Department of Nursing, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Health Psychol. 2013 Jun;32(6):706-9. doi: 10.1037/a0027356. Epub 2012 Feb 20.
Patient perception of physician expertise has important implications for adherence to treatment. This study investigates factors that may influence a patient's perception of a physician's knowledge and expertise (i.e., epistemic authority; EA). These factors are agreement with the physician regarding inoculation against the flu, physician gender, and treatment setting (private vs. public).
The sample consisted of 187 participants (111 women and 76 men). Data were collected using four scenarios, each illustrating a visit to a physician (female or male, working in private or public practice) who recommended (for or against) the flu inoculation. The physician's recommendation was manipulated in a between-subjects design. The study participants' preference regarding flu inoculation was measured before they were shown the scenarios. The dependent measure was a six-item rating of the EA attributed to the physician described in the scenario.
Physicians who recommended inoculation were perceived as having significantly higher EA than those who recommended against it. In addition, correspondence between the participant's preference and the physician's recommendation affected the physician's EA only in the condition where the physician recommended performing the inoculation. Finally, only when participants had a positive attitude toward inoculation did they view physicians in public clinics as having lower EA than those working in private clinics.
These results demonstrated that patients' evaluations of their physicians' EA are influenced by their implicit and explicit beliefs about the physician's role. One of these expectations is that expert physicians should prescribe active treatment rather than abstention from it.
患者对医生专业知识的感知对治疗依从性有重要影响。本研究调查了可能影响患者对医生知识和专业技能感知的因素（即知识权威；EA）。这些因素包括患者对流感疫苗接种的认同程度、医生的性别以及治疗环境（私人诊所与公立医院）。
该样本由 187 名参与者组成（111 名女性和 76 名男性）。使用四个情景收集数据，每个情景都描述了一位医生（女性或男性，在私人或公立医院工作）的就诊情况，该医生建议（赞成或反对）接种流感疫苗。在被试间设计中操纵了医生的建议。在向参与者展示情景之前，测量了他们对流感接种的偏好。因变量是对情景中描述的医生的 EA 进行的六项评分。
建议接种疫苗的医生被认为具有明显更高的 EA，而建议不接种疫苗的医生则被认为具有较低的 EA。此外，参与者的偏好与医生的建议之间的一致性仅在医生建议进行接种的情况下才会影响医生的 EA。最后，只有当参与者对接种疫苗持积极态度时，他们才会认为在公立医院工作的医生的 EA 低于在私人诊所工作的医生。
这些结果表明，患者对其医生 EA 的评估受到其对医生角色的隐含和明确信念的影响。其中一个期望是，专家医生应该开出积极的治疗方案，而不是不进行治疗。
