共同内群体认同对医患竞争受害感的影响及其机制

doi:10.3724/SP.J.1041.2023.00752

摘要/Abstract

摘要：

本研究基于共同内群体认同模型, 以医务人员和患者及家属为研究对象, 考察了共同内群体认同对医患竞争受害感的影响及机制。预研究通过问卷调查证明了医患群体间存在竞争受害感; 实验1采用共同内群体认同的操作范式, 发现共同内群体认同能够有效减少医患双方的竞争受害感; 实验2A进一步发现, 权力需要在医方和患方共同内群体认同和竞争受害感之间起中介作用, 而道德需要的中介作用不显著。实验2B采用更接近社会现实情境的重新范畴化范式, 结果显示共同内群体认同的主效应不显著, 但与群体身份的交互作用显著, 仅医方权力需要的中介路径成立。本研究揭示了共同内群体认同不仅能够直接降低医患双方的竞争受害感, 而且可以通过减少权力需要进一步降低竞争受害感, 从群际角度为缓和医患之间的紧张关系提供了新的视角。

关键词: 医患关系, 竞争受害感, 共同内群体认同, 权力需要, 道德需要

Abstract:

Competitive victimhood is a psychological phenomenon pervasive on both sides of an intergroup conflict; it implies that one person believes their group suffers more than the other does. As one of the most prominent and growing barriers to positive intergroup relations globally, competitive victimhood has gradually attracted the attention of researchers. However, little research has been conducted on competitive victimhood in Chinese hospitals, where the doctor-patient relationship is increasingly tense. The common ingroup identity model holds that by reconstructing social identity and breaking the boundaries of conflict groups, members can develop a common ingroup identity. This identity improves attitudes toward outer groups, which may help reduce competitive victimhood. The need-based model argues that power and morality are ingroups and outgroups’ basic needs. Members of both sides are threatened by power or morality and are motivated to restore their identities, affecting competitive victimhood. Therefore, it is worth studying whether common ingroup identity can effectively reduce competition victimization between doctors and patients and what roles power and moral needs play.

In Study 1, 90 doctors and nurses and 86 patients and their families from three hospitals in Shanghai and Sichuan were selected in a 2 (group: doctors vs. patients) × 2 (common identity: control group vs. common ingroup identity) design. A brief story about doctors and patients fighting disease together was used to improve common ingroup identity. Then we used a questionnaire about competitive victimhood to investigate whether common ingroup identity affected competitive victimhood between doctors and patients. In Study 2A, another group of participants was selected, including 71 doctors and nurses along with 73 patients and their families from three hospitals in Shanghai and Sichuan. Participants underwent the same procedure as in Study 1, then completing the power and moral needs questionnaires. Study 2A aimed to investigate the influence of common ingroup identity on victimhood between doctors and patients, as well as the roles of power and moral needs. To further test the hypothesized model, we selected 54 medical students with hospital internship experience and 54 non-medical students with recent treatment experience in Study 2B, where we activated common ingroup identities using a re-categorization strategy.

The main results were as follows. (1) In Study 1, ANOVA results showed that compared with control groups, groups with common ingroup identity reported lower competitive victimhood, and there was no interaction between group and common identity. (2) Study 2A showed that power need mediated the relationship between common ingroup identity and competitive victimhood. The indirect effect of power need was significant. The moral need was irrelevant to common ingroup identity and is not a mediator. (3) Study 2B reconfirmed the model for doctors but not for the patients group.

Based on the common ingroup identity model, this study proposed and confirmed the applicability of this model in the doctor-patient field in China. Additionally, the study proposed new methods and perspectives on the doctor-patient relationship. In the future, researchers should focus on other mediators, such as empathy and trust in different groups.

Key words: doctor-patient relationship, competitive victimhood, common ingroup identity, power need, moral need

中图分类号:

B849: C91

邓洵, 龙思邑, 沈依琳, 赵欢欢, 贺雯. (2023). 共同内群体认同对医患竞争受害感的影响及其机制. 心理学报, 55(5), 752-765.

DENG Xun, LONG Siyi, SHEN Yilin, ZHAO Huanhuan, HE Wen. (2023). Influence and mechanisms of common ingroup identity on competitive victimhood in doctor-patient relationships. Acta Psychologica Sinica, 55(5), 752-765.

图/表 5

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变量	1	2	3	4
1. 共同内群体认同	1
2. 权力需要	−0.31^*(−0.25^)	1
3. 道德需要	−0.08 (−0.01)	0.2 (0.39^**)	1
4. 竞争受害感	−0.31^(−0.34^)	0.51^*(0.61^*)	0.12 (0.32^**)	1

变量	1	2	3	4
1. 共同内群体认同	1
2. 权力需要	−0.31^*(−0.25^)	1
3. 道德需要	−0.08 (−0.01)	0.2 (0.39^**)	1
4. 竞争受害感	−0.31^(−0.34^)	0.51^*(0.61^*)	0.12 (0.32^**)	1

路径	医方		患方		比较结果
路径	β	p	β	p	比较结果
共同内群体认同→权力需要	−0.64	0.006	−0.48	0.04	0.51
共同内群体认同→道德需要	0.06	0.75	0.01	0.93	0.13
权力需要→竞争受害感	0.36	0.003	0.52	< 0.001	1.05
道德需要→竞争受害感	0.01	0.318	0.17	0.21	0.49
共同内群体认同→竞争受害感	−0.26	0.273	−0.46	0.014	0.71

路径	医方		患方		比较结果
路径	β	p	β	p	比较结果
共同内群体认同→权力需要	−0.64	0.006	−0.48	0.04	0.51
共同内群体认同→道德需要	0.06	0.75	0.01	0.93	0.13
权力需要→竞争受害感	0.36	0.003	0.52	< 0.001	1.05
道德需要→竞争受害感	0.01	0.318	0.17	0.21	0.49
共同内群体认同→竞争受害感	−0.26	0.273	−0.46	0.014	0.71

变量名称	1	2	3	4
1. 共同内群体认同	1
2. 权力需要	−0.24 (0.05)	1
3. 道德需要	0.22 (−0.02)	0.15 (0.01)	1
4. 竞争受害感	−0.35^*(0.15)	0.40^*(0.34^)	0.07 (−0.05)	1