基于社交媒体的医患互动对患者健康行为促进机制研究

In recent years, the poor physician-patient interaction has become the leading cause of nervous physician-patient relationship in our country. Social media can help improve the physician-patient relationship through providing novel interaction channels and changing the content and forms of physician-patient interaction. However, the questions such as what are the factors of social media based physician-patient interaction and what are the work mechanisms of social media based physician-patient interaction on patients' health behaviors are not addressed in previous literature. Therefore, this research will firstly identify the factors of social media based physician-patient interaction from policy, environment, technology, social, physician and patient perspectives. Then, this research proposes that social media based physician-patient interaction impacts patients' health behavior and relative outcomes through health knowledge, health self-efficacy and outcome expectancy based on social cognitive theory. At last, in line with identified factors, we will develop the promotion strategies which are based on social media based physician-patient interaction to improve patients' health behaviors and relative outcomes. Meanwhile, we will measure the effectiveness of our proposed promotion strategies according to the studied working mechanisms.

当前，医患互动不畅已成为我国医患关系紧张的最大诱因。社交媒体能够通过提供新的医患互动渠道和改变互动的内容和形式来帮助解决医患互动不畅的问题。然而当前文献中对于影响基于社交媒体的医患互动因素是什么，基于社交媒体的医患互动对患者健康行为的影响及其作用机制如何等问题并未被解答。因此，本项目首先从政策、环境、技术、社会、医生和患者等六个角度识别影响基于社交媒体的医患互动因素，再次基于社会认知理论提出了医患互动可以通过健康知识、健康自我效能和结果期望等三个机制来影响患者的健康行为和结果。最后，基于所识别的影响因素，本项目提出了基于社交媒体的医患互动的健康行为促进干预策略，并基于作用机制，提出相应的评价指标。

当前，医患互动不畅已成为我国医患关系紧张的最大诱因。对于医患互动不畅，社交媒体的普及为解决该问题供了新的思路。然而当前文献中对于影响基于社交媒体的医患互动因素、基于社交媒体的医患互动对患者健康行为的影响及其作用机制等问题还亟待解答。本项目以“因素探索→机制分析→效果评价”的研究思路展开，对基于社交媒体的医患互动对患者健康行为促进机制开展研究。首先，本项目在构建了基于社交媒体的医患互动因素量表的基础之上，基于人际关系阶段理论和双因素理论进行了医患互动的前置因素分析研究。研究发现了电子空间的便利性和物理设施的不便利性是显著影响医患互动的主要因素。其次，本项目基于社会认知理论和计划行为理论，对于社交媒体环境终得医患互动的影响机制进行了分析。研究发现了医患互动通过改变患者自我效能感、结果期望和获得知识来改变患者健康行为和健康素养，最终有可能改变患者的健康状况。最后，为了有效检验基于社交媒体的医患互动效果，本项目对于患者使用电子健康设备和形式进行了研究，为开展实地干预研究打下基础。本项目研究的开展，不仅弥补了医患互动在电子环境中的研究空白，而且丰富和发展了新时代下的医患关系研究。同时，为有效解决我国医患关系紧张的问题，提供了规律而深刻的认识和指导建议。