新发(重大)传染病社会管制内涵及三维决策理论框架思考

Connotation and theoretical framework for three-dimensional decisionmaking of social control on emerging(major) infectious diseases: a literature study

目的探索建立新发(重大)传染病的社会管制理论框架。方法通过PubMed、CNKI、万方等学术数据库检索与"社会管制"、"社会控制"概念相关的中英文文献,英文检索词包括:"social regulation/control"、"formal and informal control",共获得1900—2020年期间中英文文献全文45篇,运用文献内容分析法和专家论证对社会管制的相关要素进行解析和挖掘,采用重测信度检验各要素的解析信度。结果通过对全部45篇文献进行解析,最终运用逻辑分析法阐述11类要素,重测信度分布在0.800~1.000,信度良好,说明解析结果具有可靠性和稳定性,要素包括目的、原则、管制范围、管制主体、管制手段、管制过程、管制对象、价值取向以及结果,并在此基础上结合专家论证加入管制时间和管制强度2类要素。本研究借鉴全球治理的逻辑框架以及"结构-过程-结果"模型阐述了社会管制各要素的相互关系,并通过对传染病传播途径、传染性和严重程度3个维度综合风险的研判,构建新发(重大)传染病社会管制三维决策理论框架。结论理论框架作为科学判定不同管制类型区域、强度、时间的重要依据,对有效及时控制传染病疫情将发挥指导作用。

Objective To explore the theoretical framework of social control on emerging(major) infectious diseases.Methods With the key words such as ’social regulation/control’ and ’formal/informal control’, we searched PubMed, China National Knowledge Infrastructure(CNKI), Wanfang Academic Journal Full-Text Database(Wanfang) and other academic databases for related literatures published from 1900 through 2020. Relevant elements of social regulation were analyzed and mined using content analysis and expert argumentation. Test-retest reliability was adopted to assess the analytic reliability of each element. Results Through logical analysis on the 45 full-text Chinese or English literatures retrieved, totally 11 elements were elaborated and the elements included the purpose, principle, scope of control, subject of control, means of control, process of control, object of control, value orientation and result. The indexes of test-retest reliability were between 0.800-1.000, indicating good reliability of the analyses. Two other elements – control time and control intensity were added to the element list based on expert argumentation and logical analysis. The relationship among the elements of social regulation were expounded in the light of the logical framework of global governance and the ’structure-process-result ’model. Through the study and judgment on three dimensions(transmission route, infectivity and severity) of an infectious disease, a three-dimensional decision-making theoretical framework for social control on emerging(major) infectious diseases was constructed. Conclusion The theoretical framework, as an important basis for scientifically determining the region, intensity and time of different social control on a major infectious disease, will play a guiding role in effectively and timely controlling on an infectious disease epidemic.