移动医疗环境下医患信任构建模型与关系治理研究

The doctor-patient relationship is tense and doctor-patient trust is seriously lack in recent China. With the development of medical information technology, mobile health, a new medical service model, enabling doctor-patient interaction anywhere and anytime, can help building and improving doctor- patient trust. Based on the actual question of doctor- patient trust in our country, concerning the characteristics of doctor-patient interaction in the context of mobile health, this project serves trust building, trust evolution and trust improving as the main line. On one hand, from the perspective of patients, this project analyzes the influencing factors, dimensions and results of trust, thus constructing the doctor patient trust building model, and then analyzes the evolution of initial trust to continual trust and of online trust to offline trust, trust evaluation model based on trust evolution process, thus investigating the doctor patient trust evolution mechanism. On the other hand, considering patients’ trust, this project also studies the doctor patient relationship governance construct, governance process, and governance results in the view of doctors, thus systematically develops doctor patient relationship governance mechanism based on trust in the context of mobile health. We belief our project will help researchers, practitioners and policy makers focus on real medical problems in the background of medical information technology construction and breakthrough, extend the doctor-patient trust relationship governance research theory, strengthen the doctor-patient trust construction and management, improve the governance of the relationship between doctors and patients, thus provide theoretical and practical support for the innovation, application, and future development of mobile health.

当前我国医患关系紧张，医患信任严重缺乏。随着医疗信息化的推进，移动医疗借助其新型的医疗服务模式，实现医患随时随地交互，从而有助于构建和改善医患信任。本课题立足医患信任的实际问题，结合移动医疗环境下医患交互的特点，以医患信任形成、信任演化、信任改进为主线，从患者的角度，分析影响医患信任的关键因素、医患信任的构成维度和医患信任的结果，构建移动医疗环境下医患初始信任到连续信任的时间演化模型和线上信任到线下信任的空间演化模型，研究基于演化过程的信任评价模型。同时从医生的角度，研究以医患信任为导向的医患关系治理结构、治理过程和治理结果，系统分析移动医疗环境下基于信任的医患关系治理机制。课题有助于提升医疗信息化背景中的实际医疗问题切入，拓展医患信任构建与关系治理问题研究理论，加强医患信任的构建和管理，完善医患关系的治理机制，为移动医疗在我国医疗服务模式的创新、应用和发展提供理论和实践支持。

当前我国医患关系紧张，医患信任严重缺乏。随着医疗信息化的推进，移动医疗借助其新型的医疗服务模式，实现医患随时随地交互，从而有助于构建和改善医患信任。本课题立足医患信任的实际问题，结合移动医疗环境下医患交互的特点，以医患信任形成、信任演化、信任改进为主线，从患者的角度，分析影响医患信任的关键因素、医患信任的构成维度和医患信任的结果，构建移动医疗环境下医患初始信任到连续信任的时间演化模型和线上信任到线下信任的空间演化模型，研究基于演化过程的信任评价模型。同时从医生的角度，研究以医患信任为导向的医患关系治理结构、治理过程和治理结果，系统分析移动医疗环境下基于信任的医患关系治理机制。最终我们识别了移动医疗环境下医患交互的特点、医患信任的特点，按照交互过程分析医患初始信任和连续信任的影响因素、构成维度和信任结果，揭示了移动医疗环境下医患信任的形成机制；分析了移动医疗环境下交互前和交互后两阶段医患信任演化模型、移动医疗线上医患信任到线下医患信任的空间演化模型，揭示了移动医疗医患信任在时间维度和空间维度的演化规律；以医患信任为导向，提出了移动医疗环境下医患关系的治理框架，基于多元治理主体提出了医患关系治理策略和可行的医患信任改进方案。课题有助于提升医疗信息化背景中的实际医疗问题切入，拓展医患信任构建与关系治理问题研究理论，加强医患信任的构建和管理，完善医患关系的治理机制，为移动医疗在我国医疗服务模式的创新、应用和发展提供理论和实践支持。