Functional Translation Factors Influencing Quality Chinese Translation on Websites of Southeast Asian Medical Tourism Hospitals

Shuping He^1*, Noor Aireen Ibrahim², Myoung Sook Kang³

^1,2,3 Language Academy, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Johor Bahru, Malaysia

ABSTRACT

Chinese patients are a vital demographic for Southeast Asian hospitals competing for a larger share in the medical tourism market, where websites serve as essential platforms for information seeking, underscoring the need for high-quality translations on these hospital websites. Meanwhile, functionalists emphasize that a successful translation should be adequate for the situation and consider the texts’ communicative functions. This study aims to examine the functional-guided translation factors influencing quality Chinese translations on Southeast Asian hospital websites. The translation factors examined—situational factors and communicative functions—were analyzed through contextual and linguistic analysis, respectively, using manual text reading. Textual data were collected from 186 selected hospital websites across six countries (Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam). Situational factors were analyzed following a coding rubric developed according to Munday’s (2016) proposal for the situational elements to be considered in a translational action, adapted to this study’s context. Communicative functions were classified adopting the threefold rubrics from Reiss’s (1971) Text Typology theory. Results provide empirical evidence that the situational factors of these texts include hospitals as text producer, potential Chinese patients as target audience, and that the intended goals of the text producer are to inform and appeal to potential consumers, among others. Findings also reveal that these texts integrate informative elements (e.g., detailing services and facilities) with appellative features (e.g., promotional and empathetic language) to both inform and appeal to potential audiences, challenging the notion of prioritizing a single dominant function. This study proposes a framework of translation factors that encompasses four situational factors and preserves dual-communicative functions, offering practical insights for enhancing translation quality on medical tourism websites and enriching functionalist approaches to specialized texts.

Keywords: Southeast Asian hospitals websites, Functional translation, Situational factors, Communicative functions, Chinese translation

INTRODUCTION

Southeast Asia has emerged as a favored destination for medical tourism in recent years (Cham et al., 2020; Fitch Solutions, 2022), attracting patients from around the globe, including a substantial number from China. For hospitals in this region, Chinese patients represent a vital segment in an increasingly competitive market, which ranks third worldwide in wellness tourism expenditure (Global Wellness Institute, 2019). Notably, in 2019, 54.8% of these tourists chosen Southeast Asia as their destination (Statista, 2022). Meanwhile, websites remain a primary source of health information-seeking (Moghavvemi et al., 2017; Bandyopadhyay et al., 2022), with 74.9% of internet users turning to them as their first resource for health information (Finney Rutten et al., 2019). This trend underscores the need for hospitals to leverage their websites as key platforms for sharing information and engaging potential patients, particularly those from China, where access to platforms like Facebook may be restricted.

These dynamics emphasize the critical role of high-quality Chinese translations on the websites of medical tourism hospitals. Poor translations can confuse users, undermine trust, and deter potential patients, whereas effective translations enhance clarity, foster confidence, and boost a hospital’s appeal. This highlights the importance of identifying the factors that contribute to successful Chinese translations on these websites—factors that extend beyond the traditional emphasis on literal, word-for-word accuracy.

In this context, functionalism, a prominent approach in translation studies, offers valuable insights by framing translation as “an act of communication”, emphasizing the consideration of situational factors and texts’ communicative functions in translational actions (Reiss & Vermeer, 2014). Functionalists contend that a good translation should fulfill its purpose (Munday, 2016, p. 131) and be adequate for the situation (Reiss & Vermeer, 2014, p. 87). Situational factors—such as the text producer’s goals and the needs of the target audience—play a pivotal role in shaping the translation process. Equally important is the text’s communicative function, whether it aims to inform, persuade, or express, which steers the translator’s choices to ensure the text resonates with its readers. By combining these ideas, functional theories illuminate how translations can achieve their goals in practical settings, such as hospital websites.

Although AI-driven translation tools have gained substantial popularity in recent years (Jiao et al., 2023; Lee, 2024) and shown impressive performance across various language pairs (Dabre et al., 2020; Lee, 2024), their reliance on well-crafted prompts to enhance translation quality, as highlighted in recent studies (Calvo-Ferrer, 2024; Gupta et al., 2025), underscores the need to supply AI systems with contextual information. This suggests that, whether hospitals rely on human translators or advanced AI technologies, a deep understanding of situational factors and communicative functions remains essential for producing translations that are both functionally appropriate and appealing to their intended audience.

As such, this study focused on medical tourism hospitals in Southeast Asia, examining the translation factors that influence the quality of English-to-Chinese translations on their websites from a functionalist perspective. It centers on two key dimensions: situational factors and communicative functions. By connecting functional theory to real-world translation practices, the research seeks to clarify how Southeast Asian hospitals can deliver high-quality website translations tailored to Chinese patients. Additionally, it aims to contribute broader insights into applying functionalist principles to the translation of specialized texts within the medical tourism domain.

LITERATURE REVIEW

Functional theories have significantly shaped contemporary translation studies by shifting the focus from linguistic equivalence to the purpose and context of texts. Scholars like Reiss and Vermeer (2014) argue that a translation’s quality hinges on its adequacy for the situation, emphasizing the need to account for situational factors such as the text producer’s intention and the target audience’s expectations. This perspective is echoed by Hönig (1997), Munday (2016), and Nord (2018), who highlight how extralinguistic elements—like cultural norms and reader needs—interact with linguistic choices to determine translation effectiveness. Understanding the receiver’s intentions poses challenges in certain research contexts, such as this study of hospital websites. These sites target a broad audience, typically addressing “patients,” though readers may also include family members, caregivers, or healthcare providers exploring surgical options. Consequently, identifying the receiver’s intention requires audience research, which is inherently challenging due to the geographically dispersed and technically inaccessible nature of users. Thus, researchers are limited to identifying the intended audience as suggested by the text itself, using this to gain a rough understanding of the audience’s intended purposes for reading the texts.

In addition to stress the importance of situational factors, functionalists advocate that translations must fulfill their communicative functions, whether informative (representing objects and facts), expressive (expressing sender’s attitude), and appellative (making an appeal to text receiver), as outlined in Reiss’ (1971)Text Typology theory and supported by Newmark (1988) and Trosborg (1997). These functions are embedded in linguistic features such as syntax and tone, requiring translators to align their strategies with the text’s intended purpose. Consequently, functional translation theories consider both the linguistic and extralinguistic dimensions when translating texts. This underscores the necessity for analysing the situational factors and text functions before translating and assessing the texts.

Notably, Reiss and Vermeer (2014, p. 155) explained that the intended functions of a specific text variety may change according to different situational factors. This phenomenon was frequently seen in the present study. Take medical texts presented on the examined websites as an example. Medical texts composed for expert-expert communication functions to “inform”, while those offered on medical tourism websites often aim for persuading consumption or educating patients. Therefore, medical texts in the present study do not necessarily possess the informative function. Particularly, when these texts are composed to persuade consumption, the predominant communicative function should be appellative, which consequently requires the translators using general and even vocative words that can encourage target readers to consume.

It is important to note that prevailing arguments about text functions contend to retain only the “dominant one” among the three basic functions (Reiss, 1981, p. 181), indicating the notion of hierarchy: Dominant (high-ranking) functions prevail over lower-ranking ones, and lower-ranking functions must be “changed” if this is the only way to preserve the text type (Hönig, 1997).

Meanwhile, this study found that a singular function could not capture the features of medical texts on medical tourism websites, which aim not only to inform but also to appeal to audiences. Overlooking any of these functions could result in inadequate notions of quality and a biased assessment.

However, given that text function is a determinant of notions of quality (Reiss, 1971; Nord, 1997), it is possible that overlooking the less-dominant function could lead to an inaccurate determination of notions of translation quality, hence result in an ineffective translation. Therefore, this study argues that in a translational action, it is crucial to preserve all primary functions of texts, as they contribute to the text’s overall intended purposes and collectively indicate the appropriate translation methods. This is particularly important for texts on websites of medical tourism hospitals, where many texts are presented for not only informing readers but also appealing to them. Therefore, the realisation of appellative function in translations constitutes significant part of “a quality translation”, and the linguistic features of translated texts should contain appellative elements such as persuasive tone, reassuring and promotional vocabulary.

METHODS

Selection of countries

This study focused on Southeast Asian countries highlight the importance of medical tourism. Countries were identified through a review of authoritative medical tourism rankings: Medical Tourism: A Prescription for a Healthier Economy (World Travel & Tourism Council), Medical Tourism Index 2020–2021 (Medical Tourism Association), Travel & Tourism Development Index 2024 (World Economic Forum), and Global Wellness Economy: Country Rankings (Global Wellness Institute). Those appearing in at least one ranking were included. The selected countries include: Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam.

Selection of hospitals

Hospitals in this study encompass public and private hospitals, clinics, and similar institutions that target international patients. Hospital were limited to those accredited by the Joint Commission International (JCI), a leading international healthcare accreditation body in the world (Al Shawan, 2021), or included in the partner membership list of the Malaysia Healthcare Travel Council (MHTC), a government agency in Malaysia dedicated to promoting the medical tourism sector. The rationale for choosing JCI-accreditation and MHTC-listing as criteria was rooted in two assumptions: 1) These accredited and listed hospitals are more likely to prioritize offering multilingual content on their websites, and 2) These hospitals emphasize attracting international patients hence should provide high-quality translations on websites. After excluding inaccessible links and removing duplicates, a total of 186 hospitals were selected, including 22 from Indonesia, 77 from Malaysia, 5 from the Philippines, 15 from Singapore, 60 from Thailand, and 7 from Vietnam. Websites of these hospitals were numbered with a country-specific prefix followed by a sequential identifier, such as WM1 to WM77 for Malaysia and WT1 to WT60 for Thailand.

Data collection and analysis

Data for analysing translation factors involved textual data manually extracted from the webpage texts. For situational factors, relevant textual segments were extracted based on explicit or implicit cues indicating contextual parameters such as text producer (e.g., institutional identifiers like “We have served international patients from…”), intended audience (e.g., cultural or linguistic markers targeting Chinese patients), and intended purpose (e.g., to inform or appeal). For communicative functions, textual data were selectively gathered for a subsequent linguistic analysis, focusing on linguistic elements such as lexical choices (e.g., reassuring terms like “safe and secure” or call-to-action phrases like “call now”), and syntactic structures (e.g., descriptive sentences for informative functions).

Situational factors were analyzed following a set of rubrics: the text producer, intended target audience, purpose of texts, and medium of texts. These rubrics drew from Munday’s (2016, p. 132) framework for situational elements to be considered in a translational action, and were adapted for the specific context of this study. Specifically, the textual data from webpage texts was examined to identify clues about these situational factors. For instance, the content “We have served international patients from more than 120 countries” suggests that the hospital is the text producer.Communicative functions were analyzed by examining the texts’ linguistic elements, such as vocabulary, sentence structures, and tones, through a manual text reading. The classification of these functions adopted the threefold rubrics proposed by Reiss (1971) in her Text Typology theory: informative, appellative, and expressive functions. Although the contextual analysis of situational factors has revealed the purposes of texts, it is necessary to analyze the linguistic elements for a more detailed examination of their communicative functions, specifically to determine which of the abovementioned three functions they belong to. Therefore, linguistic analysis helps validate and refine the identification of texts functions, ensuring that these functions are grounded in the actual linguistic features of the texts. Figure 1 illustrates the analytical framework of translation factors, including situational factors and communicative functions.

Figure 1: Analytical framework for translation factors

RESULTS

Situational factors of the texts

Based on the coding rubrics outlined in the methodology, this study analyzed the following situational factors: text producer, intended target audience, purpose of texts, and the medium of texts. The situational elements observed from texts are presented in Table 1.

Table 1: The extracted situational elements

Item of elements	Elements	Samples	Sources
Text producer	Hospitals	a.  伊丽莎白医院配备了… (Mount Elizabeth Hospitals are equipped with…) b.  双威医疗中心建立了… (Sunway Medical Centre has established…) c.   吉隆坡鹰哥医院的上消化肠道手术科… (The Upper Gastro Intestinal (GI) Surgery at Gleneagles Kuala Lumpur…) d.  槟城鹰阁医院急诊科… (Gleneagles Hospital Penang’s Emergency Department) e.   我们为来自 120 多个国家/地区的国际患者提供服务 (We have served international patients from more than 120 countries) f.   盧源來專科醫院 …以成为国际性首选的医疗保健中心 (LSC is…so as to make it the destination of preference for International Healthcare.) g.  槟安医院为国际病患提供服务… (Penang Adventist Hospital have been serving international patients…) h.  国际关系中心提供… (International Relation Center offers…)	WS1   WM21   WM4   WM5   WS1   WM11     WM16   WM11
Intended target audience	i.   Potential patients	a.  一旦您进入急诊室 (once you are in the Accident &Emergency Unit) b.  您可能会接受…的治疗 (You may be treated with…) c.   如果您在我们医院有首选的专科医生 (If you have a preferred specialist at our hospital) d.  将以谨慎和全面的方式评估、管理和治疗您的病情 (will evaluate, manage and treat your condition in a careful and holistic manner) e.   帮助您踏上健康、圆满的为人父母之旅 (support you in a healthy and fulfilling journey to parenthood) f.   为了接受医疗而出国，您可能会感到身体和情绪上的压力 (Travelling abroad for medical treatment can be a physically and emotionally stressful experience for you) g.  您会看到… (You will see…) h.  您的舒适是… (Your comfort is…) i.   尽力满足您的要求 (…tries to get whatever you request) j.   与我们讨论您的医疗和交通需求 (talk to us about your medical and travel needs)	WM21   WM43   WM5   WM4   WS1   WM3     WM16   WM21   WM4   WS1
	ii.  Unclear	请将患者带到急诊室进行进一步检查 (bring the patient to the A&E for further investigation)	WM21
Purpose of texts	i.   To inform about the services, technologies and facilities provided by the hospital	a.  我们的救护车服务包括院间转移、应急响应…等 (Our ambulance services include interhospital transfers, emergency response…) b.  妇产科是处理…的两个外科医学专科 (Obstetrics and gynaecology are two surgical medical specialties dealing with …) c.   我们提供眼科检查、视力评估和有关…的治疗服务 (We offer services from eye examination and vision evaluation to …) d.  服务包括病史和临床检查、体重指数 (BMI)、血压筛查等 (Services include History & Clinical Examinations, Body Mass Index (BMI), Blood Pressure Screening, etc.) e.   我们提供服务如下：提供签证申请的证明文件…安排旅店或其他住宿…提供语言协助… (our services include: providing supporting documents for visa applications… organizing hotel or accommodation… providing language assistance… f.   机场接送服务: 需要提前预订 (Airport Transfer: Prior booking is required) g.  在5公里半径范围内为患者/家属提供往返医院的交通服务 (Provide transport for patient/family member to/from hospital within 5 km radius)	WM5   WM4   WM43   WM21     WM3       WM16   WM21
	ii.  To position the hospital as a competent provider of medical services	a.  医院每年进行超过550项心脏手术 (The hospital does over 550 heart surgeries a year) b.  …全天24小时开放，设备齐全，可处理任何伤势或医疗紧急状况 (…is open 24 hours a day and well-equipped to handle any injury or medical emergency) c.   由高级生命支持训练有素的人员带领 (Helmed by Advanced Life Support Trained Personnel) d.  完善的基础设施和从业人员随时为中风患者的抢救和康复做好准备 (…full-fledged infrastructure and practitioners stand at the ready for the rescue and recovery of stroke patients) e.   在…专家团队的额外支援下，我们能够为病患提供最佳的循证结果 (With additional support from a dedicated team of experts at the…, we are able to provide the best possible evidence-based outcome for the patient.)	WM16   WM5     WM5   WM21     WM16
	iii. To address patients’ needs and concerns	a.   我们理解到…对我们的国际患者来说压力特别大，因此我们尽最大努力提供尽可能多的支持和关怀 (We understand that…can be especially stressful for our international patients, hence we do our best to provide as much support and care) b.   宗旨是为国际病人提供这些基本服务予让他们安心 (aims for the International patients to feel at ease with all these essential services provided.) c.   使用这类服务不需要额外付费 (There is no additional cost for using the services) d.   您可能对在鹰阁医院接受治疗的费用有疑问; 我们的团队可以为您… (You may have questions about how much it costs to get treated at our hospitals. Our team can advise you…) e.   本医院里大部分的医生和护士都掌握至少两种语言能力(Most of our doctors and nurses speaks at least two languages)	WM21       WM11     WS1   WS1     WM16
Medium	Web portal of hospital (Website)	All texts were extracted from web portals of hospitals.

The contextual analysis revealed that the examined translational actions took place on the medium of websites, with hospitals and potential patients acting as communicative partners. The facilities included hospitals, centres, clinics, and other healthcare institutions. The texts were produced by hospital or its departments associated with the information displayed in the text. The present study collectively considers “hospitals” as the text producer.

Furthermore, the intended audiences were identified through analysing the texts. For example, text excerpts “You may be treated with…” and “…will evaluate, manage and treat your condition…”addressed the reader as “you”, indicating that the text speaks directly to individuals who are considering or in need of medical treatment—specifically, the potential patients. However, while most texts clearly addressed potential patients as the intended audiences, there were instances where the audience was less clear. For example, in the text excerpt “bring the patient to the Accident &Emergency for further investigation”, the intended audience could also be the patient’s family or even a passerby. As highlighted in the literature review, due to the challenges of assessing the target audience in this research, the best the researcher can do is identify the audience as indicated by the text itself and, from this, gain a rough understanding of the audience’s likely purposes for reading the texts. Additionally, since the translated texts are in Chinese language, their intended audience is likely those who prefer to seek information in Chinese.

The purposes of these texts were also identified. Their primary purpose is to inform potential patients about information such as services, technologies and facilities provided by the hospital. This is evidenced in phrases like “ambulance services include…”, “We offers services from…to…”, and “Obstetrics and gynaecology are two surgical medical specialties dealing with …”. Moreover, the texts’ subsidiary purpose is 1) to appeal to the patients by positioning the hospital as a competent care provider and encouraging patients to act, which was achieved by highlighting the hospital’s large number of surgical cases (“The hospital does over 550 heart surgeries a year”), the competence (“…is open 24 hours a day and well-equipped to handle any…”), the professional staff (“Helmed by …Trained Personnel”), the additional expert support (“With additional support from a dedicated team of experts…”), and 2) to address patients’ potential stress and challenges associated with traveling for medical care. For example, hospitals specified services tailored for international patients, such as “organizing hotel or accommodation”, providing “language assistance”, and offering “airport transfer” services. Additionally, hospitals demonstrated empathy and addressed patient concerns by stating “We understand that…can be especially stressful for our international patients”, and “There is no additional cost for using the services”. The information conveyed through these texts focused on highlighting the hospital’s commitment to providing exceptional, personalized and worry-free services for international patients.

In summary, the contextual analysis revealed that TV1 and TV6 texts on the examined websites were produced or sponsored by hospitals for their intended audiences, and were presented through the medium of websites to connect hospitals and patients. The intended communicative purposes of these texts were to inform the audience by providing essential information and appeal to them by addressing their needs and concerns, thereby persuading them to choose the facility.

Communicative functions of the texts

The previous contextual analysis revealed that the purpose of the text producer for providing these texts was to inform and appeal to the audience. However, it is crucial to examine whether language use in the texts is consistent with the conclusions drawn from the contextual analysis. It is possible that the linguistic data does not align with the contextual findings.

By examining the language use, it was observed that both informative and appellative elements are frequently found in the texts. Table 2 summarises the informative and appellative elements identified in the language use. Each element was supported by examples extracted from the Chinese texts. A literal English translation (italicized words in parentheses) was provided for each Chinese example to align with the language of this thesis.

Table 2: Informative and appellative linguistic elements in the texts

Elements	Samples	Sources
A.     Informative elements
Descriptive sentences	“荷尔蒙疗法用于减缓或阻止激素敏感肿瘤的生长。” (Hormone Therapy is used to slows down or stops the growth of hormone-sensitive tumors.) “阿儿法国际辅助生殖中心位于马来西亚雪兰莪州的主要城市-八达岭再也。” (ALPHA IVF is located in Petaling Jaya, a major city in Selangor, Malaysia.)	WM43     WM1
Structured textual organization	Texts divided into sections based on information topics, such as “Services”, “Equipment and Staff Support”, and “Panel of Professionals”.	WM16 WM21
Medical and technical vocabulary	“心血管疾病” (Cardiovascular disease), “多发性创伤”(Polytraumas), “心脏骤停” (Cardiac arrest),  “主动脉内球囊反搏泵” (Aortic balloon pump)	WM5 WM16
Context-specific vocabulary	“多语种翻译员” (multilingual interpreters), “联络服务” (liaison service),  “签证申请的证明文件” (supporting documents for visa applications)	WT5 WT10
Precise geographical terms	“八达岭再也” (Petaling Jaya), “雪兰莪州” (Selangor), “吉隆坡国际机场” (Kuala Lumpur International Airport (KLIA))	WM43
Precise geographical terms	“八达岭再也” (Petaling Jaya), “雪兰莪州” (Selangor), “吉隆坡国际机场” (Kuala Lumpur International Airport (KLIA))	WM43
Bullet points and lists	•  376张许可床位 •  40个医学专科 •  200+名医疗保健专业人员 •  9间手术室   •   376 Licensed Beds •  40 Medical Specialties •  200+ Healthcare Professionals •  9 Operating Theatres)	WM4
Use of table format	Laboratory Analysis Full Blood Count                                      P Blood Film                                    P Erythrocyte Sedimentation Rate (ESR)   P Lipid Studies                                             P	WM21
Institutional perspective	“鹰阁医院致力于” (Gleneagles strives to…) “柔佛州美迪尼的鹰阁医院的救护车…” (Gleneagles Hospital Medini Johor’s ambulance is…) “清迈曼谷医院国际医疗服务部是…” (The International Medical Services Department at Bangkok Hospital Chiang Mai is…)	WM4 WM55   WT5
B.     Appellative elements
Reassuring and promotional vocabulary	“舒适的” (comfortable),  “完全康复” (fully rehabilitated), “密切监测” (closely monitored), “优质的护理” (quality care), “安全可靠” (safe and secure), “确保效率” (ensures efficiency), “专业优质” (professional and premium), “最优质的” (most premium), “最佳的” (world-class), “资深专业” (extensive expertise), “精通” (well-versed), “安心使用” (worry-free), “无忧” (hassle-free), “顶尖” (advanced), “无数第一成就” (countless firsts), “贴心服务” (1-on-1 premium care), “超乎预料的” (exceeds their expectations), etc.	WM1 WM3 WM16 WS1 WS2 WT10 etc.
Customer-centric language	“以客户为中心” (customer-centered), “患者的需求” (patient needs), and “为您管理潜在的健康风险” (help you manage potential health risks)	WM21 WS2
Supportive and empathetic tone	“我们理解到医院就诊对我们的患者来说压力很大” (We understand that visiting the hospital can be stressful for our patients)	WM21
Call-to-action phrases	“立刻行动” (Act Now) “现在拨打” (Call Now) “立即探索” ( Have a look at…) “欢迎咨询!” (We want to hear from you!) “别再延误了，马上与我们的团队取得联系以…” (Don’t hesitate; reach out to our team today to…) “如有疑问，欢迎到脸书或电邮询问详情” (Reach us on Facebook now or drop us an email to get immediate answers of all your queries and doubts)	WM1   WM4   WM21     WM16
Certainty and assurance in modality	“能够为病患提供最佳的…” (able to provide the best possible…for patients) “将随时为您评估和管理您的病情” (… are on hand to assess and manage your condition once…) “…也 24 小时待命”(…are also on-call 24-hours) “我们提供” (we provide), “您不用担心” (you don’t need to worry), “我们能够为您解答任何疑问” (We are available to answer any queries), “我们能够为您提供翻译员” (We can provide interpreters for you)	WM3 WM16 WM21 etc.
Honorific address to patients	Address patients as “您” (honorific form of ‘you’ in Chinese language)	WM25 etc.
Friendly and warm pronoun perspective	The consistent focus on what “we” can do for “you”. e.g. “根据您的医疗需求，我们可以推荐…” (Depending on your medical needs, we can recommend…), “我们的团队可以为您提供…” (Our team can advise you on…)	WT5 etc.

Most of the texts primarily use descriptive sentences to present factual information, focusing on detailing the medical services available, the hospital’s facilities, medical technologies, location, transportation options, accommodation, and additional support services (e.g., language assistance, visa facilitation). This linguistic feature effectively supports the informative function by delivering clear and straightforward information to the intended audience.

Structured textual organization was also frequently observed, dividing information into sections describing the hospital’s services, facilities, technologies, specialist teams, and costs. This organization allows users to quickly locate specific information relevant to their needs. Similarly, the texts use bullet points, lists, and tables to organize complex information into easily digestible segments. Thess textual approaches further enhance the informative function by ensuring that audiences can easily navigate and comprehend the content.

As for lexical choices, the texts extensively use medical and technical terms, such as “cardiovascular disease”, “Polytraumas”, and “dialysis”, as well as context-specific vocabulary that are specific to the medical and international healthcare context. Precise geographical terms were also frequently seen. These elements support the informative function by conveying detailed and specialised information about medical procedures and services and providing essential information relevant to patient’s medical journey.

In some cases, the language use adopts an institutional perspective. In other words, the text predominantly employed third-person references, refering to themselves as “the hospital/center” or state the full name of the institution, emphasizing the hospital’s capabilities and offerings. This language strategy aligns with the informative function by presenting the hospital as a professional entity.

In addition to the informative elements, both text varieties also exhibit extensive appellative elements. The most common appellative element is the recurring use of reassuring and promotional vocabulary. Words and phrases such as “专业优质” (professional and premium), “最佳的” (world-class), “最尖端的” (cutting-edge), “无忧” (hassle-free), “顶尖” (advanced), “舒适的” (comfortable), and “非常方便” (very convenient) were frequently used. These terms were selected to reassure potential patients about the high standards of care, aligning with the appellative function by appealing to the reader’s desire for reliable and quality treatment.

Moreover, customer-centric language was frequently observed, such as “以客户为中心” (customer-centered), “患者的需求” (patient needs), and “为您管理潜在的健康风险” (help you manage potential health risks). These expressions help bridge the gap between complex medical information and the needs of the patient by focusing on the patient’s experience, addressing their concerns, and ensuring that they feel informed, cared for, and confident in the services provided. Thus, this language element also indicates the appellative function of texts.

The texts also exhibited certainty and assurance in modality, using strong, certain language to reassure patients with phrases like “我们提供” (We provide), “您不用担心” (You don’t need to worry), and “我们能够 (We can). This modality supports the appellative function by instilling confidence in the services offered. Additionally, many websites were observed with call-to-action phrases such as “别再延误了” (Don’t hesitate), “现在拨打” (Call Now), and “欢迎咨询!” (We want to hear from you!). These phrases were used to persuade potential patients to choose the hospital’s services, with some even introducing a sense of urgency to encourage immediate action. This element also aligns with the appellative function, aiming to influence the behavior of website audiences.

Appellative elements were further observed in the pronouns and perspective. First, the texts frequently address patients as “您”, the honorific form of “you” in Chinese language. This practice expresses respect for patients, thus appealing to them by establishing an emotional connection with them. Additionally, the texts often adopt a friendly and warm perspective with a consistent focus on what “we” can do for “you”. This use of pronouns fosters a direct and friendly connection between the hospital and the patient, reinforcing the appellative function.

The tones of language present a combination of informative and appellative functions. In general, texts adopt a professional yet reassuring tone, combining professionalism with a reassuring warmth. This dual-tone approach provides reliable information while appealing to the emotional needs of potential patients. In particular, the supportive and empathetic tone, with statements like “我们理解到医院就诊对我们的患者来说压力很大” (We understand that hospital visits can be stressful for our patients), acknowledges and addresses patients’ fears and uncertainties, helping to reduce anxiety and making them feel more comfortable and confident in their healthcare journey. This language element indicates the appellative function of texts.

To summarize, the linguistic analysis revealed that the intended functions of these texts are primarily informative, with a strong appellative feature, thus reflecting an “Informative + Appellative” function. The use of factual descriptions, coupled with reassuring, persuasive and friendly language, aim to create a comprehensive picture that both informs and persuades audiences. These findings highly align with the conclusions drawn from contextual analysis, which identified the primary purpose of text producer as both informing and appealing to target audiences.

DISCUSSION AND IMPLICATIONS

Distinctive communicative functions of texts on Southeast Asian medical tourism hospitals

This study found that texts on the websites of medical tourism hospitals in Southeast Asia reflected distinct communicative actions and language convention compared to similar texts in other contexts. For instance, the medical texts on these websites, while also using formal tone and straightforward sentence structures as general medical texts, employed promotional vocabulary and customer-centric language, such as “优质的护理” (quality care), “安全可靠” (safe and secure), and “为您管理潜在的健康风险” (help you manage potential health risks). The finding supports the argument that medical language varies from genre to genre, depending on the communicative situation and its participants (Karwacka, 2015). Another example is the legal texts. In general, legal texts employ formal and specialised language, featuring wordy expressions and complicated sentence structure. However, their source texts on the examined websites were often composed in more plain language to make them easily understandable by individuals, a characteristic that should also be delivered in translated texts. For example, WM21 in its “Patient Rights” section displayed “A patient has the right to know the various options available for the same treatment”, whereas standard legal language would typically use “is entitled to” instead of “has the right”. Overall, the texts examined in this study were tailored to address the unique context of medical tourism website communication between hospitals and patients, employing specific language norms. These findings highlight the practicality of functional concepts that situational factors should be considered when making translational decisions (Reiss & Vermeer, 2014; Munday, 2016). In this regard, it’s essential for translations on medical tourism hospital websites to employ appropriate translation strategies to address the specific situational factors and intended communicative functions of these texts.

A notable finding in this study is that texts on medical tourism hospital websites possess multiple communicative functions, each of which reflects distinct implications for translation strategies hence shall not be overlooked. This finding aligns with the recognition that hospitals initially set up web portals to inform patients while attracting consumptions (Crooks et al., 2011; Aghbolagh et al., 2024), and Yamin’s (2015) emphasis on balancing the two communicative functions when translating the tourism website texts. Specifically, a contextual and textual analysis under this study revealed that these texts simultaneously possess the informative and appellative functions. Hospitals offer these texts to not only inform audience to address their information needs, but also appeal to them to attract potential consumptions. Further, this study found extensive linguistic evidence from the analysis on communicative functions, where texts exhibited various linguistic strategies to full fill the intended functions. For example, texts on the examined websites incorporated reassuring and promotional vocabulary and supportive and empathetic tone to enhance its appeal to target audience.

Thereby, this study raises concern about previous functional concept that  “the dominant function shall prevail” (Reiss, 1981, p. 181). For instance, Reiss exemplified her Text Typology theory by stating that corporate introduction has the dominant function of informative and secondary function of appellative, while only the dominant one shall be retained when translating and assessing the texts. In the case of this study, if the appellative function is overlooked, would a translated corporate introduction that achieves the informative function by delivering all necessary information considers an adequate translation? What if such translation did not use customer-centric language and promotional vocabulary thus failed to make the texts appeal to target audiences? Therefore, this study asserts that it is crucial to preserve all primary functions of texts on websites of medical tourism hospitals, as they collectively contribute to the text’s overall intended purposes and indicate the appropriate translation methods.

Implication of translation factors for ensuring quality Chinese translation on these websites

The findings of this study revealed the situational factors and communicative functions of texts on medical tourism hospital websites in Southeast Asia, which together form a framework of translation factors for achieving high-quality Chinese translations from a functional perspective (see Figure 2).

Figure 2: Framework of functional translation factors for text on medical tourism hospital websites

As shown in the framework, these texts were provided by hospitals for potential patients or visitors, particularly those who prefer to seek information in Chinese. Moreover, their intended functions were to inform and appeal to audiences. A review of functional theories highlights that a translation should be adequate for its situations and fit for its purpose (Reiss & Vermeer, 2014; Munday, 2016), and different text varieties may serve distinct functions hence require different translating methods (Reiss, 1981, p. 127). Karwacka (2014) further specified the strategy for translating medical texts, proposing to consider text functions and targe readers’ expectations. These insights underscore the need to approach the translation of texts on medical tourism hospital websites with careful attention to their specific situational factors and intended functions.

Furthermore, the most significant implication of this study’ findings for translating texts on medical tourism hospital websites is the necessity for considering all important functions of texts. As discussed in the above section, while functionalists argue that “the dominant function shall prevail” (Reiss, 1981, p. 181), this study asserts that it is essential to preserve all primary functions of texts. In other words, both the informative and appellative functions of texts should be considered when translating and assessing them. Overlooking any of these functions could result in inadequate notions of quality and a biased assessment. Overall, the situational factors and intended functions the examined texts bring several implications for translating them.

The first implication is that translations should focus on achieving the intended goals of text producer. Overall, hospitals set up websites to present and promote themselves (Aghbolagh et al., 2024) while informing about treatment options, facilities, costs and more (Crooks et al., 2011). Additionally, hospital websites serve as marketing tools that connect health providers and patients particularly in terms of information dissemination and communication (Chiappa, 2013; Vogus & McClelland, 2016; Truong et al., 2022). This underscores the need for website translations to balance the purposes of information dissemination and appeal. Similarly, this study identified that the primary functions of texts on these websites are to inform and appeal. Therefore, their Chinese translations should aim for fulfilling the purposes of informing and appealing to audiences. As Carreira (2022) puts it, translators should consider the “pragmatic effectiveness” of target texts.

Specifically, to achieve the informative function, translations should deliver accurate content and avoid unwarranted deviations from the source texts. Moreover, translators must ensure precision, which is particularly important for medical texts on these websites, which features informing about technical and medical information and using substantial number of technical terms. The importance of accuracy in medical translation has been emphasized by many scholars (Rask, 2008; Karwacka, 2015; Alasbahy & Shamsi, 2023). Meanwhile, to enhance the appeal of texts to audiences, the language should be customer-centric, warm, and polite, adopting a persuasive tone along with reassuring and promotional vocabulary. Additionally, the texts should employ fluent target language, avoiding awkward expressions, unnecessary sentence structure transfers, or ungrammatical language use. Medical texts, in particular, should use user-friendly language, as this is essential for non-specialist target audiences (Askehave & Zethsen, 2000). In addition, it’s important to be aware that hospitals, as institutions, often aim to project an image of professionalism. This highlights the need to maintain a professional tone and, at times, adopt an institutional perspective in the language.

The second implication arises from the analysis of the target audience. Findings revealed that the target audiences of these texts were potential patients or visitors, particularly those who prefer to seek information in Chinese. As suggested by many scholars, their purpose in browsing websites is generally to search for information and mitigate perceived risks before choosing a medical destination (Mason & Wright, 2011; Khan et al., 2016; Sánchez-Cañizares et al., 2021). Therefore, translations should avoid incomprehensible meanings and use widely accepted terminology to facilitate understanding. Specifically, a translation that is accurate but contains awkward expressions or incomprehensible meanings may still hinder audiences from receiving the information the text producer intended to convey. Moreover, it is crucial to use widely accepted terminology to ensure that readers can understand the content. These strategies help ensure that translations meet the information needs of audiences.

The analysis of target audiences further brought a third implication for translational actions—attending to the linguistic and cultural norms of Chinese audiences. Since Chinese audiences and the Chinese language may have distinct norms, translations should employ appropriate expressions and lexical choices to align with these norms. On one hand, translations should sound natural and conventional in the target language, using expressions that match Chinese language and cultural conventions. On the other hand, cultural differences should be adapted, and any potential cultural loss should be compensated for in the translation.

CONCLUSION

This study highlights the critical role of functional translation factors in delivering high-quality English-to-Chinese translations on Southeast Asian medical tourism hospital websites. By analyzing 186 websites from six countries, the research demonstrates that effective translations hinge on aligning situational factors—such as the hospital as text producer, potential Chinese patients as the audience, and websites as the medium—with the texts’ dual communicative functions of informing and appealing. The findings challenge traditional functionalist views that preserve only dominant function, revealing instead that both informative and appellative functions shall be achieved to meet the needs of Chinese medical tourists. Linguistic analysis further confirms that translations must balance precision and professionalism with persuasive, customer-centric language to achieve high-quality translation. These insights were integrated in a framework of translation factors that can guide hospitals—whether using human or AI translation tools—in optimizing their website translations to attract and inform international patients. Beyond its practical implications, this study enriches functionalist translation theory by advocating for a multi-functional approach in specialized contexts like medical tourism, paving the way for future research into translation strategies across diverse contexts.

ETHICAL CONSIDERATIONS

This research does not involve ethical considerations as it does not involve human participants or sensitive data.

CONFLICT OF INTEREST

No potential conflict of interest was reported by the author(s).

DATA AVALABILITY

Data are available from the corresponding author upon request.

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