The Influence of Sociality in Cancer Treatment Decision-Making

社会性对癌症治疗决策的影响

• 批准号: 1354336
• 负责人: Carolyn Sargent
• 金额: $ 12.6万
• 依托单位: Washington University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1354336&HistoricalAwards=false
• 关键词: Influence; Sociality; Cancer; Treatment; Decision

Carolyn Sargent of Washington University will research how transnational communications about disease generate therapy management group decision-making. The research will contribute to scientific understandings of how disease shapes social interaction and how meanings of illness acquire legitimacy and influence treatment decisions. Medical anthropologists have long emphasized the ways in which many treatment decisions are influenced not just by communications between doctor and patient, but also by a range of larger social networks. The research focuses on meanings and strategies about breast cancer among immigrants from the Senegal River Valley (Mali, Mauritania, Senegal) in Paris, France, an appropriate research context because of the robust and complex transnational decision-making networks that have emerged. Migrant communities such as these have proven to be an ideal social laboratory for exploring the formation of decision-making networks as these are typically spaces where a range of social relationships are observably emergent. Three central questions are posed: (1) how sufferers, families, interpreters and clinicians collectively and progressively define and manage cancer; (2) how social relations are restructured around the collective experience of cancer and how the symbolic importance of cancer figures into these reconfigurations; (3) how transnational meanings and strategies are continuously generated by means of cell phone and other communications. To investigate these questions, the researchers have designed a two-year study, to follow 40 women with breast cancer, as well as caretakers, clinicians and interpreters. Regular home visits will be conducted to assess kinship obligations, social hierarchies, and moral conventions, using semi-structured interviews and a mix of qualitative methods. Participant observation in women's immigrant associations will allow the researchers to assess popular representations of breast cancer and treatment modalities.The broader impact of this research lies in its implications for public health policy and clinical practice. The research explores the impacts to medical treatment that arise when biomedical practitioners, patients, and families do not share a common language or core illness constructs and treatment expectations. It points to areas that merit attention to ensure that policies acknowledge the potential for serious disruptions in the provision of care to gravely ill patients when these issues remain unaddressed. The researchers' connections with clinicians and public health officials will facilitate the dissemination of research findings and produce relevant workshops, working papers, and publications.

华盛顿大学的卡罗琳·萨金特将研究有关疾病的跨国传播如何产生治疗管理小组决策。这项研究将有助于科学地理解疾病如何塑造社会互动，以及疾病的意义如何获得合法性并影响治疗决策。长期以来，医学人类学家一直强调，许多治疗决策不仅受到医生和患者之间沟通的影响，还受到一系列更大的社交网络的影响。该研究的重点是从塞内加尔河谷（马里，毛里塔尼亚，塞内加尔）在法国巴黎，一个适当的研究背景下，因为已经出现了强大而复杂的跨国决策网络的移民乳腺癌的意义和策略。像这样的移民社区已被证明是探索决策网络形成的理想社会实验室，因为这些通常是一系列社会关系明显涌现的空间。提出了三个核心问题：（1）患者，家庭，口译员和临床医生如何集体和逐步定义和管理癌症;（2）社会关系如何围绕癌症的集体经验进行重组，以及癌症的象征意义如何融入这些重组;（3）跨国意义和策略如何通过手机和其他通信手段不断产生。为了调查这些问题，研究人员设计了一项为期两年的研究，跟踪40名乳腺癌患者，以及护理人员，临床医生和口译员。定期家访将进行评估亲属义务，社会等级制度，道德习俗，使用半结构化的访谈和定性方法的组合。参与观察妇女的移民协会将使研究人员评估乳腺癌和治疗models.The更广泛的影响，这项研究在于其对公共卫生政策和临床实践的影响。该研究探讨了当生物医学从业者，患者和家庭没有共同的语言或核心疾病结构和治疗期望时对医疗的影响。报告指出了一些值得关注的领域，以确保政策承认，如果这些问题得不到解决，向重病患者提供护理可能会受到严重干扰。研究人员与临床医生和公共卫生官员的联系将促进研究结果的传播，并制作相关的讲习班，工作文件和出版物。