The Influence of Sociality in Cancer Treatment Decision-Making

华盛顿大学的卡罗琳·萨金特将研究关于疾病的跨国交流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。医学人类学家长期以来一直强调，许多治疗决定不仅受到医患之间交流的影响，还受到一系列更大的社会网络的影响。该研究侧重于法国巴黎塞内加尔河谷（马里、毛里塔尼亚、塞内加尔）移民乳腺癌的意义和策略，这是一个合适的研究背景，因为已经出现了强大而复杂的跨国决策网络。诸如此类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，因为这些是一系列社会关系明显涌现的典型空间。提出了三个核心问题：(1)患者、家属、口译员和临床医生如何共同并逐步定义和管理癌症；(2)社会关系是如何围绕癌症的集体经历进行重构的，以及癌症的象征重要性如何体现在这些重构中；(3)跨国意义和战略是如何通过手机和其他通信手段不断产生的。为了调查这些问题，研究人员设计了一项为期两年的研究，跟踪调查了40名患有乳腺癌的女性，以及护理人员、临床医生和口译员。将定期进行家访，以评估亲属义务、社会等级和道德习俗，采用半结构化访谈和混合定性方法。妇女移民协会的参与者观察将使研究人员能够评估乳腺癌的流行表现和治疗方式。这项研究更广泛的影响在于它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，对医疗产生的影响。报告指出了一些值得注意的领域，以确保政策承认，如果这些问题得不到解决，向重症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成果的传播，并举办相关的讲习班、工作文件和出版物。

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.