Читать книгу Medical Communication: From Theoretical Model To Practical Exploration - Tao Wang - Страница 18

The basic view of contextual model is that the public is not an empty bottle waiting for knowledge to be injected; instead, the absorption and processing of information will be influenced by social environment and personal psychology. Therefore, previous experience, cultural context and personal environment will influence the public’s view of science. In the process of science communication, we are not facing a single audience, but a pluralistic audience with different cultural backgrounds. Why do they need scientific information? Under what circumstances do they need scientific information? Therefore, we need a model of disseminating scientific information to different audiences at different times and in different ways, according to different contexts. This is the contextual model. The contextual model is widely used in the fields of audience perception, such as health communication, risk communication, and risk perception.

First of all, the contextual model takes into account many factors of personal and environment, including life stage, personality, and interpersonal relationship, which will affect the reception of information. Secondly, the social system and media presentation will also deepen or weaken the public’s attention to certain issues. Therefore, contextual model scholars use modern market segmentation method to analyze the scientific literacy of different groups and disseminate different scientific knowledge.

We give some appropriate examples to illustrate how the contextual model apply to medical communication in the following.

For example, Tibet is a famous tourist destination, while Potala Palace is a place where many people need pilgrimage. But Tibet is a typical plateau area. Compared with the plain area, the oxygen content there is obviously low. Many people are likely to have altitude sickness because of lack of oxygen for the first time. High-altitude reaction is a common disease in plateau area, including common symptoms of headache, insomnia, loss of appetite, fatigue, dyspnea, etc. Generally speaking, 50%–75% of the people in the plain experienced altitude reaction when they entered the plateau above 3000 m suddenly, but the symptoms gradually disappeared after 3–10 days of acclimation. Acute high-altitude reaction is very likely to result in high-altitude pulmonary edema and/or high-altitude brain edema. If we do not pay attention to it, we may lose our lives. Because of the particularity of plateau reaction, many people going to travel will be very concerned about how to prevent altitude sickness, and they will pay attention to the medical knowledge of it. Considering the focus of these groups, the contextual model of medical communication is to popularize medical knowledge among those who are going to travel to the plateau about how to prevent from and treat with the plateau reaction after the plateau reaction occurs. Compared with the deficit model, at least it focuses on the needs of the public, and its publicity and popularization shoot the arrow at the target.

For another example, chronic hepatitis B, or hepatitis B for short, is caused by infection with hepatitis B virus. China is a high incidence area of hepatitis B. According to statistics, the number of hepatitis B virus carriers in China is as high as 120 million, and the number of cases is more than 30 million. A considerable number of hepatitis B patients present family clustering characteristics. The incidence of cirrhosis and hepatocellular carcinoma in patients with hepatitis B was significantly higher than that in non-hepatitis B patients. Hepatitis B virus listed as a carcinogen of Class I in October 2017. Therefore, for a large number of hepatitis B virus carriers, patients, or the members of their families, they are quite concerned about the health knowledge of hepatitis B. They want to know which way hepatitis B is transmitted, how to avoid infection or the common complications of hepatitis B, and how to keep healthy after getting hepatitis B. Then combining with their concerns, they, on the one hand, communicate the importance of hepatitis B vaccine injection in the population, on the other hand, publicize the importance of regular physical examination and liver protection for the people who are already carriers of hepatitis B. That is a good combination of public needs, and also a reflection of the contextual model.

Sometimes, we will find that the concern about the topic will change with the influence of personal environment or personal psychology. That is to say, the context may change. For example, recently someone’s friend, a middle-aged man, whose age and work are similar to him, developed lung cancer suddenly. During this period of time, he will be very concerned about various medical knowledge about lung cancer. After a while, another friend of his died of acute myocardial infarction, then he turned to the medical knowledge of myocardial infarction instead of the lung cancer that he had paid attention to previously. Therefore, the context will change with the environment and psychology around the individual. However, in the contextual model, we also need to consider whether the individual needs to focus on. The context problem is whether it is the real medical issue that needs to be concerned about. For example, if the middle-aged man mentioned above usually does not smoke or drink, is of moderate size, not overweight or obese, has no history of chronic diseases, such as hypertension, diabetes, hyperlipidemia, and has no history of lung cancer or cardiovascular and cerebrovascular diseases in his family, then he is not at high risk for cardiovascular diseases such as lung cancer or myocardial infarction. However, his family has a history of colorectal cancer, and he himself has a long history of constipation, so he is of a high-risk group of colorectal cancer. He should know or master the relevant medical knowledge of colorectal cancer rather than the knowledge of lung cancer and cardiovascular and cerebrovascular diseases.

In addition, many critics pointed out that the contextual model was only an upgraded version of the deficit model, both of which equated “public understanding of science” with “public appreciation of the benefits of science to society”. Since the 1980s, science communication scholars have begun to emphasize layman knowledge and public participation, thus putting forward the following two models.