【作者】 陈一笛； 马金金； 朱焕雅； 甘怡群；

【Author】 Yidi Chen;Jinjin Ma;Huanya Zhu;Yiqun Gan;School of Psychological and Cognitive Sciences, Peking University;

【机构】 北京大学心理与认知科学学院；

【摘要】 目的:近年来,中国的医患矛盾已经侵蚀了公众对医生的信任,中国的医患信任随着杀医伤医案件的爆发跌至谷底。但是,自2020年1月以来,与COVID-19大流行的斗争可能改变了公众对医护人员的看法。我们的研究探究了公众信任在疫情爆发后是否发生变化,如果发生了是如何变化的,以及"封城"、隔离的政策和社会支持如何促进公众对医生的恢复。方法:采用具有全国代表性的纵向样本,于2020年2月至3月在中国大陆29个省进行了基于人口的纵向研究。基线样本(N=3233)是在中国COVID-19传播最快的期间获得的(2020年2月1日至9日)。研究随访(N=1380)在疫情恢复期进行(2020年3月17日至24日)。排除30名地理位置发生改变的个体,共得到1350名参与者在这两个时间点匹配的数据。使用M-plus 7.0的极大似然估计法估计了两个时间点民众对医生信任的潜剖面模型,和一个潜在转化模型探究社会支持、风险感知对医患信任变化的影响。结果:民众对医生的信任在疫情爆发期间有显著的改善。通过两个时间点的潜剖面模型发现,两个class的潜剖面模型拟合最好,参与者被分为中度信任组(T1时潜剖面类别概率为21%,T2时有45%转变为高信任组)或高信任组(T2有88%保持在高信任组)。在有隔离经历的人群中[B=0.52, p=0.041, 95%CI (0.02-1.03),OR=1.68],以及在社会支持较高的人群中[B=0.60, p=0.001, 95%CI=(0.29-1.02),OR=1.83]观察到了从中度信任组到高信任组的转化。社会支持调节了向高信任潜剖面的转变。结论:我国COVID-19疫情爆发和隔离经历与患者对医生信任度的提高有关。在突发公共卫生事件中,公众对医疗服务提供者的信任可以恢复,应利用社会支持和风险管理策略进一步促进维持医患信任。更多还原

【Abstract】 Background For over a decade, conflicts between physicians and patients in China have eroded public trust in physicians(PTP). The recent battle with the COVID-19 epidemic ongoing since January 2020 may have changed public perceptions. Our study investigated whether and how PTP changed since the outbreak and how lockdown experience and social support contributed to restoration of PTP. Methods A Population based, longitudinal study were conducted in 29 provinces in Chinese mainland with nationally representative longitudinal data from February to March,2020. The baseline sample(N = 3,233) was obtained during the most rapid progression of COVID-19 in China(February 1 to 9). Study follow-up(N=1,380) took place during the recovery period(March 17 to 24). A total of1,350 participants were matched between the two time points(30 participants were removed due to change of location). Two latent profile models and a latent transition model were estimated using robust maximum likelihood estimation(MLR) by M-plus 7.0. Results PTP significantly improved during the outbreak. Participants were classified into either a moderate trust(21% at T1; 45% transition into high group at T2) or a high trust(88%maintained at T2) in physicians’ latent profile. A latent transition from the moderate trust to the high trust group was observed between baseline and follow-up in locked-down regions [B = 0.52, p = 0.041, 95% CI(0.02-1.03),OR =1.68] and among those with higher social support [B = 0.60, p = 0.001, 95% CI =(0.29-1.02), OR = 1.83]. Social support moderated the transition to the high trust latent profile. Conclusion The COVID-19 epidemic outbreak and lockdown experience in China was associated with increased patient physician trust. The public trust can be restored in health care providers during a public health emergency and social support and risk management strategies should be utilized to further promote to maintain PTP.更多还原