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激励在中国器官捐献登记中的作用及心理机制
Alternative TitleThe effect and psychological mechanism of incentives for organ donation registration in China
符佳慧
Contributor梁竹苑 ; 李 纾
2021-06
Abstract移植器官短缺是全球人类健康面临的严重挑战之一。由于移植 器官短缺,全球每年都有大量患者在等待器官移植的过程中死亡 。 我国为人口大国,器官短缺问题尤为严重 。 2015-2018年中,我 国公民逝世后器官捐献 为 18,294例 ,然而每年都有超过 30万 人次的移植需求 。 导致该问题的 首要原因是 我国公民参与器官捐献的程度不高 在我国现有的“决定参加”器官捐献制度中 引入 适宜的 激励 措施, 可能是推动公民参与器官捐献登记的突破口。 但目前 学界对于 激励在 器官捐献登记 领域 中 的作用仍缺乏指导和实证数据, 现有 研究存在以下不足 其一,激励对 器官捐献登记 作用的研究尚未达成一致结论。 其原因主要在于, 目前对激励内容的划分较为混乱,尚无对激励内容进行全面总结和科学性分类,导致研究结果无法相互比较。 其 二 激励对器官捐献登记的影响机制有待深入 研究 。已有研究大多从促进和抑制这两种结果来比较激励的作用,但 导致 这两种 结果 的 机制性 原因 仍缺少 探索 。 其三,影响器官捐献登记 的心理因素研究缺少整合。 一方面, 实证性研究通常只探讨单一或若干变量, 尚存的 综述性文章 也 仅有两篇。另一方面, 中国本土的影响因素研究存在空白,需要对理论和研究的框架进行探索。 为回答以上问题, 并探讨激励在我国器官捐献中的作用及心理机制, 本论文在中国成人样本中,以网络调查问卷为主的方式, 进行了 3个研究研究 一 初步比较 3种激励方式 对不同捐献动机者 的作用。研究 采用网络问卷法 ,设计了被试内和被试间两个子研究,比较健康激励、金钱激励和精神 激励对捐献 登记 意愿的影响 。发现 健康激励和金钱激励对原本捐献动机不高人群 (不确定和低捐献倾向者) 具有提高登记意愿的作用,精神激励在总人群中起到了降低登记意愿的作用 。 研究二 比较健康激励、金钱激励和优先权激励对登记意愿的影响,以及社群规范和自主感在其中的中介作用 ,同时考察了认知性因素和情绪性因素组成的器官捐献心理影响因素在中国是否具有适用性 。研究 收集了 各年龄段、教育程度被试的数据N=1502 结果发现: 3种激励均能提高登记意愿, 提高程度由高至低为:健康激励、优先权激励、金钱激励。 中介分析发现: 健康激励会通过高自主性来提高登记意愿;优先权激励 下的中介效应不显著;金钱 钱激励通过低社群规范对登记意愿产生负性影响 。 此外, 研究 二 还 发现 ,认知性因素和情绪性因素对登记意愿均具有显著预测作用。 在研究二 的基础上, 研究三从中介变量的角度探索如何优化激励作用。具体而言,研究三操纵了健康激励和金钱激励的社群性框架描述,探索是否可以通过提高社群性的途径进而提高器官捐献登记意愿与行为 。 结果重复验证了社群规范的中介作用, 但 发现操纵反而降低了健康激励的社群规范。 总之,本研究发现:1)激励可以有效提高中国成人器官捐献登记的意愿与行为;2)不同激励方式对中国成人器官捐献登记的意愿的作用存在差异:与金钱激励、优先权激励相比,健康激励对器官捐献登记意愿的提高程度最大,其作用机制在于,健康激励提高了人们选择的自主感,且未降低社群规范;但表彰形式的精神激励会降低登记意愿;3)不同激励方式对中国成人器官捐献登记的行为的作用存在差异:金钱激励可以吸引人们进一步了解器官捐献登记;4)认知性因素和情绪性因素对中国成人器官捐献登记意愿具有预测作用,人们对器官捐献的认知越高,消极情绪越低,其登记意愿越高。 本研究结果可为器官捐献与移植的普及和发展提供理论性基础证据,为我国建立器官捐献体系的激励机制提出实证建议,为心理学在公共政策领域中发挥作用进行了有益尝试。
Other AbstractShortage of transplant organs is one of the serious challenges to human health in the world. Due to the shortage of transplant organs, a large number of patients die every year while waiting for organ transplant. As one of the countries with the largest population in the world, organ shortage is especially serious in China. Between 2015 to 2018, a total of 18,294 organs were donated after the deaths of Chinese citizens, yet more than 300,000 transplants are needed each year in China. The main reason for this problem may be the low participating rates in organ donation registration in Chinese citizens. With the currently existing organ donation system of “opt-in” in China, introducing appropriate incentives to organ donation may be a breakthrough to attract more Chinese citizens to registe as organ donors. However, proper guidance and empirical data on the role of incentives in organ donation registration are still lacked in literatures. The existing studies have the following shortcomings. First, the consensus was still lack on the role of incentives in organ donation registration. The possible main reason might be that due to no comprehensive summary and scientific classification of incentive content, comparing the results from diverse research seemed impossible. Second, the mechanism of the influence of incentives on organ donation registration needs to be further studied. Most studies have compared the effects of motivation either by promoting or inhibiting outcomes, but the mechanism underlining the two outcomes is still lack of exploration. Third, the previous research are lack of integration to the psychological factors affecting organ donation registration. Empirical studies usually only explored a single or several variables, including two only existed reviews. The relative evidences of the influencing factors in China are even more rare, building a gap between the theoretical framework and practice. To explore the role and psychological mechanism of incentives to organ donation registration in China, this thesis conducted three studies in Chinese adult samples by online questionnaires. In study 1, we compared the effects of three kinds of incentives on participants with different tendency to organ donation registration. Two sub-studies were designed to compare the effects of health incentive, financial incentive and spiritual incentives on the willingness to donate. The results showed that health incentive and monetary incentive increased the registration intention of the participants with low motivation (uncertain and low propensity), but spiritual incentive reduced the registration intention of the whole sample. Study 2 (N = 1502) compared the effects of health incentive, monetary incentive and priority incentive on the willingness to register, as well as tested the mediating effect of communal norms and autonomy. We also examined whether the psychological factors of organ donation, composed by cognitive factors and emotional factors, are applicable in China. The results showed that all three incentives could improve the willingness to register, and the level of improvement ranged from high to low was: health incentive, priority incentive and monetary incentive. Results of mediating analysis showed that health incentive improved the registration intention through high autonomy, and the monetary incentive reduced the registration intention through low communal norms, however, the priority incentive showed no significant mediating effects. We also found that cognitive factors and emotional factors are significant predictors of the willingness to register. Based on study 2, study 3 explored how to optimize the incentive effect through the path of mediating variables. Specifically, study 3 manipulated the description of the communal norms in health incentive and monetary incentive, and explored whether the intention and behavior of organ donation registration could be improved by enhancing the communal norms. Results the mediating effect of communal norms was confirmed repeatedly, however, the manipulation of communal norms had decreased the communal norms in health incentive. Taking together, the current thesis suggested that: 1) compared with money incentive and priority incentive, health incentive can increase the registration intention by improving autonomy and keeping the high communal norms; 2) spiritual incentive reduced the registration intention; 3) monetary incentive can attract people to know more about organ donation registration; 4) the cognitive and emotional factors can predict the registration intention. The results of this study can provide theoretical evidence for the popularization and development of organ donation and transplantation and provide empirical suggestions for establishing the incentive mechanism of organ donation system in China. It might be a beneficial attempt for psychology to nudge the public policy.
Keyword器官捐献登记 激励 社群规范 中国样本 器官捐献
Subtype硕士
Language中文
Degree Name硕士学位
Degree Discipline应用心理学
Degree Grantor中国科学院心理研究所
Place of Conferral中国科学院心理研究所
Document Type学位论文
Identifierhttp://ir.psych.ac.cn/handle/311026/39542
Collection社会与工程心理学研究室
Recommended Citation
GB/T 7714
符佳慧. 激励在中国器官捐献登记中的作用及心理机制[D]. 中国科学院心理研究所. 中国科学院心理研究所,2021.
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