是以患者为中心还是以人口为中心? 知识学上的差异是如何造成伤害和种植不信任的
1Princeton University, 118 Julis Romo Rabinowitz, Princeton, NJ, 08540, USA.
Social science & medicine (1982)
|January 1, 2024
概括
医疗不信任源于患者和医生之间的不同观点,而不仅仅是错误信息. 这种对身体理解的分歧导致伤害,并侵蚀了对医疗保健提供者的信任.
科学领域:
- 医学社会学 医学社会学
- 卫生沟通健康沟通
- 认识论的认识论学.
背景情况:
- 医疗不信任通常归因于错误信息或缺乏知识.
- 这种观点忽视了影响患者与提供者关系的更深层次的系统性问题.
- 了解不信任的根本原因对于改善医疗保健结果至关重要.
研究的目的:
- 挑战医疗不信任的传统观点,认为这只是一个错误信息问题.
- 探索患者和医学专家之间的认识论分歧在培养不信任方面的作用.
- 分析不同的世界观如何影响患者的体验和对医疗机构的信任.
主要方法:
- 来自在线Facebook小组讨论避孕药副作用的数据的定性分析.
- 与医疗保健提供者进行深入采访,以了解他们的观点.
- 对患者和提供者认识论 (认识方式) 的比较分析.
主要成果:
- 医生使用"身体作为主体"的框架,优先考虑人口健康目标.
- 患者,特别是在Facebook群组中,采用"身体作为代理人"的观点,强调个人自主权.
- 医疗系统对提供者认识论的特权化导致了认识论上的不公正和患者的伤害.
结论:
- 认识论的分歧,而不是错误信息,是医学不信任的重要驱动因素.
- "身体作为主体"与"身体作为代理人"的框架突出了理解健康和身体的核心冲突.
- 解决认识不公正是重建患者和医疗界之间的信任的关键.
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