为何最优化患者对医生更警惕?道德推脱的中介作用OA

Growing social uncertainties have heightened public psychological defensiveness,with particularly pronounced effects in clinical encounters where patients exhibit heightened vigilance toward doctors.This vigilance elicits cognitive and physiological stress responses that,while not immediately causing overt conflict,gradually undermine relational resilience and increase confrontation risks.Thus,patient vigilance constitutes a critical form of"psychological latent risk,"facilitating the transition from psychological opposition to behavioral conflict.Yet how individual decision-making traits influence this vigilance remains unclear.Our research investigates how maximization orientation affects patient vigilance through moral disengagement,and how doctor friendly behavior moderates this relationship. Study 1 preliminarily examined the effect of maximization orientation on patient vigilance and the mediating role of moral disengagement using a sample of patients surveyed after their clinical visits.Participants self-reported their maximization orientation,vigilance toward doctors,moral disengagement,and common ingroup identity.They were also asked to predict doctors'potential behaviors across eight typical medical scenarios,with their vigilance quantitatively assessed through standardized coding of these predictions.Results confirmed maximization orientation increased vigilance through moral disengagement(supporting H1-H2),while excluding common ingroup identity as an alternative explanation. Study 2 conducted a field survey of patients who consulted the same target doctor to further examine the relationships among maximization orientation,moral disengagement,and patient vigilance toward doctors,as well as the moderating role of doctor friendly behavior.Participants completed pre-consultation measures assessing maximization orientation and demographic variables,followed by post-consultation evaluations of doctor friendly behavior,vigilance,moral disengagement,and control variables.Vigilance toward doctors was measured using the identical subjective prediction method employed in Study 1.The results not only replicated the mediation effect observed in Study 1 but also revealed that doctor friendly behavior significantly moderated the moral disengagement pathway(supporting H1-H4),thereby establishing external validity for our full theoretical model. Study 3 employed a 2(maximization:maximizing vs.satisficing)×2(friendly behavior:present vs.absent)between-subjects design to experimentally test the full model,thereby providing causal evidence for the proposed relationships.After successful manipulation and verification of the maximization mindset,participants read eight typical medical scenarios(with or without doctor-friendly behaviors)and assessed the likelihood of doctors engaging in behaviors that could harm patients'interests,which served as our measure of vigilance.Subsequently,participants reported their moral disengagement and demographic information.The results provided causal evidence for our theoretical model,robustly confirming all hypothesized relationships(H1-H4). Collectively,this study reveals that maximization orientation heightens patient vigilance through moral disengagement,thereby advancing social vigilance research,uncovering novel interpersonal consequences of maximization orientation,and extending moral disengagement theory through empirical evidence of its extra-moral motivational effects.Importantly,this study proposes a comprehensive prevention framework for doctor-patient conflicts,comprising:(1)establishing a"prevention-first"conflict management principle;(2)incorporating maximization orientation into risk early-warning indicator systems;(3)integrating the impact of patients'maximization orientation into healthcare professionals'communication training;and(4)developing targeted clinical interventions based on the moral disengagement mechanism.