心理学视角下的医患关系:解释水平的作用

The Doctor-Patient Relationship from the Perspective of Psychology: The Role of Construal Level

物质生活的不断改善和提高使得大众对医疗质量和水平提出越来越高的要求,但目前医疗服务尚不能充分满足群众需求,医患关系和矛盾日趋紧张与激化。已有研究多从医患双方行为层面(如合作行为)提出改善医患关系和解决医患矛盾的策略与方法,鲜有研究探讨和分析医患双方心理认知表征方式的差异或不一致在造成不良医患关系中的重要作用。解释水平理论是新近发展的社会认知表征理论,该理论被广泛的应用于解释个体的行为差异。本文从解释水平理论以及与其密切相关的心理距离角度出发,分析解释水平和心理距离对医护人员和患者认知、情绪与行为的不同影响,及其在医患沟通与医疗决策等医疗实践领域的研究应用,进而从提高医疗信息的共享水平、改变医生和患者对不对等权利的认知、调整医生和患者对医患关系的归因方式三个方面,提出解决医患矛盾、促进医患关系改善的建议。

The continuous improvement of material life has led to higher requirements for medical quality and standards, but present medical services cannot fully meet the needs of the public. Doc-tor-patient relationship is becoming increasingly tense. Previous researches focused on behavioral strategies (such as cooperative behavior) to improve the doctor-patient relationship. However, little research has paid attention to the inconsistence of the cognitive representation between doctors and patients in causing bad doctor-patient relationship. Construal level theory, a newly developed social cognitive representation theory, has been widely applied to explain individual’s behavioral differences. From the perspective of construal level theory and psychological distance, the current paper described the different effects of construal level and psychological distance on the cognition, emotion and behavior of medical staff and patients, as well as the applications of construal level and psychological distance in the field of medical practice, such as communication among doctors and patients and medical decision-making, and then proposed suggestions from three aspects to promote the improvement of the relationship between doctors and patients: improving the sharing strategies of medical information, changing the cognition of unequal rights between doctors and patients, and adjusting the attribution to doctor-patient problems of medical staff and patients.