), 梁竹苑() 中国科学院大学心理学系, 北京 100049
收稿日期:2018-03-12出版日期:2018-08-07发布日期:2018-07-02基金资助:* 国家自然科学基金项目(71471171, 71761167001), 北京市自然科学基金项目(9172019)资助Nudging: Default option effect and response mode promote organ donor registry participation in China
HUANG Yuan-Na, SONG Xing-Yun, SHAO Yang, LI Shu(), LIANG Zhu-Yuan() Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
Received:2018-03-12Online:2018-08-07Published:2018-07-02摘要/Abstract
摘要： 器官短缺是全世界共同面临的难题, 中国器官短缺形势尤为严重。为填补中国器官供需不平衡导致的严重缺口, 本研究试图借鉴行为经济学手段中的默认选项、选项架构等心理学效应, 兼顾总体器官捐献率和捐献器官的数量, 探索提高中国器官捐献水平的可能方法。本研究以中国在校大学生为样本, 通过3个调查研究考察了器官捐献制度和器官捐献登记表设计对我国民众器官捐献登记的影响。研究1在器官捐献制度层面上, 发现在中国文化背景中, “决定退出”制度比“决定参加”制度下的器官捐献登记率更高。研究2在器官捐献登记表设计层面上, 比较采用不同捐献制度的国家/地区的捐献登记表形式对器官捐献登记率的影响, 发现在决定退出制度中的器官捐献率高于决定参加制度, 且前者内各种形式间无明显优劣之分; 但在决定参加制度中, 采用拒绝反应模式登记表形式的器官捐献率最高, 甚至与决定退出制度下的各登记表形式相比不相上下。研究3在具有潜在器官捐献意愿人群中, 探索提高捐献者愿意捐献器官数量的可能途径, 发现使用拒绝反应模式的捐献登记表能够增加捐献登记的器官数量; 且低影响外观器官的捐献率在拒绝反应模式下以升序排列时最高。这些结果说明, 决定退出制度和反应模式等行为经济学手段可以有效助推中国器官捐献行为。鉴此, 政府和相关机构可考虑采取如下措施提高中国的志愿器官捐献水平：或改现行的“决定参加”为“决定退出”的器官捐献制度; 或在现行的“决定参加”器官捐献制度下, 在器官捐献登记表中采用拒绝反应模式, 并按对外观影响大小升序排列捐献器官种类。
图/表 4
表1各器官捐献制度组被试的样本分布及其器官捐献率
| 实验条件 | n | 男性比例 | 年龄(M ± SD) | 有宗教信仰的比例 | 器官捐献知识正确率(M ± SD) | 器官捐献率(M ± SE) |
|---|---|---|---|---|---|---|
| 对照组 | 74 | 45.96% | 22.66 ± 1.34 | 6.76% | 72.3% ± 11.7% | 59.46% ± 6.00% |
| 决定参加 | 60 | 51.67% | 22.48 ± 1.19 | 3.33% | 75.0% ± 10.2% | 68.33% ± 4.74% |
| 决定退出 | 61 | 50.82% | 22.35 ± 0.97 | 3.28% | 74.8% ± 10.5% | 83.61% ± 5.72% |
表1各器官捐献制度组被试的样本分布及其器官捐献率
| 实验条件 | n | 男性比例 | 年龄(M ± SD) | 有宗教信仰的比例 | 器官捐献知识正确率(M ± SD) | 器官捐献率(M ± SE) |
|---|---|---|---|---|---|---|
| 对照组 | 74 | 45.96% | 22.66 ± 1.34 | 6.76% | 72.3% ± 11.7% | 59.46% ± 6.00% |
| 决定参加 | 60 | 51.67% | 22.48 ± 1.19 | 3.33% | 75.0% ± 10.2% | 68.33% ± 4.74% |
| 决定退出 | 61 | 50.82% | 22.35 ± 0.97 | 3.28% | 74.8% ± 10.5% | 83.61% ± 5.72% |
表2各制度下不同捐献登记设计形式条件中被试分布与捐献率统计表
| 实验条件 | n | 男性比例 | 年龄(M ± SD) | 有宗教 信仰比例 | 器官捐献知识 正确率(M ± SD) | 器官捐献 率(M ± SE) | |
|---|---|---|---|---|---|---|---|
| 捐献制度 | 登记表架构 | ||||||
| 决定参加 | (平均) | 460 | 30.21% | 21.47 ± 2.63 | 7.83% | 70.5% ± 10.6% | 72.83% ± 4.58% |
| 对照版本 | 92 | 31.52% | 21.80 ± 2.63 | 9.78% | 70.1% ± 10.6% | 69.57% ± 4.78% | |
| 问题排列顺序 | 81 | 37.03% | 21.15 ± 2.80 | 7.41% | 72.2% ± 11.1% | 60.49% ± 5.43% | |
| 明确选项内涵 | 126 | 26.19% | 21.52 ± 2.86 | 7.94% | 69.7% ± 11.6% | 76.98% ± 3.75% | |
| 拒绝反应模式 | 69 | 36.23% | 20.95 ± 2.01 | 1.44% | 69.6% ± 9.2% | 85.51% ± 4.24% | |
| 接受反应模式 | 92 | 23.91% | 21.73 ± 2.49 | 10.87% | 71.1% ± 9.5% | 71.74% ± 4.69% | |
| 决定退出 | (平均) | 232 | 29.31% | 20.96 ± 2.50 | 8.19% | 70.6% ± 9.4% | 81.90% ± 4.25% |
| 对照版本 | 104 | 34.62% | 21.17 ± 2.50 | 11.54% | 69.9% ± 10.3% | 76.92% ± 4.13% | |
| 提供第三个选项 | 63 | 25.39% | 21.19 ± 2.40 | 7.93% | 70.1% ± 8.6% | 80.00% ± 4.78% | |
| 询问理由 | 65 | 24.61% | 20.38 ± 2.54 | 3.10% | 72.4% ± 8.6% | 87.93% ± 3.84% | |
表2各制度下不同捐献登记设计形式条件中被试分布与捐献率统计表
| 实验条件 | n | 男性比例 | 年龄(M ± SD) | 有宗教 信仰比例 | 器官捐献知识 正确率(M ± SD) | 器官捐献 率(M ± SE) | |
|---|---|---|---|---|---|---|---|
| 捐献制度 | 登记表架构 | ||||||
| 决定参加 | (平均) | 460 | 30.21% | 21.47 ± 2.63 | 7.83% | 70.5% ± 10.6% | 72.83% ± 4.58% |
| 对照版本 | 92 | 31.52% | 21.80 ± 2.63 | 9.78% | 70.1% ± 10.6% | 69.57% ± 4.78% | |
| 问题排列顺序 | 81 | 37.03% | 21.15 ± 2.80 | 7.41% | 72.2% ± 11.1% | 60.49% ± 5.43% | |
| 明确选项内涵 | 126 | 26.19% | 21.52 ± 2.86 | 7.94% | 69.7% ± 11.6% | 76.98% ± 3.75% | |
| 拒绝反应模式 | 69 | 36.23% | 20.95 ± 2.01 | 1.44% | 69.6% ± 9.2% | 85.51% ± 4.24% | |
| 接受反应模式 | 92 | 23.91% | 21.73 ± 2.49 | 10.87% | 71.1% ± 9.5% | 71.74% ± 4.69% | |
| 决定退出 | (平均) | 232 | 29.31% | 20.96 ± 2.50 | 8.19% | 70.6% ± 9.4% | 81.90% ± 4.25% |
| 对照版本 | 104 | 34.62% | 21.17 ± 2.50 | 11.54% | 69.9% ± 10.3% | 76.92% ± 4.13% | |
| 提供第三个选项 | 63 | 25.39% | 21.19 ± 2.40 | 7.93% | 70.1% ± 8.6% | 80.00% ± 4.78% | |
| 询问理由 | 65 | 24.61% | 20.38 ± 2.54 | 3.10% | 72.4% ± 8.6% | 87.93% ± 3.84% | |
表3不同反应模式和呈现顺序条件下被试分布统计表
| 实验条件 | n | 男性比例 | 年龄(M ± SD) | 有宗教信仰比例 | 器官捐献知识正确率(M ± SD) | |
|---|---|---|---|---|---|---|
| 反应模式 | 呈现顺序 | |||||
| 拒绝 | 升序 | 53 | 26.42% | 21.64 ± 2.40 | 13.20% | 70.0% ± 10.1% |
| 降序 | 47 | 17.02% | 21.30 ± 2.29 | 8.51% | 69.4% ± 9.1% | |
| 接受 | 升序 | 46 | 23.91% | 21.52 ± 2.30 | 6.52% | 69.7% ± 10.1% |
| 降序 | 56 | 25.00% | 21.48 ± 2.78 | 1.79% | 71.7% ± 10.6% | |
表3不同反应模式和呈现顺序条件下被试分布统计表
| 实验条件 | n | 男性比例 | 年龄(M ± SD) | 有宗教信仰比例 | 器官捐献知识正确率(M ± SD) | |
|---|---|---|---|---|---|---|
| 反应模式 | 呈现顺序 | |||||
| 拒绝 | 升序 | 53 | 26.42% | 21.64 ± 2.40 | 13.20% | 70.0% ± 10.1% |
| 降序 | 47 | 17.02% | 21.30 ± 2.29 | 8.51% | 69.4% ± 9.1% | |
| 接受 | 升序 | 46 | 23.91% | 21.52 ± 2.30 | 6.52% | 69.7% ± 10.1% |
| 降序 | 56 | 25.00% | 21.48 ± 2.78 | 1.79% | 71.7% ± 10.6% | |
图1研究3中被试器官捐献比例(M ± 1 SE)。(a)在不同反应模式与不同排列顺序下捐献器官数量的比例; (b)被试对于两类不同程度影响外观的器官在不同反应模式与排列顺序下捐献器官数量的比例。
图1研究3中被试器官捐献比例(M ± 1 SE)。(a)在不同反应模式与不同排列顺序下捐献器官数量的比例; (b)被试对于两类不同程度影响外观的器官在不同反应模式与排列顺序下捐献器官数量的比例。参考文献 46
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