Doctoral Dissertation Research: Knowledge, Practice, and Clinical Experiences of Oncology

博士论文研究：肿瘤学的知识、实践和临床经验

• 批准号: 1917871
• 负责人: Adrienne Strong
• 金额: $ 2.41万
• 依托单位: University of Florida
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1917871&HistoricalAwards=false
• 关键词: Doctoral; Dissertation; Research; Knowledge; Practice

As chronic diseases, such as cancer, begin to dominate the landscape of threats to global health and development targets, it is of vital importance to improve our understanding of how to implement biomedical programs in non-Western, low resource environments. Research from within anthropology has repeatedly shown medical treatments are rarely implemented in a new context unchanged, and that biomedical systems adapt to local conditions and beliefs. Through a careful examination of implementation of oncology practice, this project explores the ways that care for cancer is shaped by differences in technology, infrastructure, economics, development, medical practice, and cultural beliefs. By gaining a better understanding of the ways that these forces impact care for cancer, this project has the potential to yield insights for improvement in biomedical and development practice in oncology. Further, the lessons learned from this specific case study may be fruitfully extended to improve biomedical and development practice more broadly, including use in other cases of implementation of systems of care for non-infectious diseases. Thus, as the global health community begins to pivot towards the problems of chronic illness, this project has the potential to yield concrete, actionable recommendations for improving biomedical practice, training, and the development of sustainable infrastructure in this context.Rebecca Henderson, under the supervision of Dr. Adrienne Strong of the University of Florida, will investigate how knowledge, technology, and treatment protocols of cancer are created an enacted in clinical settings, with the aim of understanding how biomedicine is transformed as it travels. This research will be conducted in several of the key cancer research centers in Haiti in the capital city of Port-au-Prince, as well as those in more rural areas. Using a qualitative approach, this project will capture the perspectives of clinicians, patients, and families as they encounter oncology. It will employ participant observation in order to document activities in hospitals and health centers, as well as centers of diagnosis such as laboratories and imaging centers. It will also employ semi-structured interviews with patients, their families, and the clinicians engaged in their care in order to capture local understandings of cancer, cancer treatment, and disease course. Oral histories will allow for an improved understanding of the development of cancer care over the last decade. All interviews and fieldnotes will be thematically coded using an iterative, inductive methodology based on grounded-theory. Finally, a review of medical records will be conducted at clinical centers in order to more fully describe changes in oncological care over time, as well as to better understand the effect of these factors on patient outcomes.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

随着癌症等慢性病开始成为全球健康和发展目标面临的主要威胁，提高我们对如何在非西方、低资源环境中实施生物医学项目的理解至关重要。人类学内部的研究一再表明，医疗很少在新的环境中不变地实施，生物医学系统适应当地的条件和信仰。通过对肿瘤学实践实施的仔细检查，该项目探讨了癌症护理的方式是由技术，基础设施，经济，发展，医疗实践和文化信仰的差异形成的。通过更好地了解这些力量影响癌症护理的方式，该项目有可能为改善肿瘤学的生物医学和发展实践提供见解。此外，从这一具体案例研究中吸取的经验教训可以卓有成效地推广，以更广泛地改进生物医学和发展做法，包括在其他情况下使用非传染性疾病护理系统。因此，随着全球卫生界开始转向慢性病问题，该项目有可能产生具体的，可操作的建议，以改善生物医学实践，培训，并在此背景下发展可持续的基础设施。丽贝卡亨德森，在佛罗里达大学的阿德里安娜斯特朗博士的监督下，将调查知识，技术，癌症的治疗方案是在临床环境中制定和实施的，目的是了解生物医学在传播过程中是如何转变的。这项研究将在海地首都太子港的几个主要癌症研究中心以及更多农村地区进行。使用定性的方法，该项目将捕捉临床医生，患者和家庭的观点，因为他们遇到肿瘤。它将采用参与式观察，以记录医院和卫生中心以及实验室和成像中心等诊断中心的活动。它还将采用半结构化的采访与患者，他们的家人，和临床医生从事他们的护理，以捕捉当地的理解癌症，癌症治疗和疾病的过程。口述历史将使人们更好地了解过去十年来癌症护理的发展。所有的访谈和现场记录将使用基于交叉理论的迭代归纳方法进行主题编码。最后，将对临床中心的病历进行审查，以便更全面地描述肿瘤治疗随时间的变化，以及更好地了解这些因素对患者结局的影响。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。