October  2023 66
ICA年度雙語論文ICA Annual Bilingual Paper
Chinese Patients’ Trust in Physicians: Dynamics Between General and Particular Trust
作者 李紅梅、湯潞
Author Hongmei LI, Lu TANG
關鍵詞 醫患溝通、健康傳播、信任、中國醫療改革、消費主義
Keywords Doctor-patient communication; health communication; trust; China’s medical reforms; healthcare; consumerism
摘要 本文旨在建立一個以普遍信任和特定信任之間動態關係為核心的理論模型,來研究中國患者對醫生的信任議題。該模型考慮了宏觀層面的因素(如醫療改革、健康消費主義與資訊環境)和個體層面的因素(如患者特點、醫患交流以及疾病性質等)如何影響患者對醫生的信任。我們使用智慧交互法(phronetic iterative approach)對多年的研究項目收集的數據進行分析。我們的研究表明,普遍信任和特定信任都包括了對於能力和道德的信任,病人對醫生的信任是一個動態過程,普遍信任和特定信任之間相互影響。小城鎮、農村和大城市的居民,由於社會經濟地位和獲得醫療資源的差異,對醫生的信任有所不同。本文還研究了醫生和患者應對信任缺失的策略,顯示出即使在信任不足的情況下,醫患互動仍然可以進行,積極的醫患溝通和制度規範可以幫助醫患雙方重新獲取信任。
Abstract This study examines patients’ trust in physicians in China through the establishment of a theoretical model centered around the dynamic relationship between general trust and particular trust. The model accounts for how macrolevel factors (such as medical reforms, health consumerism, and the information environment) and individual-level factors (such as patients’ attributes, their encounters with physicians, and the nature of illnesses) contribute to patients’ trust in physicians. Data collected through a multi-year research project were analyzed through the phronetic interactive approach. We found that trust in physicians is a dynamic process, with general and particular trust mutually influencing each other, and that both types of trust comprise perceived competency and perceived ethics. We also found that people in small towns and big cities trusted physicians differently due to their different socioeconomic status and access to medical resources. Furthermore, we identified the strategies that physicians and patients used to manage the lack of trust, demonstrating that physicians and patients could still function even when there was insufficient trust. Our research implies that trust can be regained through effective doctor-patient communication and well-regulated institutional arrangements.


Citation of this article:
Li, H., & Tang, L. (2023). Chinese patients’ trust in physicians: Dynamics between general and particular trust. Communication and Society, 66, 239–298.
No.65  2023 July
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