模拟医学情境中的框架效应初探  

The framing effect in imitatively medical situation：an preliminary exploration

作　　者：彭嘉熙[1] 肖玮[1] 张锋[1] 苗丹民[1] 

机构地区：[1]710032西安,第四军医大学心理学教研室

出　　处：《中华行为医学与脑科学杂志》2012年第6期546-548,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：军队医药卫生科研项目（10SY01）

摘　　要：目的验证Levin划分的三种框架效应在模拟医学情境中是否依然存在。方法自编医疗情境问题，包括医疗水平评价、医生建议依从、医疗方案决策，分别以获益与损失框架进行描述。300名被试被随机分为6组，分别完成2道不同类别，不同属性的决策问题，并评估决策确定程度。结果3种类别的决策问题均存在显著的框架效应：分别以治疗有效或无效人数描述医生，人们倾向给前者更好的评价（x2=32．09，P〈0．01）；当分别以存活率与死亡率描述治疗方案，人们倾向于在以存活率进行描述的情况下，采用短期受损，长期获益的冒险方案（X2=25．92，P〈0．01）；当分别以获益或受损描述医嘱时，前者的遵从性更好（0=11．07，P〈0．01）。不同框架属性与类别下，人们选择保守、冒险方案的确定程度部分差异有统计学意义（t属性，正性=3．84，P〈O．01；t目标，负性=6．44，P〈0．01；t风险，正性=6．57，P〈O．01），且表现为人们对符合框架效应的选项，确定程度更高。结论框架效应在模拟医学情境中依然存在。Objective To verify whether the three different framing effects distinguished by Levin still exist in imitatively medical situation. Methods Established medical decision making problems concerning doctor evaluation, medical compliance and treatment options selection. All these problem were described in the gain and loss frames. 300 volunteers were randomly assigned to six groups. Every volunteer completed 2 decision making problems and evaluated their degrees of certainty. Results If doctors were described in valid number, people tended to make more positive evaluations than described in invalid number（ ~2 = 32.09, P〈 0.01 ）. If treatment options were described in survival rates, people tended to choose adventure option of long-term benefit, otherwise people tended to choose conservative option of short-term benefit（X2 = 25.92 P 〈 0.01 ）. If doctors＇ advices were respectively described in damaging or beneficial frames, the former one has better compliance （ X2 = 11.07, P 〈 0.01 ）. Parts of the deferences between the decision making confidence of choosing the adventure or conservative options were significant （ t attribute,positive = 3.84, P 〈 0. 01 ; t goal,negatlve = 6.44, P 〈 0.01 ; t rlsky,positive = 6.57, P 〈 0.01 ）. People were likely to be more confident with these options conforming to the framing effect. Conclusion Framing effect exists in imitatively medical situation.

关 键 词：框架效应 模拟医学情境 决策确定程度 

分 类 号：R197.1[医药卫生—卫生事业管理]