Risk communication between doctors and patients: Matching role and information
2023, 31 (1):
Distortion of doctor-patient communication often leads to high misdiagnosis rate and conflict. How to scientifically and effectively carry out risk communication between doctors and patients? This is a hot spot in recent years, such as "Nature", "Science" and other journals and it is also an important issue that our country needs to overcome urgently. Two types of risk theories have been proposed to explain this. Among them, the concrete representational of risk communication believes that risk information is difficult to understand, and if the risk information is concreted, risk communication distortion can be reduced; the abstract representational of risk communication believes that abstract risk information is convenient for transmission, if risk information is abstracted, risk communication distortion can be reduced. These two contradictory risk concepts are difficult to provide accurate solutions for clinical doctor-patient communication, and it is also difficult to explain why sometimes the risk concretization is better, and sometimes the risk abstraction is better.
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Based on construct level theory, we proposed a mixed model of event experience and probability experience by matching doctor-patient role and information, to reconcile contradictions and provide countermeasures. Specifically, in the event experience of the disease, doctors provide advice to others, and the event is less attractive to them, so doctors have a farther psychological distance from the disease, and are better at representing abstract risk information. When faced with concrete risk information, risk perception bias is large. Patients make decisions for themselves, and the event is more attractive to them, so patients have a closer psychological distance from the disease, and are better at representing concrete risk information. When faced with abstract risk information, the risk perception bias is large; In terms of the probability experience of disease information, doctors have rich experience in diagnosis and are more sensitive to experiential probability information. Therefore, doctors have a closer psychological distance with disease information, and are more inclined to make decisions based on experience, which are easy to underestimate small probability events. Patients lack experience in diagnosis and are insensitive to descriptive probability information. Therefore, patients have a farther psychological distance from disease information, and are more inclined to make decisions based on description, which are easy to overestimate high-probability events. In conclusion, in the risk communication between doctors and patients, the "matching" of roles and information can promote the accurate perception of risk information by doctors and patients, that is, communicating abstract representational risk with doctors and communicating concrete representational risk with patients, which can reduce the risk distortion.
In real life, the process of doctor-patient risk communication is complex, and further research is needed in the future: 1) The impact of individual differences on the matching effect, such as the individual's computing ability, spatial ability, etc.; 2) In the doctor-patient risk communication, ecological validity of matching effect should also be take into account, such as doctor-patient empathy, emotional needs of relatives, etc.; 3) Explore more appropriate education models from a theoretical perspective, and develop more risk experience and risk transformation technologies from a practical perspective, so as to improve the quality of doctor-patient risk communication more scientifically and effectively.