人际医患信任的概念内涵、正向演变与影响因素

人际医患信任是人际水平上的医患信任, 是医患双方在互动过程中, 相信对方不会做出不利于自己甚至有害于自己行为的一种预期判断和心理状态。理想化的人际医患信任的正向演变可能呈现出由计算型信任到了解型信任, 再到认同型信任这一逐渐深化的过程。社会环境、就医情境与个体特征因素交互作用于医患信任建立与演变的心理机制与过程。未来研究应收集纵向数据探索医患信任的内容维度、影响机制及其演变特征, 并验证医患信任对于医患双方态度与行为的具体作用机制。     

Judgmental God image,social embeddedness,and social trust among the highly religious in the United States

In this article we explore two propositions concerning the manner in which judgmental God image affects social trust among the highly religious in the United States. One proposition argues that having a judgmental God image and being highly embedded in a community of co-religionists can create low levels of social trust through social bonding and the formation of particularized trust. The other proposition maintains that embeddedness in a moral community of co-religionists helps to reinforce the idea that people are basically good and require love and forgiveness. This leads to higher levels of trust. We test an interaction between judgmental God image and social embeddedness with OLS analysis and data from the 2014 Baylor Religion Survey. We restrict the analysis to the highly religious, those who have no doubt about the existence of God and belong to a place of worship. We find that respondents with a judgmental God image who do not belong to a moral community with any or a few friends have the lowest levels of social trust. Those who have a judgmental God image but are highly embedded in a moral community with at least half of their friends have higher levels of social trust. Embeddedness negates the negative effects of judgmental God image on social trust. Implications for research are discussed in the conclusion.     

Culture, trust, and social networks

Although the role of trust in group processes has been well established, less is known about the role of trust in social network processes. Trust, conceptualized to have generalized and particularistic aspects, was measured by generalized trust (people can be trusted in general) and relationism (people can be trusted if one has relationships), and their relations with social network characteristics of network homogeneity (extent to which one has a number of friends with similar attitudes) and network closure (extent to which one's social network is closed) were examined in three Western (Australia, Germany, and the United Kingdom) and two East Asian countries (Japan and Korea). Although generalized trust was shown to be positively related to network closure across the five countries, generalized trust and relationism had different relations with network homogeneity in different cultures. The results were interpreted in terms of social institutional and cultural differences.     

Trust,risk, and the social contract

The problem of trust is discussed in terms of David Hume’s meadow-draining example. This is analyzed in terms of rational choice, evolutionary game theory and a dynamic model of social network formation. The kind of explanation that postulates an innate predisposition to trust is seen to be unnecessary when social network dynamics is taken into account.     

Unbalanced triangle in the social dilemma of trust: Internet studies of real‐time,real money social exchange between China,Japan, and Taiwan

Using a dyadic game theory paradigm, three experiments on the social dilemma of trust were conducted over the Internet in real time, involving real money. It was predicted and found that in‐group favouritism in trusting behaviour was contingent on historical relationships between societies. In the China–Japan experiment, mainland Chinese but not Japanese trusted and made fair allocations to in‐group members more than out‐group members, and out‐group trust was best predicted by positive stereotypes of the out‐group for Chinese and identity for Japanese. In the China–Taiwan experiment, Taiwanese but not Mainland Chinese trusted in‐group members more than out‐group members, and in‐group trust for Taiwanese was best predicted by perceptions of current realistic threats. In the Taiwan–Japan experiment, there were slight in‐group favouring tendencies in trust, and positive stereotypes of the out‐group were the best predictors of out‐group trust. Japanese were unique in not displaying in‐group favouring behaviour at all, whereas both Chinese and Taiwanese were context specific in their in‐group favouritism. Stereotypes, social identities, perceptions of realistic threat, and historical anger made significant contributions to predicting trusting behaviour, but overall these survey measures only accounted for small and inconsistent amounts of variance across the three experiments.     

医患信任关系的结构和测量及其整合模型

从概念结构和测量工具角度对相关文献进行系统梳理和剖析发现：既有研究主要集中于患方视角而相对忽视了医方信任测量;测量维度上存在各种不同指标,主要涉及医患双方在就医过程中的态度、能力和行为,以及二者对医患关系亲密程度感知的心理结构。总结不同视角的相关研究,本研究提出了医患信任关系的总体概念框架和医患信任测量的整合模型,旨在构建医患信任测量的总体框架及测量指标,以期为后续研究和实践工作提供参考和指导。     

When views about alternative medicine,nature and god come in the way of people's vaccination intentions

In spite of the safety and efficiency of the COVID-19 vaccines and the many promotion efforts of political and expert authorities, a fair portion of the population remained hesitant if not opposed to vaccination. Public debate and the available literature point to the possible role of people's attitudes towards medical institutions as well as their preference for complementary and alternative medicine (CAM) on their motivations and intentions to be vaccinated. Other potential ideological factors are beliefs about environmental laissez-faire and divine providence insofar as they encourage people to let the pandemic unfold without human interference. In three cross-sectional samples (total N = 8214), collected at successive moments during the Belgian vaccination campaign, the present research examines the distal role of these psychological and ideological factors on vaccination intentions via motivational processes. Study 1 gauges the relation between trust in medical institutions and preference for CAM on intentions to get vaccinated via motivations. Study 2 examined the role of beliefs in the desirability of letting nature take its course (‘environmental laissez-faire beliefs’) on vaccination intention via motivations. Study 3 tests whether people's adherence to environmental laissez-faire and beliefs about divine providence are linked to their motivations for vaccination via trust in the medical institutions and CAM. Results show that adherence to CAM has a deleterious effect on vaccination intentions, whereas trust in medical institutions has a positive effect. Both ideological factors pertaining to external control are only moderately related, with environmental laissez-faire beliefs having stronger effects on CAM, medical trust and vaccination motivations. We discuss the importance of this set of results in light of the growing interest in CAM and the increasing presence of messages appealing to the environment.     

Examining the impact of social commerce dimensions on customers' value cocreation: The mediating effect of social trust

One of the main aspects of the Web 2.0 revolution has been social commerce that has resulted in many people across the world increasingly engaging with commercial activities over social media platforms. However, the academic and research interest in social commerce is still low, and more studies are required to accelerate awareness of the most important issues relating to social commerce, in particular, social trust and value cocreation. Thus, the present study aims to propose a conceptual model that is intended to enable greater understanding of the causal interactions between social commerce constructs, social trust, and customer value cocreation. We collected data using a sample of 300 followers and fans of online Facebook communities, and we analysed them by using a structural equation model. The results show that social commerce constructs positively impact on social trust. Furthermore, we found that social trust positively impacts on the three dimensions of customer value cocreation. We found that social trust mediates the relationship between the social commerce and customer value cocreation dimensions. The paper presents a considerable theoretical contribution for being the first study that links social commerce constructs with social trust. The linkage between social commerce constructs, social trust, and customer value cocreation dimensions will also be beneficial for social media marketing strategists and managers.     

Effects of trustors' social identity complexity on interpersonal and intergroup trust

Although previous literature has revealed the effect of a single social identity on trust, only few studies have examined how multiple social identities affect trust in others. The present research examined the effects of trustors' social identity complexity on their level of trust toward another person (interpersonal trust), outgroup members (outgroup trust), and ingroup members (ingroup trust). Study 1, which was a correlational study, indicated that trustors' social identity complexity was positively related to their interpersonal and outgroup trust. Three experimental studies were performed to identify causal relationships. Study 2 found that activating trustors' high social identity complexity produced high levels of interpersonal trust, and Studies 3 and 4 found that this effect was more pronounced when the trustee was an outgroup member (outgroup trust) rather than an ingroup member (ingroup trust). The implications of these results for social harmony are discussed.     

The impact of civility interventions on employee social behavior, distress, and attitudes

Although incivility has been identified as an important issue in workplaces, little research has focused on reducing incivility and improving employee outcomes. Health care workers (N = 1,173, Time 1; N = 907, Time 2) working in 41 units completed a survey of social relationships, burnout, turnover intention, attitudes, and management trust before and after a 6-month intervention, CREW (Civility, Respect, and Engagement at Work). Most measures significantly improved for the 8 intervention units, and these improvements were significantly greater than changes in the 33 contrast units. Specifically, significant interactions indicating greater improvements in the intervention groups than in the contrast groups were found for coworker civility, supervisor incivility, respect, cynicism, job satisfaction, management trust, and absences. Improvements in civility mediated improvements in attitudes. The results suggest that this employee-based civility intervention can improve collegiality and enhance health care provider outcomes.     

Everyday dynamics in generalized social and political trust

We applied the traits as density distributions of states approach to generalized expectations of trustworthiness, namely, social trust and trust in politicians. Using an experience sampling study (N = 47), we assessed state social trust and trust in politicians four times a day for 2 weeks. Within-person variability was found to be low but meaningful as it was predicted by variations in affect, interactional trust, and prior experiences. There was high stability in interindividual differences in the mean levels of state trustworthiness expectations and in the levels of within-person variability. Our study provides a comprehensive understanding of stability and variability in generalized expectations of trustworthiness and indicates broad applicability of the traits as density distributions of states approach.     

The link between social interactions and trust recovery in customer–business relationships

Trust plays a crucial role in interpersonal relationships, including customer–company relationships, where the customer expects that a company will behave predictably in any particular situation. Companies do not always fulfill customers' expectations and thereby breach the trust relationship. To avoid negative consequences of this trust violation, companies may issue a formal apology as one possible path to regaining customer trust. In the same way, a previous social interaction, which can increase the customer's levels of oxytocin, can help to recover trust after service failures. In this study, three experiments were conducted as follows: the first manipulating a simulated social interaction with images; the second manipulating a physical social interaction, (i.e., a hug); and the third with exogenous oxytocin administration. The results showed that both physical interaction, (i.e., a hug) and simulated social interaction, (i.e., images of people interacting with each other) had a positive effect on customer trust recovery and provided support for oxytocin release as the underlying mechanism in this process. This research contributes to understanding of the link between social interactions and trust by elucidating the effects of both simulated and physical interactions on trust recovery.     

Trust in the medical profession and patient attachment style

Attachment style is a person’s approach to interpersonal relationships, which develops from early experiences with primary caregivers and can remain stable into adulthood. Depending on a person’s attachment style, the amount of trust one has in others can vary when forming relationships, and trust is important in formation of the patient–physician relationship. The purpose of this study was to see if there is an association between attachment style and trust in physicians in general. Participants were recruited from an emergency department (ED) and an online university participant pool, and completed short questionnaires assessing attachment style and trust in the medical profession. Results revealed that individuals with a fearful attachment style reported significantly lower levels of trust in the medical profession than those with a secure attachment style. ED participants also reported higher levels of trust in the medical profession in comparison to student participants. This study provides a better understanding of trust in the medical profession, and insight into future care for patients who have low trust.     

It hurts both ways: How social comparisons harm affective and cognitive trust

Organizations often expect employees to collaborate with and trust the same coworkers with whom they compete for promotions and raises. This paper explores how social comparisons in self-relevant achievement domains influence affective and cognitive trust. We find that both upward and downward social comparisons harm trust. Upward comparisons harm affective trust and downward comparisons harm cognitive trust. We find no benefits of upward comparisons on cognitive trust, and we find no benefits of downward comparisons on affective trust.     

Trust in managed care organizations

Two basic criticisms of managed care are that it erodes patient trust in physicians and subjects physicians to incentives and pressures that compromise the physician's fiduciary obligation to the patient. In this article, I first distinguish between status trust and merit trust, and then argue (1) that the value of status trust in physicians is probably over-rated and certainly underdocumented; (2) that erosion of status trust may not be detrimental if accompanied by an increase in well-founded merit trust; and (3) that under conditions of managed care the physician's commitment to traditional medical ethics cannot serve as an adequate basis for merit trust. Next, drawing on an analogy between managed care organzations and politics, I argue that (4) the most appropriate basis for merit trust in managed care is a conception of organizational legitimacy that includes procedural justice, empowerment of constructive criticism within the organization, and organizational accommodation of the noninstrumental commitment to patient well-being that is distinctive of medical professionalism. I then explore the conditions necessary for robust competition for merit trust among managed care organizations and indicate the kinds of public policies needed to facilitate such competition. Finally, I show how the account of organization-based merit trust can accommodate the special fiduciary obligation of medical professionals, without indulging in the delusion that it is the physician's fiduciary obligation always to provide all care that is expected to be of any net benefit to the patient.     

The social context of trust: The role of status

The current paper examines how status, a universal feature of organizational life, affects people’s initial trust in others. In three experiments – which employ a range of status manipulations and trust measures – we consistently observed that the possession of high status led individuals to trust others more. In addition, our results help shed light on why this occurs. Namely, mediation analyses illustrated that having status alters how we perceive others intentions, such that the belief that others have positive intentions toward us (i.e., benevolence) accounted for the relationship between status and trust. These findings contribute both to our knowledge of the contextual features which impact trust and provide insight into the psychological consequences of status.     

Australian community responses to the use of genetic testing for personalised health promotion

Personalised genetic health promotion may soon be available and affordable. To explore its likely public acceptance in Australia, a community sample (N = 800) provided quantitative and qualitative responses to a vignette scenario about a hypothetical expert who could test their genes and, based on this genetic profile, provide personalised health promotion advice. Three theoretical models were tested to explicate the process by which cognitive–affective factors of risk beliefs, benefit beliefs, and trust judgements influenced behavioural intentions. Results supported an expert trust model, where general beliefs about the risks and benefits of medical advances and general medical trust had indirect influences, while trust in a specific medical expert had a direct influence, on health promotion intentions. Subjective reasons for intentions included moral concerns, fear, trust, mistrust and a desire to maintain health at any cost. The advent of personalised genetic health promotion may heighten the need for specialised health psychologists.     

Understanding the Trusted Doctor and Constructing a Theory of Bioethics

This paper offers a constructivist account of bioethics as an alternative to previous discussions that explained the ethics of medicine by an extrapolation of principles or virtues from ordinary morality. Taking medicine as a higher and special calling, I argue that the practice of medicine would be impossible without the trust of patients. Because trust is a necessary condition for medical practice, the ethics of the profession must provide the principles for guiding physician behavior and the profession toward promoting trust and being trustworthy. In a phrase, that principle is “seek trust and deserve it.” I sketch out how the concept of trust provides a different justification for common sense principles of bioethics and explain how the concept of trust provides reasonable guidance for resolving moral conflicts within medicine. The trust-seeking approach provides a new and unexpected ordering of some traditional medical values, it reveals the weightiness of previously undervalued bioethical precepts, and illuminates the centrality of some largely ignored obligations of medicine. It also has the power to guide clinical practice and to inform the profession about standards for medical institutions. This revised version was published online in August 2006 with corrections to the Cover Date.     

Normative goals and the regulation of social behavior: The case of respect

The rational actor model has a long and successful history of explaining human motivation across several disciplinary fields, but its focus on material self-interest fails to explain the many courtesies that people extend to each other and the frequent sacrifices they make on a day-to-day basis. What promotes this pro-social behavior—in particular trust in other people? I argue that interpersonal trust is supported by normative goals, in that people trust others, even complete strangers, because of a sense of what they ought to do, by social rules and obligations they feel they must follow. In particular, people feel they must respect the character of the other person, constrained to act as though the other individual is an honorable human being, irrespective of what they may privately believe. I describe how respect underlies trust in economic games as well as pro-social behavior in other social settings. This focus on normative goals, such as respect, suggests that people do not always act in alignment with their expectations, regulate themselves in terms their actions rather than possible outcomes of those actions, and choose pro-social action not out of desire to benefit others as much as a simple acquiescence to situational demands.     

A double-edged sword: How social diversity affects trust in representatives via perceived competence and warmth

Previous research has claimed that diversity erodes trust, even though the empirical evidence is mixed and restricted to ethnic neighborhood diversity. Against the backdrop of increasing diversity within the political sphere and concurrently declining political trust, we examined the impact of social diversity on trust in groups of political representatives. In two experiments (N₁ = 109, N₂ = 248) we tested how the diversity of political parties affected citizens’ trust in them. In line with predictions of the stereotype content model, diverse parties were perceived as warmer and less competent than non-diverse parties (Experiments 1–2). Additionally, party diversity was perceived as having more benefits, but also involving more threats (Experiment 2). Consequently, diversity had both positive (via warmth and benefits) and negative (via competence and threats) indirect effects on trust. These results help to untangle previously mixed, for the most part non-experimental, findings of the relationship between diversity and trust.