基于社会交换理论视角下的医患信任关系建设研究

Research on the Construction of Doctor-patient Trust Relationship Based on Social Exchange Theory

医患信任危机已成为我国不可忽视的严峻问题。从社会交换理论视角出发,医患信任关系实质上就是一种社会交换行为,交换主体由医方和患方构成。医生治病救人,以实现自我价值、获得物质报酬;患者通过金钱购买医疗服务,以恢复健康、提高生命质量。当双方进行成本-效益评估后,如果感知到非等价交换,就会产生亏损心理,从而出现心理和行为的失衡,引发医患矛盾。本文在分析医患之间的交换类型和权力构成的基础上,提出医患之间理想交换模式——互惠型,以及理想权力模式——大致对等型,并提供相应的改良策略。

The crisis of trust between doctors and patients has become a serious problem which could not be ignored in China. In fact,based on social ex-change theory,the doctor-patient trust relationship is a kind of social exchange,which is composed of doctors and patients as subjects. In order to realize self-value or get material rewards,doctors work to save lives. In order to restore health and improve quality of life,patients spend money to buy health services. After cost-effect evaluation and sensing inequality of the relationship,they will generate a loss,as well as mental and behavioral imbalance; even worse,this situation will lead to a tensional doctor-patient relationship. At first,we analyzed the exchange type and power structure between doctors and patients in this study. Besides,we ventured the ideal exchange model—reciprocal exchange relationship and the ideal power model—roughly equal relationship. At last,we provided some improvement strategy for improving doctor-patient trust relationship.