Structural Discourse Markers in German Palliative Care Interactions

The aim of this study is to provide a systematic account of structural discourse markers operating at a conversational macro-level in German Palliative Care interactions, focusing on their frequency, distribution, co-occurrence, and speaker-group-specific usage. By combining qualitative approaches from conversation analysis and interactional linguistics with quantitative methods from corpus linguistics, discourse markers are analyzed together as a functional category from multiple analytical perspectives to enhance the overall understanding of the use of discourse markers. The analysis reveals a functional distribution across different transition points in conversation: Whereas the German so most frequently appears in openings and transitions to non-verbal activities, gut and okay predominate in topic shifts and conversation closings. However, gut and okay differ in their composition of discursive functions, although discourse structuring emerges as the second most frequent function in both cases, an observation that stands in contrast to the continued neglect of this function in standard dictionary entries. The institutional asymmetries inherent in medical interactions are reflected in the finding that both doctors and caregivers use significantly more structural discourse markers than patients and their relatives. Differences between physicians’ and caregivers’ use of discourse markers can be attributed to their different professional roles and communicative responsibilities.