Arndt Jamie, Vess Matthew, Cox Cathy R, Goldenberg Jamie L, Lagle Stephen
Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO 65211, USA.
Med Decis Making. 2009 Mar-Apr;29(2):175-81. doi: 10.1177/0272989X08323300. Epub 2008 Sep 9.
Prejudice by medical providers has been found to contribute to differential cardiac risk estimates. As such, empirical examinations of psychological factors associated with such biases are warranted. Considerable psychological research implicates concerns with personal mortality in motivating prejudicial biases. The authors sought to examine whether provoking thoughts of mortality among medical students would engender more cautious cardiac risk assessments for a hypothetical Christian than for a Muslim patient.
During the spring of 2007, university medical students (N=47) were randomly assigned to conditions in a 2 (mortality salience) x 2 (patient religion) full factorial experimental design. In an online survey, participants answered questions about their mortality or about future uncertainty, inspected emergency room admittance forms for a Muslim or Christian patient complaining of chest pain, and subsequently estimated risk for coronary artery disease, myocardial infarction, and the combined risk of either of the two. A composite risk index was formed based on the responses (on a scale of 0-100) to each of the 3 cardiac risk questions.
Reminders of mortality interacted with patient religion to influence risk assessments, F(1,41)=11.57, P=0.002, eta2 =.22. After being reminded of mortality, participants rendered more serious cardiac risk estimates for a Christian patient (F1,41 =8:66, P=0:01) and less serious estimates for a Muslim patient (F(1,41)=4.08, P=0.05).
Reminders of personal mortality can lead to biased patient risk assessment as medical providers use their cultural identification to psychologically manage their awareness of death.
研究发现医疗服务提供者的偏见会导致对心脏风险的评估存在差异。因此，有必要对与这种偏见相关的心理因素进行实证研究。大量心理学研究表明，对个人死亡的担忧会引发偏见。作者试图研究在医学生中引发死亡念头是否会使他们对假设的基督教患者比对穆斯林患者进行更谨慎的心脏风险评估。
在2007年春季，将大学医学生（N = 47）随机分配到一个2（死亡凸显）×2（患者宗教信仰）的完全析因实验设计的条件中。在一项在线调查中，参与者回答了有关他们的死亡或未来不确定性的问题，查看了一名抱怨胸痛的穆斯林或基督教患者的急诊入院表格，随后估计了冠状动脉疾病、心肌梗死以及两者之一的综合风险。根据对三个心脏风险问题中每个问题的回答（0 - 100分）形成了一个综合风险指数。
死亡提醒与患者宗教信仰相互作用以影响风险评估，F(1,41)=11.57，P = 0.002，eta2 =.22。在被提醒死亡后，参与者对基督教患者的心脏风险估计更为严重（F1,41 = 8:66，P = 0:01），而对穆斯林患者的估计则不那么严重（F(1,41)=4.08，P = 0.05）。
个人死亡提醒可能导致患者风险评估存在偏差，因为医疗服务提供者利用他们的文化认同来心理上管理他们对死亡的意识。
