITAS AIRLANGGA
SURABAYA
THE ANALYSIS OF SPEECH ACTS IN MEDICAL CONSULTATIONS
BETWEEN MIDWIVES AND PATIENTS
IN BPS S.MIRANINGSIH, AMD.KEB GELURAN TAMAN SIDOARJO
A THESIS
Submitted as Partial Fulfillment of Requirements for the Sarjana Degree of
English Department, Faculty of Humanities,
Universitas Airlangga Surabaya
By :
Rukhoiyah Swandani
St. Number : 121112057
ENGLISH DEPARTMENT
FACULTY OF HUMANITIES
UNIVERSITAS AIRLANGGA
SURABAYA
DECLARATION
This thesis contains no material which has been accepted for the award of
any other degree or diploma in any university. And to the best of this candidate‘s knowledge and believe, it contains no material previously published or written by
other person except where due reference is made in the text of the thesis.
Surabaya, 16 June 2015
Writer,
The writer dedicates this thesis to
her beloved mother and father for
the love and sacrifice they always
Approved to be examined
Surabaya, 16 June, 2015
Thesis Advisor,
Dra. Lilla Musyahda, M.Pd.
NIP. 196612102007012001
Head of English Department,
Dra. Lilla Musyahda, M.Pd.
NIP. 196612102007012001
ENGLISH DEPARTMENT
FACULTY OF HUMANITIES
UNIVERSITAS AIRLANGGA
SURABAYA
This thesis has been approved and accepted by the Board of
Examiners,English Department, Faculty of Humanities, Universitas
Airlangga
on 30June 2015
The Board of Examiners are:
Noerhayati Ika Putri, M.A. NIP. 197807162005012002
Dra. Lilla Musyahda, M.Pd. NIP. 196612102007012001
ACKNOWLEDGEMENTS
Foremost, I would like to express my deepest gratitude to Allah SWT who
always blesses my life and especially helps to strengthen me finishing this thesis.
Deepest gratitude is also expressed to Prophet Muhammad SAW who influences
me to have great spirit for finishing this thesis with his inspiring and enlightening
way of life.
I would like to express the deepest appreciation to my thesis advisor, Dra.
LillaMusyahda, M.Pd, a genius who is filled with excellent idea. Without her
supervision and constant helps, this thesis would not have been possible. I am
grateful to be one of her pupils. It is an honor for me.
Deep appreciation is also given for the lecturers of English Department,
Faculty of HumanitiesUniversitas Airlangga, for the knowledge they have shared,
especially linguistics lecturers who inspire me a lot. I learn from them how to be a
‗real human‘, not only excellent in hardskill, but also softskill.
My endless love will always be sent for my mother, Mami, and my father,
Suwani, for all your support, motivation and prayers. You are the greatest parents
I have. For my four young sisters, thank you so much for always making me smile.
My deep gratitude is also for my grandparents, Munarah and Suyono, who always
support and pray for me. I would like to thank my aunt, Indah, for all her supports
and helps whenever I need. I also feel grateful for Yuli‘s help. Thank you for
lending me your laptop when mine is broken.For Mbak Nicky who does not mind
family members who I cannot mention all, thank you for all support you have
given to me.
Last but not least, I would like to say thank you to all my friends. They are
my friends in genk NERO: Nabilah ‗qubil‘ and Kartika ‗cungkring‘, who are full with brilliant idea, Desi ‗wiwik‘ who cares me so much, Putri ‗siomay‘, and Ariel ‗upiels‘) who always cheer me up with their ‗harsh joke‘. We study hard and play
hard together. I also want to say thank you to all of my friends in EDSA 2K11. We
have been together and have shared many unforgettable moments. I also want to
thank my friends in UKM Taekwondo Universitas Airlangga who strengthen me
with their spirit and support. I love you all.
Surabaya, 16 June 2015
“
If they give you ruled paper,
write the other way”
TABLE OF CONTENTS
Thesis Examiners‘ Approval Page vi
Acknowledgements vii
2.1 Types of Utterances and Speech Events 10
2.3 Positioning Theory 21
2.4 Review of Related Studies 22
CHAPTER III METHOD OF THE STUDY
3.1 Research Approach 25
3.2 Participants and Setting 26
3.2.1 Participants 27
3.2.2 Setting 27
3.3 Instrument 28
3.4 Technique of Data Collection 28
3.5 Technique of Data Analysis 29
CHAPTER IV DISCUSSION
4.1 Data Presentation 30
4.1.1 Assertive 31
4.1.2 Performative 34
4.1.3 Verdictive 36
4.1.4 Expressive 38
4.1.5 Directive 40
4.1.6 Commissive 47
4.1.7 Phatic 49
4.2 Discussion 51
CHAPTER V CONCLUSION
Conclusion 60
REFERENCES 63
TABLE OF CONTENTS
Thesis Examiners‘ Approval Page vi
Acknowledgements vii
2.1 Types of Utterances and Speech Events 10
2.3 Positioning Theory 21
2.4 Review of Related Studies 22
CHAPTER III METHOD OF THE STUDY
3.1 Research Approach 25
3.2 Participants and Setting 26
3.2.1 Participants 27
3.2.2 Setting 27
3.3 Instrument 28
3.4 Technique of Data Collection 28
3.5 Technique of Data Analysis 29
CHAPTER IV DISCUSSION
4.1 Data Presentation 30
4.1.1 Assertive 31
4.1.2 Performative 34
4.1.3 Verdictive 36
4.1.4 Expressive 38
4.1.5 Directive 40
4.1.6 Commissive 47
4.1.7 Phatic 49
4.2 Discussion 51
CHAPTER V CONCLUSION
Conclusion 60
REFERENCES 63
Swandani, Rukhoiyah. 2015. The Analysis of Speech Acts in Medical Consultations between Midwives and Patients in BPS S.Miraningsih, Amd.Keb Geluran Taman Sidoarjo.
ABSTRACT
Every utterances are speech act because humans utter their utterances with intentions behind their utterances (Robinson, 2006). One of speech community which employ speech acts in their communication is midwives and patients. This study aims to find what speech acts are mostly used by the midwives and patients and why those speech acts are used. Qualitative research approach through a case study inquiry is implemented in this study. The conversation between midwives and patients were recorded for the data. In analyzing the data, the writer uses speech acts theory proposed by Charles W. Kreidler (1998). The result shows that assertive utterances are mostly used, especially by the midwives. Since it is a consultation, the midwives frequently give information to the patient based on the empirical fact while the patients frequently use assertive to report their experience. While speech act appears the least is performative type for the patients and expressive type for the midwives. The analysis leads to a conclusion that the position of the speakers are also related to the types of speech acts and the speech functions they employ.
CHAPTER I
INTRODUCTION
1.1 Background of the Study
Humans are dependable creature and in order to fulfill their needs, they
communicate their thoughts and feelings. Communication, generally, is
understood as the processes in which humans construct and make meaning
together, whether it is verbal or nonverbal, spoken or written, cooperation or
conflict, and face-to-face or not (Stewart, 2002). One of elements in a
communication is language which makes a communication successful. It denotes
everything in this world, concrete and abstract things. Humans use language for
many purposes since language seems to have many different functions as there are
occasions for using language, therefore, humans call it as speech functions
(Kreidler, 1998); humans use language to tell others what they know or what they
feel, to ask questions, to thank, to say hello and goodbye, and so on. Those speech
functions will also affect its form, why they select one way rather than another to
convey their message. The form of an utterance does not necessarily coincide
with the speaker's real intention. A speaker may produce an utterance that is just
the opposite of the message he wants to convey. What makes those utterances
understandable is the context or the people being involved (Kreidler, 1998).
There are a lot of examples on how humans employ the speech functions
to interact and fulfill their needs in daily speech community, how humans convey
order to get health service. Based on Fischer and Ereaut (2012), medical
consultations can be defined differently according to their organizing principles of
purpose. In narrower sense, they might be organized around the achievement of a
diagnosis, a transaction involving the transfer of knowledge, whereas in a
complex sense means they might be organized around the development of
complex shared understanding: the creation of new knowledge for both
participants, unique to that patient. Medical profession who has right to deliver
medical consultation is a midwife, for example.
A midwife is a woman who attends women in confinement (The
American Medical Association, 1989) or she can be considered as a woman who
is educated and trained to help delivering babies and to advise pregnant women.
In Indonesia until 2013, the number of midwives is ranked at the top position with
136.489 persons compared to other medical professions (BKKBN, 2014).
Midwives outnumber doctors (42.189 persons), dentists (13.022 persons), and
specialist (38.210 persons). This is also supported with the data from Badan
Kependudukan dan Keluarga Berencana Nasional or BKKBN (National Family
Planning Coordination Board) in 2014 which claimed that in East Java the ratio
for doctors/people is 7,43 : 100.000, while the ratio for midwives/people is 33,48 :
100.000.
The number above is also equivalent to health problems in Indonesia
because health problems in Indonesia are dominated with maternal and children
health problems which are the focus of midwives care (Wang et al., 2009). In
Development Program which established eight goals named as Millenium
Development Goals. Millenium Development Goals are eight international
development goals as the result of United Nations summit in 2000 (UNICEF,
2012). Two of the eight goals are to reduce child mortality and to improve
maternal health. Those two issues are pertinent to midwife‘s scope of activity. Those are the reason why midwives outnumber doctors in Indonesia and are still
needed in health service according to dominant health problem in Indonesia.
Interaction between a midwife and a patient includes the process of
examination and consultation. In this communication, the midwife differs from
the patient because of her roles, one of them is as a medical consultant. According
to Cohn (2003) the role of the medical consultant is to identify and evaluate a
patient‘s medical status and provide a clinical risk profile, to decide whether further tests are indicated prior to surgery, and to optimize the patient‘s medical
condition in an attempt to reduce the risk of complications. Based on the roles
(explained by Cohn above), it can be considered that a midwife, as medical
consultant, positions herself as a person who knows and gives the information
while a patient positions herself as a client who needs and receives the
information.
All of conversation characteristics of midwives are shaped in midwifery.
In the midwifery, they are taught on how to do medical conversation with their
colleagues and their patients. They practice to communicate in accordance with
the foundation of professional conversation called as Positioning Theory proposed
position, storylines, and determinate speech acts, developing from the everyday
social interactions of professional conversations (Davies and Harre, 1990).
Furthermore, individuals manifest the concept of positioning by a certain set of
right, duties, and obligations through the story line within speech acts of the
conversation (Phillips & Hayes, 2007). Therefore, a midwife also uses different
ways to express particular speech functions to fit the context of communication
she is in and her position while she delivers medical consultation.
From the phenomenon above, the writer presumes there are some
intentions and act performed differently by the midwives and the patients through
their speech since they are involved in different role or position. In those speech
functions, several different kinds of utterances, or speech acts, will be recognized
then classified according to their general purpose. Smith et al. argued that ―the notion of speech acts is a valuable contribution to health communication research
because of the positive and negative affect certain acts can have‖ (2009, p.2).
Therefore, the writer is interested in analyzing the speech acts mostly used in
medical conversation or consultation between a midwife and a patient since this
topic is valuable. The writer chooses midwives and patients as the research object
because linguistic research on medical conversation delivered by midwife has not
been conducted extensively, especially in Indonesia. In addition, it fits with
Indonesian people health need phenomenon as mentioned above.
The writer conducts this research at a private clinic or Bidan Praktek
Swasta in Geluran, Sidoarjo named BPS S. Miraningsih, Amd.Keb to be the
health facility of private sector to health facility of state sector for health cases
such as maternity (birth), childhood diarrhea, and Acute Respiratory Infection.
Moreover, a private clinic is chosen because the number of state clinic, such as
Puskesmas (Public Health Centre), is still low only 9.599 unit compared to private
clinic such as Bidan Praktik Swasta or BPS (Midwives in Private Practice) which
is 47.000 unit. Considering this number, the needs for getting health service from
midwives especially Midwives in Private Practice are high enough.
BPS is a Midwife who has Surat Ijin Praktek Bidan or SIPB (Midwives
Practice License) in compliance with medical laws, registered legally to have
private practice (Ikatan Bidan Indonesia, 2004). Therefore, BPS is always named
with the BPS owner‘s name itself because BPS refers to the midwife as the
individual. In addition, BPS S. Miraningsih, Amd.Keb is one member of Bidan
Delima. Bidan Delima is a midwife system standardization program launched by
Ikatan Bidan Indonesia or IBI (Indonesian Midwives Association) in 2003, to
educate and incentives Indonesian private midwives to meet and maintain the
standard of care. In contrast, there is still a major barrier in providing and
maintaining quality maternal health services in Indonesia because of the lack of
supervision, monitoring and evaluation of compliance with best practices of
private midwives. Thus, this clinic is trusted because it has been accredited with
Bidan Delima.
There have been many studies discussing speech acts. First is Ohtaki S,
Ohtaki. T, and Fetters MD‘s study (2003) about doctor-patient communication in
speech acts in the USA and Japan were similar. Syaifana (2007) conducted
a study titled Speech Act in Military Conversations Performed by the Indonesian
Navy’s Personnel at KRI Lambung Mangkurat. She found that performative utterances that are found in each data contain order, question, request, advising,
and warning. In addition, Amelia (2008) discussed the functions of speech acts
used by male and female preachers in a church in Surabaya and drew to a
conclusion that personal character, culture, and power-relation are determinant
factors in the use of direct or indirect language style.
Another study was conducted by Arifin (2008) who analyzed the speech
acts used by non-Madurese police officer and Madurese victims and witnesses and
revealed that representative act is the act most frequently used by police officers
and victims or witnesses and Indonesian is the chosen language in the process of
interrogation. Smith et al. (2009) conducted a research on memorable messages
about breast cancer and their speech acts (purposes of the messages). They found
that individuals who had personal and friend or relative experience with breast
cancer were significantly more possible to recall memorable messages than other
respondents and the most frequently perceived speech acts were providing facts,
providing advice, and giving hope. Hayati (2011) did an observation about speech
acts analysis of public service advertisement and found that directive function was
most frequently used. The last is Ismail (2013) who analyzed the illocutionary act
used in Jokowi‘s campaign speech using John Searle‘s speech acts theory and
found that Jokowi mostly used representative act in his campaign speech.
Almost all of studies above use the same theory that is five types of speech
acts proposed by John Searle (1969) and different participants such as between
doctors and patients in different culture, police and victim or witness, preachers,
and so on. The present study, by contrast, utilizes Kreidler‘s theory, which proposes seven kinds of speech acts as analytic tool to examine the utterances in
the medical conversation between a midwife and a patient. This study is
conducted to examine what speech act frequently appears and why it appears most.
The information about the most common used speech acts and whether those
speech acts are effective and understandable is the importance of this study. By
knowing this information, what speech acts frequently appear in the consultation
between midwives and patients, the writer hopes this study could help the
midwives to use effective speech acts for improving their service in their clinics
better.
1.2 Statement of the Problem
According to position and role, a midwife and a patient will use different
ways to express particular speech acts. To know more about speech acts used in
consultation between midwives and patients and the relationship between speech
acts and role, problems are discussed in this study as follow:
1. What kinds of speech acts used dominantly by both midwives and patients in
consultation BPS S Miraningsih, Amd. Keb Geluran Taman Sidoarjo?
2. Why are those speech acts used in the consultation at BPS S Miraningsih,
1.3 Objective of the Study
Based on the statement of the problem mentioned above, the objectives of
this study are:
1. To find the speech acts used dominantly by midwives and patients in BPS S
Miraningsih, Amd. Keb., Geluran Taman Sidoarjo
2. To find the reasons why those speech acts are used in the consultation
1.4 Significance of the Study
The result of this study is expected to give both theoretical and practical
significance to the society. The writer hopes it will give new insights to linguistic
studies, especially pragmatics, since it concerns speech acts. Moreover, this study
is expected to make linguistics readers, especially linguistics students, understand
about speech acts theory as important in analyzing verbal communication uttered
by each person with different role or position. Since this study is related health
service, this study can be used as references to improve a better service in medical
centers by using right speech acts to avoid redundancy and gain an effective
consultation. It is also expected to be further reading or reference for other
researchers who plan to conduct pragmatics studies, especially related to speech
act theory.
1.5 Definition of Key Terms
Medical : pertaining to medicine or to the treatment of disease (The
Consultation : a consultation with a doctor or other expert is a meeting with
them to discuss a particular problem and get their advice (Collins
COBUILD Dictionary on CD-ROM 2006, 2006).
Midwife : a woman who attends women in confinement (The American
Medical Association, 1989)
CHAPTER II
LITERATURE REVIEW
This section presents the theory applied in analyzing the intentions of
midwives and patients in their communication and the relation between their
speech and their position in a determined situation, in the context of medical
consultation. The main theory used for this study is the theory proposed by
Kreidler (1998) who categorized the speech act based on the utterances
characteristic. Furthermore, Kreidler also provides the explanation about speech
act and its categorization. Therefore, the writer uses the theory proposed by
Kreidler as the main theory for categorizing the speech acts because Kreidler
gives more specific speech acts categorization and more understandable
explanation about speech act. To gain more understanding about speech act, the
writer prefaces Kreidler‘s theory with the theory of speech acts proposed by
Austin and Searle. The last but not least positioning theory proposed by Rom
Harre which has relation with communication and position is used to see the
correlation between speech act and position.
2.1 Types of Utterances and Speech Events
Pragmatics would serve as the linguistic approach for this study, since
pragmatics is one of the major fields in linguistic that could reveal meaning in
language use or simply as a systematic way of explaining the language used in
context and situation. Leech (1983) stated that pragmatics aims to explain aspects
context in which they are uttered. Therefore, the writer confines her attention to
language utterances. There are two types of utterances proposed by Austin as cited
in Lyons (1977), constative utterances and performative utterances. Constative
utterances are statements which functions to describe some event, process or state
of affairs, and they have the property being either true or false while performative
utterances attempts to study people doing things with words rather than saying
something is true or not.
According to Robinson (2006), performativist see a language as a drama.
All participants involved in this drama have collaborated on a group of speech act.
Austin in 1962 (as cited in Robinson, 2006) also suggested that performativist see
language as made up of speech acts. The speech acts can form a speech event
(Yule‘s term) or speech situation (Robinson‘s term), and every speech event is a
little drama. Speech event is a set of speech generated from social situations
involving participants who need to have social relationships and may have a
special purpose on certain circumstance (Yule, 1996) or it is simply the
circumstances surrounding the utterance. In a speech event, it often includes a
central speech act accompanied by other utterances reacting to that central action,
but it can also exclude a central speech act. An example to explain speech event
without central speech act is proposed by George Yule (1996, p.57) as the
following:
Him: Oh,Mary.I’m glad you’re here. Her: What’s up?
Him: I can’t get my computer to work.
Her: Is it broken?
Him: I don’t know. I’m useless with computers. Her: What kind is it?
Him: It’s a Mac. Do you use them?
Her: Yeah.
Him: Do you have a minute? Her: Sure.
Him: Oh, great.
The dialogue above is about ‗request‘. The request above is not made up with
obvious speech act of request such as can you fix my computer? or I need you to
fix my computer. The dialogue above can be called as a ‗request‘ speech event without the presence of a central speech act of request.
2.2 Speech acts
Because of the fact that people perform some actions through the use of
words, the theory of speech acts would serve as a tool for analysis of the selected
speeches in this study. Speech act makes the writer able to discover the intention
of the utterances of midwives and patients when they are communicating.
When people speak, they use language to achieve several functions like
expressing uncomforted situation, offering an apology, greeting, request,
complaint, compliment, invitation, or refusal. Thus, all things can be done through
process of speaking (Saddock, 1974). The speech acts theory was firstly proposed
by Austin in 1962 and further developed by Searle in 1969. Austin (as cited in
Robinson, 2006, p. 76) assumed that every utterance does something, performs an
action and according to Searle, speaking a language is performing speech acts,
acts such as making statements, giving commands, asking questions or making
promises (as cited in Kreidler, 1998). Searle also stated that all linguistic
fundamental units of linguistic communication because the principal of
communication is to construct meanings together between the speaker and the
addressee. By ―knowing‖ what speech act in every utterance is, both speaker and
hearer are able to understand the meaning or the intention of their counterpart.
There are three levels of speech act introduced by Austin (as cited in Archer,
Aijmer, and Wichmann, 2012), those three levels are: locution, illocution, and
perlocution. Locution refers to the actual words uttered, so this level concerns
with the meaning of the words themselves. Illocution refers to what is performed
in saying something, the speaker‘s intention to communicate to the addressee. Illocution is discussed in the next subchapter for further explanation. Perlocution
refers to the result of taking the hearer‘s perspective, his interpretation of what the
speaker says. Perlocutionary act is the actual effect of speaker‘s utterance to the addressee, so this act happens after the locution and illocution act are produced.
Since this study is primarily focused on the meaning and act performed of
midwives and patients speech, so the writer continues to the illocutionary act
which is also considered as speech act itself. It is not necessary to discuss locution
act because This study does not concern with semantic level of the utterances.
Communication in a determined situation does not ask how languages organize
and express meanings, but rather the participants‘ utterances are success or not in
accomplishing their intentions or aims (Kreidler, 1998). In addition, it is a
pragmatics study which emphasizes the speaker‘s intended meanings, meaning in
use and meaning in context (Thomas, 1995). Moreover, because it has no purpose
evaluated especially the effects on the patients it takes deeper research with
prolonged time, so this study excludes perlocutionary act as a tool for analyzing
the data.
2.2.1 Illocutionary Act
The illocutionary act is one of sub levels of speech act proposed
firstly by Austin. Illocutionary act is the central concept of the speech act
theory which functions as analyzing tool the use of language in
communication. It is employed to understand the meaning of someone‘s utterance. It is in accordance of the statement that illocutionary acts are
important because they are basic units of meaning in the use and
comprehension of language (Vanderveken, 1990). Austin also classified
speech acts into expositives, verdictives, commissives, exercitives, and
behabitive, but then, Ballmer and Brennenstuhl in 1981 argued that
Austin‘s approach is far too limited, only five categories (as cited in
Robinson, 2006).
Another theory of speech acts and its categorization was proposed by
John Searle in 1969. It is a wide and helpful theory because he gives a
great explanation about speech act, but still a narrow taxonomy. According
to Searle there are just five basic kinds of action that one can perform in
saying utterance. Five basic kinds of action are: declaration,
representatives, expressive, directives, and commissives (as cited in Archer,
Aijmer, and Wichmann, 2012), but the writer thinks those five macro
two big theories of speech act above are lack of categories. Both of them
do not include the polite formulas such as chitchat about weather, asking
for someone‘s health and so on. However, those utterances are equally
important from linguistic perspective (Holmes, 2008). So, the writer
considers another profound and newest taxonomy of speech acts which is
proposed by Kreidler, but it still has the correlation with the theory
proposed by Austin and Searle. Kreidler (1998) grouped the speech acts
into more specific categorization. According to Kreidler, the categories of
illocutionary acts are assertive, performative, verdictive, expressive,
directive, commissive, and phatic (Kreidler, 1998). The following are the
explanation of each illocutionary act categories proposed by Kreidler.
2.2.1.1 Assertive
Assertive is an utterance which functions to tell what the speakers or
the writers believe or know. Assertive concerns with facts and its purpose
is to inform. Generally, assertive can be verified or falsified, not
necessarily at the moment the speaker utter them or by the addressee hear
them. The form of the utterances can be either direct or indirect assertive.
Direct assertive starts with the subject I or we and an assertive verb,
whereas indirect assertive no need those all. Here are the examples:
a. We declare that most plastics are made from soy beans. (direct
assertive)
Shortly, the use of assertive is for stating, claiming, denying,
concluding, and deducing in our daily life. There are certain conditions to
make an assertive appropriate such as what is reported must be possible,
the speaker commits himself to the truth of what is reported, and the
addressee also receive it as a truth (Kreidler, 1998).
2.2.1.2. Performative
Performative is an utterance that brings the state of affairs.
Performative changes the world by uttering something and it makes things
happen just by being uttered. Performative utterances are appropriate if
those are spoken by someone who has authority to make them accepted
and in appropriate circumstance. Performative functions can be found in
the daily life such as for firing, marrying, and arresting. It also includes
things said in ceremonies and official acts which affect the people as the
addressee.
There are some qualifications for utterance can be a performative.
First of all, the performative verb must be in the present tense which
means that the speaker utters performative utterances in the present time in
accordance with the performance of actions. The most important is that the
speaker must be appropriate; he must have the authority to utter those
performatives. Performative utterances are valid only if spoken by an
appropriate person in socially determined situations. The success of this
community or the addressee. Therefore, performatives usually take place
in formal settings.
The last, the subject of the sentence must be I or we. However, it is
necessary to distinguish between explicit or direct and implicit or indirect
performative. Here are the examples:
a. I declare this meeting adjourned. (direct performative)
b. This meeting is adjourned. (indirect performative)
The example ―I declare this meeting is adjourned‖ is a direct performative while ―This meeting is adjourned‖ is an indirect performative
when it is spoken by the same person (Kreidler, 1998).
2.2.1.3 Verdictive
Verdictive is an utterance which the speaker makes an assessment or
judgement about the previous action of the addressee or their present
results. Verdictive utterances include congratulation, accusation,
appraising, and blaming.
The action of the addressee also can be viewed as positive or
negative by the speaker. Verdictive verbs used to judge the addressee‘s
previous action as positive or as negative. Verdictives are considered as
positive when the speaker honors, compliments or praises the addressee.
Verdictives are viewed as negative when the speaker accuses, blames or
criticizes the addressee.
Felicity conditions for verdictive are the act was feasible, the
utterance, and the addressee believes that the speaker is sincere (Kreidler,
1998).
2.2.1.4 Expressive
Expressive is similar with verdictive. Whereas verdictives assess the
addressee’s previous actions or the failure of those actions, expressive utterances assess the speaker’s previous actions or the failure of those actions, and even the present results of those actions or failures Therefore,
expressive is retrospective (concerns with something happened or has
happened) same as verdictive. Here are the examples:
a. We admit that we were mistaken.
b. I apologize for having disturbed you.
Felicity conditions of expressive are: the possibility of the act, the
ability of the speaker to perform it, the sincerity of the speaker in making
the utterance, and the addressee‘s belief that the speaker is sincere
(Kreidler, 1998).
2.2.1.5 Directive
Directive is an utterance used by the speaker to get the addressee to
do something or refrain from doing something. Therefore, directive has
pronoun you as the object or the doer of an action the speaker means,
whether the pronoun is shown in the utterance or not.
A directive utterance is prospective which means it is oriented
something in the past. Three kinds of directive utterances are often found
in daily communication: commands, request, and suggestions.
A command is effective if only the speaker has power, control, or
even the authority to get the addressee to perform or refrain from the
actions. Command is viewed as positive when the speaker orders,
commands, tells the addressee to do something while it is viewed as
negative when the speaker forbids the addressee to do something.
A request is the speaker‘s expression to get the addressee to fulfill
the speaker‘s wants. Whereas a command needs the authority or the
control power of the speaker toward the addressee, a request does not need
all of those.
A suggestion is the utterance the speaker makes to give other
persons his/her opinion what they should do or not. So, the addressee has a
choice of performances and the speaker gives an opinion about it.
Expression for suggestion can be viewed positively or negatively.
Suggestion is viewed as positive when the speaker use ‗nice‘ verbs such as
recommend, advise and so on. Suggestion is viewed as negative when the
speaker gives pressure by using verbs such as warn, caution and so on.
The felicity conditions for directive are the act is feasible and the
addressee is capable to do it. There is addition for each subdivisions of
directive speech act. A command to be felicitous, the addressee must
suggestion will be felicitous if the addressee accepts the speaker‘s
judgment (Kreidler, 1998).
2.2.1.6 Commissive
Kreidler (1998) explained that commissives are the utterances which
can be used to commit or refuse to commit oneself to some future actions.
Therefore, commissive is retrospective because it concerns toward later
happenings, it is yet to occur, and it is speaker-involved also since the
utterance makes the speaker commits to some future actions. Commissives
include promise, pledge, threat, and vow.
Commissive has the addresse whether the utterance shows it or not
because the speaker must be making a commitment to somebody. Felicity
conditions for commissive are the speaker intends to perform it, the ability
of the speaker to perform that act, the addressee believes the speaker‘s
ability and intention. Here are the examples:
a. I promise to be on time.
b. We volunteer to put up the decorations for the dance.
2.2.1.7 Phatic
Kreidler (1998) stated that phatic is an utterance which expresses
solidarity with others and its purpose is to maintain social bonds between
members of the same society. Phatic utterances include greetings and
farewells, the polite chitchat about weather, and whatever is expected in
particular society. Phatic utterances are no less important compared to the
Holmes (2008), phatic utterances convey social message rather than a
referential one because language is not only functioned to convey only
referential information but also the information about social relationship.
Kreidler stated that phatic utterance is felicitous if the speaker and
the addressee share the same social customs and recognize phatic
utterances for what they are (1998, p.194).
Finally, predicates used in those seven types of speech acts above can be
described according to their relative ‗strength‘, politeness, and consequences.
Direct speech acts contain a first-person pronoun and a predicate that specifies
what utterance it is, whereas indirect speech acts lack of these.
2.3 Positioning Theory
As mentioned above that we can see language as a drama. Analogically, in
the dramaturgical model, people are seen as actors with lines already written and
their roles determined in the play they are in, but they still have freedom as to how
to play their roles in the play (Davies and Harre, 1990). This is what is called as
positioning by Harre, how people position themselves or another in their
conversation. Position, storylines and relatively determinate speech acts are three
key factors inherent during conversations (Davies and Harre, 1990). By using this
theory, the writer is going to be able to reveal the reason why specific speech acts
are uttered by the midwives or patients in their conversation related to their
position in the context of midwife-patient consultations.
Furthermore, individuals manifest the concept of positioning by a certain
conversation (Phillips & Hayes, 2007). In the medical consultation context,
midwives represent certain rights and duties because one of their roles as the
medical consultant is to identify and evaluate a patient‘s medical status and
provide a clinical risk profile, to decide whether further tests are indicated prior to
surgery, and to optimize the patient‘s medical condition in an attempt to reduce the risk of complications (Cohn, 2003). By knowing what the participants‘ role in the consultation, the writer is able to identify participants‘ specific reason beyond
their utterances or the functions of their utterances.
2.4 Review of Related Studies
There are a lot of works related to speech act in the recent years. First is
the study conducted by Sachiko Ohtaki, Toshio Ohtaki and Michael D Fetters
(2003) about doctor–patient communication in the United States of America and Japan. They aim to examine communication patterns of doctor–patient consultations in two different cultures, namely the USA and Japan, and to find
linguistic differences and similarities in communication. They use quantitative
discourse analysis from linguistics to compare 20 consultations of four physicians
in Japan with 20 consultations of five physicians in USA are taken as the data.
They measure the time spent in each consultations, number of categorized speech
acts, distribution of question types and frequencies of back-channel responses and
interruptions.
Another research was conducted by Syaifana (2007) titled Speech Act in
Lambung Mangkurat. She found that performative utterances that are found in
each data contain order, question, request, advising, and warning.
There are two studies from year 2008. Amelia (2008) discussed the
functions of speech acts used by male and female preachers in a church in
Surabaya. The female preacher was from USA and the male preacher was from
Germany. Both of them gave sermons in English and then the interpreter
translated those sermons into Indonesian language. She drew to a conclusion that
personal character, culture, and power-relation are determinant factors in the use
of direct or indirect language style. Another study was conducted by Arifin (2008)
who analyzed the speech acts used by non-Madurese police officer and Madurese
victims and witnesses. He revealed that representative act is the act most
frequently used by police officers and victims or witnesses and Indonesian is the
chosen language in the process of interrogation.
Smith et al. (2009) conducted a research on memorable messages about
breast cancer and their speech acts (purposes of the messages). Their participants
are the individuals who are breast cancer patients or have relation with breast
cancer patients. They found that individuals who had personal and friend or
relative experience with breast cancer were significantly more possible to recall
memorable messages than other respondents and the most frequently perceived
speech acts were providing facts, providing advice, and giving hope.
Hayati (2011) did an observation about speech acts analysis of public
service advertisement. She observed the public service advertisement such as
frequently used. The last is Ismail (2013) who analyzed the illocutionary act used
in Jokowi‘s campaign. He took the Jokowi‘s speech in the form of video from
Youtube. Ismail categorized Jokowi‘s utterances using John Searle‘s speech acts theory and found that Jokowi mostly used representative act in his campaign
speech.
The researchers above had already conducted research related to speech
act. Most of the studies above especially in Indonesia, still observed the speech
acts in the social themes conversations such as politic and still used the speech act
categories proposed by Searle. Their object in their study also varied, from the
written discourse such as public advertisement until the spoken discourse such as
the Jokowi‘s speech. However, this study utilizes Kreidler‘s categories of speech
act and discusses different theme of conversation and different participants,
CHAPTER III
METHOD OF THE STUDY
3.1 Research Approach
In analyzing the data, the writer uses qualitative method. Flick argues that
qualitative methods take the researcher's communication with the object as an
explicit part of knowledge instead of judging it as an intervening factor and are
used to make sense of the individual‘s subjective experience in a natural setting (Flick, 2009). Furthermore, the characteristics of qualitative research are taking
place in the natural setting, using multiple methods that are interactive and
humanistic, and emergent rather than tightly prefigured. (Kwary, 2014, p.16). The
writer considers this study is more appropriate to apply qualitative method since
the writer has to gain information about the setting where the consultation occurs
and about the participants‘ identity. Moreover, this study is presented in a
descriptive way.
For the strategy of inquiry, the writer uses case study. Case study is one
case (or perhaps a small number of cases) that is studied in detail, using whatever
methods seem appropriate (Punch, 1998, p. 150). Case study aims to understand
case depth, and in its natural setting, recognizing its complexity and its context.
Thus, this approach is appropriate because in this study, the writer will focus on
the type and use of speech acts based on the specific circumstance, the situation of
a consultation between a midwife and a patient and the reason why some certain
3.2 Participants and Setting
In doing this research, the writer specifically takes the data from BPS,
stands for Bidan Praktik Swasta (Midwives in Private Practice) clinic. The
preference of doing this research in the BPS is because the fact that almost
Indonesian people prefer health facility of private sector to health facility of state
sector for health cases such as maternity (birth), childhood diarrhea, and Acute
Respiratory Infection (Wang et al., 2009). Moreover, the woman patients tend to
see midwives in BPS rather than in Puskesmas. They state that BPS is nearer from
their place, accessible, and fast-service.
Location for this research is in a BPS or Midwives in Private Practice
named BPS S.Miraningsih, AMd.Keb in Geluran Taman Sidoarjo. Geluran is
chosen because the writer has known the area very well and there is no research
conducted in this area especially linguistics research related to medical practice.
Thus, the writer was curious about the pattern of the medical communication in
this area. The writer chose this BPS because it is one of the three biggest BPS in
Geluran and it is in strategic place, therefore, this BPS has more clients or patients
compared to others. In addition, BPS S. Miraningsih, Amd.Keb is one member of
Bidan Delima. Bidan Delima is a midwife system standardization program
launched by Ikatan Bidan Indonesia or IBI (Indonesian Midwives Association) in
2003. Therefore, this clinic is trusted because it has been accredited with Bidan
3.2.1 Participants
Participants of the research is all of the patients, with average 30
patients per day and two midwives in there. In order to get the best
respondents and manageable results, the writer only takes ten consultations
by limiting on the patients number using some criteria. The writer includes
all the midwives in the BPS as her particpants because there are only two
midwives, the senior midwife as the BPS owner and her assistant (junior
midwife). The criteria for choosing the patients are followed. First, the
patients must be registered in BPS S. Miraningsih, AMd.Keb. The writer
uses case study in BPS S. Miraningsih, Amd. Keb for this research, so the
patients must be registered to make the data requirements fulfilled.
Second, the patients must understand and speak both Javanese and
Indonesian. The reason why the writer used this criterion is to anticipate
their code mixing in the consultation, so their consultation is
understandable. Third, their conversation is about medical consultation.
This criterion was to make the data accurate and fit with the topic of this
study. Finally, the writer finds ten up to thirteen patients per day who have
consultation sessions with the midwives. Therefore, the writer considers
taking ten consultation sessions which are qualified with those three
criteria as the data.
3.2.2 Setting
In this study, the writer took the recordings at October 29th 2014
Amd. Keb Geluran Taman Sidoarjo. Ten transcribed conversations were
used in this study. Each conversation is between two persons, a midwife
and a patient. Their conversation are about maternal and children health
problems. The participants also talk more informally and they use the
mixture of Javanese and Indonesian language as in their daily conversation
since they usually have known each other. Therefore, the writer assumes
that she can get the adequate data of the most natural midwife-patient
consultations for the intention of fulfilling the naturalism that is one of the
characteristic of qualitative approach.
3.3 Instrument
In order to record the conversation in midwife-patient consultations, the
writer uses two cellular phone sound recorders. Cellular phone was preferred
because it is capable enough to record middle range audio. Moreover, the
condition of the clinic is quiet enough so disturbance from outside is very
minimum. In addition, cellular phone could camouflage well to get hidden
recording. Although the participants‘ gesture could not be recorded, the writer
noticed that they sometimes used it. The writer was able to notice their gesture
because she is camouflaged as the midwives‘ assistant. However, the writer
considered to use sound recorder instead of video recorder to protect their identity
and unwanted situation that would disturb the participants.
3.4 Technique of Data Collection
There are several steps in collecting the data. First the writer observed the
knowledge about the routine activity happens there and made a trial for her
recorders to make sure, at least, one of the recorders could work properly. Second,
she recorded all the exchanges in the BPS at October 29th 2014 and from April 7th
2015 until April 20th 2015 by placing the cell phones on the desk near the position
of participants. The last, she sorted the recordings based the criteria above that the
conversation should be a medical consultation in order to be examined in this
study.
3.5 Technique of Data Analysis
After selecting the data, the writer began to analyze the data starting from
preparing and transcribing the data manually. The writer chose to transcribe in
common orthography because the writer only focuses on the meaning of the
utterances. Second step was reading through all the data. Then the writer
categorized the data of the medical consultations into macro classes of speech acts
proposed by Kreidler. Those macro classes are: Assertive, Performative,
Verdictive, Expressive, Directive, Commissive, and Phatic. The next step is
analyzing the speech act used by the midwives and the speech act used by the
patients. The last step, the writer related participants‘ utterances with the context, their position as midwife or patient. Finally, the writer concluded the finding of
CHAPTER IV
DISCUSSION
4.1 Result
In the ten recorded conversation, the writer finds 330 utterances which can
be classified into some kinds of speech act proposed by Kreidler. Almost all of
those speech acts appear in the form of indirect speech act. They do not contain
first-person pronoun and performative verb, a predicate which specifies what type
of speech acts the utterance is. As the researcher, the writer should be careful to
identify the intention behind the speaker‘s utterances. The results are presented
below.
Table 1
Types of Speech Act and Their Occurrences in Medical Consultation
Category
Total Occurences Patients Midmives
Occurences % Occurences % Occurences %
Assertive 174 52,73 50 15,15 124 37,58
Performative 8 2,42 0 0,00 8 2,42
Verdictive 10 3,03 1 0,30 9 2,73
Expressive 10 3,03 9 2,73 1 0,30
Directive 78 23,64 5 1,52 73 22,12
Commissive 10 3,03 7 2,12 3 0,91
Phatic 40 12,12 20 6,06 20 6,06
In the following analysis there are some abbreviations so the writer would
like to give explanation first to make them understandable. KB stands for
Keluarga Berencana (Family Planning), but in the context of the community here,
it refers to birth control or contraception medicines (pill, injection, and so on). P
stands for patient and M stands for Midwife.
4.1.1 Assertive
Assertive is used to state speaker‘s belief that something is true. The aim
of this speech act is to inform the addressee what is in speaker‘s mind. From the conversations have been recorded with 330 utterances classified as speech acts,
the writer finds many assertive utterances both from the patients and midwives,
with 174 occurences or 52,73% of the total (330) occurrences. It is then specified
into two, the speech act performed by the patients and the speech act performed
by the midwives. From the patients, there are 50 occurrences or 15,15 % of the
total utterances while from the midwives, there are 124 occurrences or 37,24%.
The following excerpts are midwives and patients utterances which contain
assertive speech acts.
Consultation I
P: Yo maksude sing iso cepetan mens iko loh mbak. (I mean the pills which
make me get menstruation as soon as possible, miss.)
you will get menstruation. But, in the three months usually you do not get
menstruation directly.)
In the consultation above, the patient made a request to the midwife to give
her KB (Keluarga Berencana) or Birth Control pill which would make her get
menstruation as soon as possible. The midwife replied her request using assertive
to explain and guarantee that the period of getting menstruation depends on the
patient‘s condition itself. She was confident to guarantee because she knew that
her information is based on empirical fact. She focused the speech act on the
truth-value of her utterance. Because the midwife in this consultation is a Moslem,
she asserted indirectly that her utterance is true and she guaranteed the truth by
using Insha Allah. This phrase is commonly uttered by Moslems. It means that if
human has done the best then God will do the rest.
Consultation III
P: Sakbotol mbak. (One bottle, miss.)
M: Kenapa kok nggak asi? Iki loh kok kurang eh mbak. Pancet ae nang garis kuning, gak naik. Arek sakmene iki minimal berat’e 6. (Why not breast
milk? It is underweight, ma‘am. Still in the yellow line, it is not increased.
Children in this age should be weighed 6 kilograms.)
In the excerpt from the Consultation III above, the midwife examined and
evaluated the patient‘s infant. When the patient was questioned how much she
gave her infant the formula (milk), the patient answered, informed that it was one
speech acts on information, but there is still difference in the content of their
information. The difference between patient and midwife in using assertive is the
patient reported what she had done to her baby (giving a bottle of formula) while
the midwife reported the result of her investigation toward the baby‘s condition
and emphasized the importance of breast milk and ideal weight for the baby.
Consultation VII
P: Laah kula biyen niku lak ndamel KB sing tiga bulan sekali, ternyata niku loh
kok mboten men. Nopo’o? (So, in the past I used trimester KB/ birth control, but I did not get menstruation. Why?)
M: Soalnya buk yaa.. Setiap orang itu berbeda-beda hormonnya. Nah.. Ada yang pake tiga bulan, lancar, ada yang nggak lancar. Itu menurut hormonnya
ibuk sendiri. Soalnya setiap hormone itu berbeda beda, ada yang pake satu
bulan, nggak mens. Ibuknya sebelum pake tiga bulan pake apa? (It is
because everybody has different hormones. There are people who consume
the trimester one then they get menstruation and there are people who do not.
It depends on you hormone itself. Because every hormone is different, there
are people who consume monthly but they do not get menstruation. What do
you consume before the trimester ones?)
The context of the consultation above is about a patient who wanted to
consult her KB program. She told the midwife her problems when she had used
her previous KB pill. The midwife gave her information and explanation about her
problem and its solution. It can be seen that the patient used assertive to report the
reporting her experience. She also focused on the nature of the message by
narrating a unified series of events, that she had used trimester KB but she did not
get menstruation yet. In contrast, the midwife used assertive to explain and
emphasize the fact based on empirical investigation that the patient‘s problem was caused by her hormones, because everyone has different hormones (state). The
midwife emphasized her information by telling the patient frequently that
everyone‘s hormones are different.
4.1.2 Performative
Performative is an utterance that changes the state of an affair and it is
acceptable if spoken by appropriate person. In the conversation, the writer finds 8
occurrences or 2,42% from the total utterances. Interestingly, not even once the
patient uttered this kind of speech act. All of the performatives are uttered by the
midwives. Here are the excerpts from the consultations which contain
performative speech act.
Consultation IX
M: Ayoo satune. Monggo Buk. (Okay the next. Please, ma‘am.) P: Nggih. (Yes)
Consultation X
M: Pun buk.(Finished ma‘am)
The first utterance above was uttered by the midwife in the beginning of
the consultation to let the patient come in and start sharing her problems soon
after previous patient left. Indirectly, the midwife had decided that the
in the second consultation above was used by the midwife to finish a session of
examination or a consultation. Not only changing the state of the consultation,
‗not started‘ became ‗started‘ and ‗not finished‘ became finished‘. Performative
can also change the state of the patients like the excerpts below.
Consultation V
M: Terus niki hepatitis BCG ne kan pun telas, sakniki tak paringi BCG dulu. (Because the BCG is used up, so I am going to give you BCG firstly)
Consultation VIII
M: Yawes kalau gitu pake yang pil. (Okay then you consume the tablets/ pills.)
In the consultation V, the midwife prescribed new medicine for the patient
because the patient had used up her medicine. In the consultation VIII, the patient
consulted about her KB program. After listening to her patient, the midwife
decided to give her certain type of KB. Both of the statements in the two
consultations above are categorized as performatives because those would change
the condition of the patients after those utterances were uttered by the midwives.
Patient in the consultation V was changed from the condition ‗she did not give her baby the BCG because she has used up it all‘ become ‗she will give her baby the BCG again because the midwife is prescribing it again‘. While patient‘s condition in the consultation VIII would be changed from ‗not consuming the pills‘ become ‗will be consuming the pills‘. Because midwives have the authority to
prescribe those medicines, they are also appropriate to utter those performatives
4.1.3 Verdictive
Verdictive is an utterance which the speaker makes an assessment or
judgment about the acts of another, usually the addressee (Kreidler, 1998).
Verdictive occurs in this conversation, either uttered by the patients or the
midwives. Total occurrences are 10 or 3,03 % of the total occurences. The
patients uttered only once or 0,30% and the midwives uttered 9 times 2,73%. The
number between patients‘ utterance and midwives‘ utterances is different enough.
The following excerpts containing verdictives are from the consultations between
midwives and patients.
Consultation II
M: Biasane nganu mbak, terlalu panas. Sampean ndeleh’e kepanasen. (It is
usually ehm, too hot. You put it in hot condition.)
The midwife uttered the utterance above as her response to the patient who
stated that she found her medicines being crystallized. The midwife hypothesized
that it was because she had put it in wrong place. She also judged negatively the
patien‘t action at the same time that what the patient did by placing the medicine
in the hot place was a mistake. Beside to admonish the hearer, the speaker can use
verdictive to judge other addressee, the third person such as in the excerpt below.
Consultation VI
P: Oh belum buk, ini kemarin dapet info dari temen, eeh kalau udah berumur,
udah agak tua, mendekati paruhbaya mending kamu Pap Smear. Makanya
my friend: hey, if you are aged, almost middle aged you better do Pap Smear.
Therefore, I come here for asking.)
M: Nah yoo bener seperti ibu iku. Soale ya... apa yang namanya Pap Smear itu harus, diwajibkan buat orang yang sudah menikah atau yang sudah
melakukan hubungan intim. Apalagi ibuknya sudah punya anak toh ibuk?
(That woman is right. Because... what is called as Pap Smear is an obligation
for women who has married or who has mated. You even have kids, right?)
The patient above came to the midwife and told her what she had heard
from her friend about Pap Smear. The midwife who considered that her friend is
right and what the patient did by coming to her is right also, so she assessed both
of the patient and her friend‘s action as something right. In other words, she
assessed and complimented on what they have done as positive.
Although most of verdictives are uttered by the midwives, but there is still
a verdictive uttered by the patient as her denial toward midwife‘s action. When
the midwife uttered assertive utterance to inform the result of measurement, the
patient wanted to criticize indirectly that her measurement might be wrong. See
the excerpt below.
Consultation II
M: (Menimbang berat badan) Inggih, tujuh koma empat. [(Measuring the weight)
Yes, seven point four.]
Verdictive are mostly used by the midwives because once again, either patients or
midwives themselves unconsciously position the midwife as the person who has
right to judge or assess the action or the failures of the addressee, the patients.
4.1.4 Expressive
Expressive is similar with verdictive. Whereas verdictive is about what the
addressee has previously done, an expressive utterance springs from the previous
actions of the speaker, or perhaps the present result of those actions or failures.
From the record, expressive appears ten times or 3,03%. Almost of xpressive were
uttered by the patient, 9 times or 2,73% while the midwives only uttered it once or
0,30% from the total occurrences. Patients more often use this kind of speech act
to express their judgment toward their action or their failures.
Consultation I
M: Nopo’o mbak?(What is up, ma‘am?)
P: Mari mulih loh mbak lali aku... sek tas pirang dino iku. (After coming home,
I forgot it...It was only few days)
Consultation IX
M: ...Sisan, ambek mbak’e iku sering minum air putih ya.. Pinggange sakit? (And also, you should drink water frequently, okay..Is your waist alright?)
P: Kula minum air putih sering buk, tapi kadang-kadang lali. (I frequently drink water ma‘am, but sometimes I forget.)
The patient in the first excerpt above forgot that she had a schedule for
regular meet (KB) with the midwife after she came back (from her origin). She
