对于宿命观，中国人并不陌生，不论是文学作品还是在哲学社会思想中都能 见到类似的表达。中国古代哲学中把天当作神，天能致命于人，决定人类命数。 我们现在所熟知的孔、孟、老、庄、墨、阴阳等诸子的思想虽有差异，但都受到 “天命论”的影响。“尽人事听天命”(《镜花缘》)、“天人合一”(《道德经》)、 “谋事在人成事在天”(《三国演 义·第一百三回》)也常见于人们的表达和行 动之中。通过对 1979-2018 年间国外宿命观与健康传播相关研究进行梳理发现， 作为一种健康信念，宿命观就像是一堵无形之墙阻隔在健康传播的多个方面。对 于基础的健康信息行为来说，宿命观阻碍了人们对于健康信息的寻求，从而影响 他们寻医问药，可是过多的和矛盾的健康信息又给人们带来了困扰和恐惧，形成 信息过载，波及着人们的宿命观;在具体的传播中，宿命观又像是一堵“无形的 墙”阻碍着医患沟通，影响病人和家属之间的正常交流;站在健康传播受众的视 角来看，基于文化的宿命观可能远比现实环境带来的压力更为复杂和牢固，遗传 风险及其传播也需要考虑宿命观的潜在影响，然而在中国语境下，宿命论在内涵 和外延上可能不同于国外，对健康传播的影响可能也是大不相同的。

基于这样的研究背景，本文从健康传播的关键环节——健康沟通出发，去探 究健康宿命观的本土内涵，以及它对健康传播可能产生的影响。沟通对于健康来 说是很重要的一环，不论是与医生还是家人、朋友，亦或是在网络上的宣泄与倾 诉，它都它反映着人们对信息的把握和运用，影响着我们的下一步行动以及认知 态度，所以本文在研究时从广义的健康沟通出发，把健康信息的寻求、评价、应用、沟通和反馈，对沟通对象的选择和态度都纳入研究设计中来。本研究以理性 行为理论为基础，从沟通态度、主观规范和沟通意向出发，探究健康宿命观对沟 通可能产生的影响，并试图对理论模型进行补充和修正，对健康宿命观与健康信 息、沟通和遗传风险感知之间的关系做进一步的了解，并在文献和理论研究的基 础上提出研究假设、设计问卷。运用 SPSS24.0 分析软件对问卷数据进行分析与 假设检验,得出研究结论。

研究发现，悲观是人们健康宿命观的主要表现，虽然人们相信天命和命运的存在，但是在健康问题上，人们的自我效能和主观能动性也同样强烈的，人们对 于健康宿命观的理解既包括对于现实中无法克服的障碍的感知，也同样相信自身 具有追求健康的信心和能力;健康宿命观影响人们对于医生的信任度，虽然在调查中人们对于医生信任度很高，但是医护交流的主动性不强，塑造人们对医务人 员的信任是解决医患矛盾的重要出发点，缓解人们的悲观、焦虑，帮助我们与命 运正面交手;遗传风险感知与健康宿命观之间的相关性也得到了证实，人们并未 将其与先定和运气混为一谈，事实上对遗传风险的认知越强烈，对生活方式与健 康的关系认同就越高，遗传更有可能成为人们采取健康措施的原因，而不是健康 宿命观的诱因;人们寻求健康信息的积极性受到健康宿命观的影响，但是媒介健 康信息接触又在一定程度上缓解了健康宿命观的负面效应，健康宿命观阻碍了健 康信息效用的充分发挥;在加入医生信任和媒介健康信息两个变量之后，理性行 为理论对健康沟通意向的预测力增强，知和信是预测健康沟通基础;健康宿命观 影响沟通态度和意向，运气影响人们对主观规范的认同，人们的侥幸心理会影

Chinese are familiar with fatalism, which can be found in both literary works and philosophical social thoughts. In ancient Chinese philosophy, the heaven was regarded as a god, which could create lives and determine their destiny. Although the thoughts of Confucius, Meng, Lao, Zhuang, Mo, Yin and Yang that we are now familiar with are different, they are all influenced by the “theory of destiny”. "Do one's best and leave the rest to Heaven" (Jing Hua Yuan), "the unity of man and nature" (Dao De Jing), "Man proposes, God disposes" (" The Romance of The Three Kingdoms · the 133rd time ") are also common in people's expressions and actions. Based on the analysis of foreign studies on fatalism and health communication from 1979 to 2018, this paper finds that fatalism, as a health belief, is an invisible wall blocking various aspects of health communication. For the basic health information behavior, fatalism hinders people's searching behavior for health information, which affecting their desire to consult doctors and seek for medicine. Excessive and contradictory health information brings people trouble and fear, causing information overload and affecting people's fatalism. In the specific communication situation, fatalism is like an "invisible wall" that blocks doctor-patient communication and influences the normal communication between patients and their families. From the perspective of the audience of healthy communication, the culture-based fatalism may be far more complex and solid than the pressure brought by the real environment.

We should consider the potential impact of fatalism when we talk about genetic risk. In the context of China, the connotation and extension of fatalism may be different from that in foreign countries, its impact on the health communication could also be very different, based on these backgrounds, this article proceeds with the key point in the process of health communication-health talk, and to explore native connotation of health fatalism, and its impact on health communication. Communicating is an important link of health, whether it is with doctors, family, friends, or on the Internet, it reflects people’s grasp and use of information, and affects our next action, the formation of acknowledge and attitude, therefore, this paper starts from the generalized health communication, and integrates health information seeking, evaluation, appling, communicating and feedback, as well as the choice and attitude of communication objects into the research design. This study is based on the theory of rational behavior, from the perspective of communication attitude, subjective norm and communication intention, to explore how health fatalism might affect health talks, and attempts to supplement and correct the theory model, for further understanding relationships between health fatalism and health information, communication, perceptions of genetic risk, and put forward the research hypothesis, design the questionnaire basing on the research of the literature and theory. SPSS24.0 analysis software was used to analyze the questionnaire data and test the hypothesis.