The purpose of this paper is the identification of linguistic features that work to co‐construct identities and meaning making processes in a transnational medical consultation. Health scholarship has demonstrated that the medical consultation is essentially an interview that tends to be controlled by the medical provider. However, this paper demonstrates that the epistemic status and stance attributed to the patient and the provider can affect the interaction as can the introduction of a third party and multiple languages. Data analyzed in this paper come from a consultation in a low‐income community clinic in Southern California that involves a monolingual Spanish‐speaking patient, her Spanish–English bilingual daughter, and a Spanish–English bilingual nurse practitioner. Data analysis methodology includes membership categorization analysis (MCA) and interactional sociolinguistics (IS). Findings reveal that occasioned membership categories develop micro‐interactionally, which affect how meaning is negotiated within the interaction and the quality of care that the patient receives. Language choice, prosody, phrase choice, paralinguistic signs, and participation framework contribute to the co‐construction of occasioned membership categories. Implications include the need to attend to how the participation framework and occasioned membership categories may contribute to health disparities for transnational populations.

中文翻译：

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跨国医疗咨询中的偶尔会员分类：互动，边缘化和健康差异

本文的目的是确定在跨国医疗咨询中共同构建身份和意义产生过程的语言特征。卫生奖学金表明，医疗咨询实质上是一次采访，通常由医疗提供者控制。但是，本文证明，归因于患者和提供者的认知状态和立场可能会影响互动，就像引入第三方和多种语言一样。本文分析的数据来自南加州一家低收入社区诊所的一次咨询，该咨询涉及一名说西班牙语的单语患者，她的英语-英语双语女儿和一名西班牙语-英语双语护士。数据分析方法包括成员资格分类分析（MCA）和交互社会语言学（IS）。研究结果表明，偶尔的会员资格类别会以微互动方式发展，这会影响互动中如何协商含义以及患者所获得的护理质量。语言选择，韵律，短语选择，副语言符号和参与框架有助于共同构建偶尔的会员类别。含义包括需要关注参与框架和偶尔的成员类别如何导致跨国人群健康差异。这会影响在互动中如何协商含义以及患者获得的护理质量。语言选择，韵律，短语选择，副语言符号和参与框架有助于共同构建偶尔的会员类别。含义包括需要关注参与框架和偶尔的成员类别如何导致跨国人群健康差异。这会影响在互动中如何协商含义以及患者获得的护理质量。语言选择，韵律，短语选择，副语言符号和参与框架有助于共同构建偶尔的会员类别。含义包括需要关注参与框架和偶尔的成员类别如何导致跨国人群健康差异。