自我-他人医疗决策差异研究  

A Study on Self-other Medical Decision Making Difference

作　　者：彭嘉熙[1] 张石磊[1] 肖玮[1] 苗丹民[1] 

机构地区：[1]第四军医大学心理学教研室,陕西西安710032

出　　处：《中国临床心理学杂志》2012年第4期477-479,共3页Chinese Journal of Clinical Psychology

基　　金：军队医药卫生科研项目(10SY01)的资助

摘　　要：目的:考察医疗情境中,自我决策与为他人提供建议是否存在决策偏差,并基于解释水平的理论,解释这种偏差的由来。方法:改编Ficchhoff等使用过的医疗决策问题,分别以正/负框架(2)×自我/他人(2)进行描述。355名临床专业大学生被随机分为四组完成决策任务。结果:社会距离对医疗决策影响显著(χ2=8.636,P=0.003),自我决策与向他人建议相比,被试更倾向短期获益,长期受损的保守方案。框架效应对医疗决策影响显著(χ2=9.804,P=0.002),正性框架相比负性框架,被试更倾向短期受损,长期获益的手术方案。解释水平与框架效应交互作用显著:正性框架中,自我-他人决策差异显著(χ2=12.309,P<0.001),自我决策更倾向手术方案,负性框架中,自我-他人决策无显著差异(χ2=0.706,P=0.401);自我决策中,框架效应不显著(χ2=0.91,P=0.340),向他人建议,框架效应显著(χ2=13.256,P<0.001)。结论:社会距离与框架描述对医疗决策存在影响。Objective： To explore whether self-other decision making difference exsist in medical situation and to explain this difference based on the Construal Level Theory. Methods： 355 clinical undergraduates were randomly assigned to four groups and investigated with questionnaire adapted from Ficchhoff＇s medical decision making problem which were described in positive-negative frame （2）xself-other form （2）. Results： Social distance had significant impact on decision making （χ2=8.636,P=0.003）. Compared with giving advice to others, self decision making was more prone to chemical treatment of short-term benefit hut long-term loss. Framing effect existed in medical situation （χ2=9.804,P=0.002）. People tended to choose operation option of long-term benefit in positive frame; otherwise people tended to choose chemical treatment. In positive frame, there was a significant defference between self-other decision making （χ2=12.309, P〈0.001）; while in negative frame, this defference was not significant（χ2=0.706,P=-0.401）. Framing effect was significant when the decision was made for others （χ2=13.256, P〈0.001）, but not significant for decision maker himself （χ2=0.91, P=-0.340）. Conclusion： Social distance and frame description have significant impacts on medical decision making.

关 键 词：医疗决策 社会距离 框架效应 

分 类 号：R395.1[哲学宗教—心理学]