关键词: 攻击, 大五人格, 医生病人关系, 医患信任

Abstract: Background　In recent years，the intensification of doctor-patient conflict and the crisis of doctor-patient trust have occurred from time to time．Scholars at home and abroad have explored the importance of doctor-patient relationship and the influencing factors of doctor-patient trust from different levels．However，it is unclear whether aggression and personality of patients have an impact on doctor-patient trust．Objective　To explore the relationship among aggression of patients，doctor-patient trust and big five personality traits，and big five personality traits' mediator role in patient aggression and doctor-patient trust．Methods　By convenience sampling，patients were extracted from Shenzhen First People's Hospital，Shenzhen Traditional Chinese Medicine Hospital，Shenzhen Guangming New District People's Hospital，Shenzhen Luohu Hospital Group Luohu People's Hospital，Shenzhen Seventh People's Hospital，Women & Children Health Institute Futian，Shenzhen，Shenzhen Fourth People's Hospital，Guangdong Provincial Hospital of Traditional Chinese Medicine from December 2017 to February 2018．The Chinese College Students' version of Buss-Perry Aggression Questionnaire（CC-BPAQ），Chinese version of the Wake Forest Physician Trust Scale（C-WFPTS） and Ten-Item Personality Inventory in China（TIPI-C） were used for investigation．The Mann-Whitney U test was used to compare the differences in aggression，trust in doctors，and big five personality traits among patients by sex．Spearman rank correlation analysis was used to analyze the correlation between patient aggression，doctor-patient trust and big five personality traits．The mediation model was fitted using AMOS 20.0 software，and the mediation effect was analyzed using the Bootstrap program．Results　A total of 500 questionnaires were distributed and 384 responsive ones were returned，achieving a response rate of 76.8%．The CC-BPAQ total score，physical aggression and impulsive subscale scores in male patients were higher than those in female patients（P<0.05）．Sex-specific differences in the hostility and anger subscale scores of CC-BPAQ，C-WFPTS total score，and the scores of its benevolence，and technical ability dimensions，the subscale scores of extroversion，agreeableness，conscientiousness，neuroticism，and openness of TIPI-C in the patients were not significant（P>0.05）．The CC-BPAQ total score was negatively correlated with C-WFPTS total score（rs=-0.173），subscale scores of extroversion（rs=-0.185），agreeableness（rs=-0.296），conscientiousness（rs=-0.237），neuroticism（rs=-0.422），and openness（rs=-0.140）of the TIPI-C（P<0.05）．The C-WFPTS total score showed a positive correlation with the subscale scores of agreeableness（rs=0.207），and neuroticism（rs=0.211）of the TIPI-C（P<0.05）．The estimated indirect effect of patient aggression on trust in physician was -0.33〔95%CI（-0.92，-0.09）〕．The big five personality traits played a complete mediator role between patient aggression and doctor-patient trust．Conclusion　Patient aggression predicted doctor-patient trust via the mediating role of the TIPI-C．Appropriate personality traits are the protective factors for doctor-patient trust．They can prevent patients with high aggressive traits from engaging in aggressive behavior such as violence against doctors，and can effectively improve the level of patient's trust in physicians．

Key words: Aggression, Big five personality, Physician-patient relations, Doctor-patient trust