消极刻板印象对老年人医疗决策的影响及归因偏差的作用

doi:10.3724/SP.J.1041.2022.00951

摘要/Abstract

摘要：

随着年龄的增长, 对老年人的消极刻板印象和医疗决策逐渐成为了与老年群体越来越相关的两个概念。在此背景下, 很有必要系统地探讨消极刻板印象对老年人医疗决策的效应及其机制。本研究以158名老年人为被试, 通过两个实验考察了消极刻板印象、归因偏差和老年人医疗决策质量间的关系。实验1结果发现, 消极刻板印象负向影响老年人的医疗决策质量, 同时, 归因偏差在刻板印象对老年人医疗决策质量的效应中起到中介作用。实验2结果表明, 减少归因偏差的干预控制可以有效降低刻板印象对医疗决策质量的消极效应。本研究对理解刻板印象效应机制、缓解刻板印象消极效应、以及改善老年人医疗决策质量具有一定的理论意义和实践价值。

关键词: 消极刻板印象, 归因偏差, 医疗决策质量, 老年人

Abstract:

The quality of decision-making in older people decreases with age. In medical decision-making, poor medical decisions in older adults can have a range of adverse effects. Therefore, exploring the influencing factors of the quality of medical decision-making is necessary. Aging stereotypes are closely related to the quality of decision-making. Negative aging stereotypes will have a negative impact on the decision-making of older adults. However, the relationship between aging stereotypes and the quality of medical decision-making has not been fully studied, and the mechanism between the two remains unclear.
As an important concept in social cognitive psychology, attribution bias is closely related to aging stereotypes and medical decision-making. When encountering behaviors or phenomena consistent with stereotypes, people are more inclined to attribute such behaviors internally to maintain the stereotypes. Furthermore, attribution bias is an important factor in decision-making, and the attribution bias of the older adults will have a significant impact on their subsequent treatment decisions. Nevertheless, the role of attribution bias in the relationship between aging stereotypes and medical decision-making in older adults remains unknown. Thus, this study attempts to clarify the relationship between aging stereotypes and medical decision-making and reveal the mediating role of attribution bias in the relationship between aging stereotypes and medical decision-making.
This study has two experiments. Experiment 1 attempted to explore the relationship between aging stereotypes, attribution bias, and quality of medical decision-making in older adults. Experiment 2 attempted to verify further the relationship between the three by training attribution bias. Seventy-eight older adults (26 males and 52 females) were recruited as participants in Experiment 1. All participants were randomly assigned to the stereotypes threat group or the control group. Attribution bias and the quality of medical decisions in both groups were then measured. Eighty participants (30 males and 50 females) were recruited in Experiment 2. All participants were randomly assigned to the stereotypes threat group or the attribution bias intervention group. First, the aging stereotypes of all participants were activated. Participants in the stereotype threat group completed the same measurement as Experiment 1. Participants in the attribution bias intervention group completed attribution bias measurement and medical decision-making tasks after attribution bias control training.
SPSS 25.0 was used for the statistical analysis of the data. Experiment 1 found that the aging stereotypes negatively predicted the quality of medical decisions and increased the internal attribution bias. The internal attribution bias in the stereotype threat group was significantly higher than that in the control group, and the quality of medical decision-making was substantially lower than that in the control group. The study also found that internal attribution bias was mediating in the relationship between aging stereotypes and medical decision quality. Results of Experiment 2 show that the internal attribution bias of participants in the attribution bias intervention group was significantly lower than that in the stereotypes threat group, and the quality of medical decision-making was significantly higher than that in the stereotypes threat group. That is, aging stereotypes negatively affected the quality of medical decisions, and internal attribution played a mediating role between the two. Furthermore, the control training of attribution bias can effectively alleviate the adverse effects of stereotypes in old age.
This study enriches the previous research on the influence of stereotypes on decision-making. It has certain practical value for alleviating the negative effect of stereotypes in older adults and improving the quality of individual medical decision-making.

Key words: negative stereotypes, attribution bias, quality of medical decision making, older adults

中图分类号:

B844

张宝山, 金豆, 马梦佳, 徐冉. (2022). 消极刻板印象对老年人医疗决策的影响及归因偏差的作用. 心理学报, 54(8), 951-963.

ZHANG Baoshan, JIN Dou, MA Mengjia, XU Ran. (2022). The effect of negative aging stereotypes on the quality of medical decision-making and the mediating role of attribution bias. Acta Psychologica Sinica, 54(8), 951-963.

图/表 6

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变量	威胁组 (n = 40)	控制组 (n = 38)	t/χ²	Cohen’s d
年龄M (SD)	68.45 (7.08)	67.53 (7.69)	-0.55	-0.12
自评健康M (SD)	3.50 (0.68)	3.42 (0.55)	-0.56	-0.13
生活满意M (SD)	3.88 (0.69)	3.92 (0.49)	0.34	0.07
性别N (%)
男	14 (35.0%)	12 (31.6%)	0.10
女	26 (65.0%)	26 (68.4%)
文化程度N (%)			4.77
小学	5 (12.5%)	2 (5.3%)
初中	15 (37.5%)	9 (23.7 %)
高中	6 (15.0%)	12 (31.6 %)
本科及以上	14 (35.0%)	15 (39.5 %)
归因偏差M (SD)	3.33 (1.38)	1.57 (0.93)	-6.63^***	-1.50
决策质量M (SD)	0.15 (1.44)	2.61 (1.31)	7.87^***	1.79

变量	威胁组 (n = 40)	控制组 (n = 38)	t/χ²	Cohen’s d
年龄M (SD)	68.45 (7.08)	67.53 (7.69)	-0.55	-0.12
自评健康M (SD)	3.50 (0.68)	3.42 (0.55)	-0.56	-0.13
生活满意M (SD)	3.88 (0.69)	3.92 (0.49)	0.34	0.07
性别N (%)
男	14 (35.0%)	12 (31.6%)	0.10
女	26 (65.0%)	26 (68.4%)
文化程度N (%)			4.77
小学	5 (12.5%)	2 (5.3%)
初中	15 (37.5%)	9 (23.7 %)
高中	6 (15.0%)	12 (31.6 %)
本科及以上	14 (35.0%)	15 (39.5 %)
归因偏差M (SD)	3.33 (1.38)	1.57 (0.93)	-6.63^***	-1.50
决策质量M (SD)	0.15 (1.44)	2.61 (1.31)	7.87^***	1.79

变量	干预组 (n = 40)	威胁组 (n = 40)	t/χ²	Cohen’s d
年龄M (SD)	65.30 (5.42)	66.13 (6.58)	-0.61	-0.14
自评健康M (SD)	3.50 (0.68)	3.50 (0.68)	0.00	0.00
生活满意M (SD)	3.80 (0.79)	3.85 (0.66)	-0.31	0.07
性别N (%)			1.92
男	18 (45.0%)	12 (30.0%)
女	22 (55.0%)	28 (70.0%)
文化程度N (%)			4.31
小学	1 (2.5%)	3 (7.5%)
初中	7 (17.5%)	9 (22.5%)
高中	8 (20.0%)	12 (30.0%)
本科及以上	24 (60.0%)	40 (40.0%)
归因偏差M (SD)	0.16 (0.26)	3.96 (4.03)	-5.96^***	-1.33
决策质量M (SD)	3.00 (1.75)	0.65 (1.85)	5.83^***	1.31

变量	干预组 (n = 40)	威胁组 (n = 40)	t/χ²	Cohen’s d
年龄M (SD)	65.30 (5.42)	66.13 (6.58)	-0.61	-0.14
自评健康M (SD)	3.50 (0.68)	3.50 (0.68)	0.00	0.00
生活满意M (SD)	3.80 (0.79)	3.85 (0.66)	-0.31	0.07
性别N (%)			1.92
男	18 (45.0%)	12 (30.0%)
女	22 (55.0%)	28 (70.0%)
文化程度N (%)			4.31
小学	1 (2.5%)	3 (7.5%)
初中	7 (17.5%)	9 (22.5%)
高中	8 (20.0%)	12 (30.0%)
本科及以上	24 (60.0%)	40 (40.0%)
归因偏差M (SD)	0.16 (0.26)	3.96 (4.03)	-5.96^***	-1.33
决策质量M (SD)	3.00 (1.75)	0.65 (1.85)	5.83^***	1.31