中国临床心理学杂志

自我-他人医疗决策差异研究

作者：彭嘉熙张石磊肖玮苗丹民

关键词：医疗决策社会距离框架效应

分类号：R395.2

出版年,卷(期):页码：2012,20(4):477-479

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)×self-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 but 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.

基金项目：

军队医药卫生科研项目(10SY01)的资助

作者简介：

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