Impact of Emotions on Treatment Decisions About Low-Risk Thyroid Cancer

情绪对低风险甲状腺癌治疗决策的影响

• 批准号: 10443661
• 负责人: Susan C Pitt
• 金额: $ 26.06万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-11 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10443661
• 关键词: Address; Affect; Age; Anxiety; Attention; Behavior; Behavior Therapy; Benign; Cognition; Cognitive; Communication; Decision Making; Deglutition; Diagnosis; Disease; Educational Intervention; Effectiveness of Interventions; Emotional; Emotions; Exercise; Experimental Psychology; Fatigue; Feeling; Foundations; Fright; Funding; Goals; Health; Health Services; Incidence; International; Intervention; K-Series Research Career Programs; Knowledge; Lead; Life; Longevity; Malignant Neoplasms; Malignant neoplasm of thyroid; Measurement; Mentors; Methodology; Mind; Modeling; Morbidity - disease rate; Muscle Cramp; Operative Surgical Procedures; Outcome; Patient Preferences; Patients; Pharmaceutical Preparations; Postoperative Period; Prognosis; Psychology; Public Health; Qualitative Research; Quality of life; Randomized; Reflex action; Research; Research Personnel; Research Training; Risk; Role; Science; Scientist; Societies; Surgeon; Testing; Tetany; Thyroid Gland; Thyroid Nodule; Thyroidectomy; Time; Training; Treatment outcome; Treatment-Related Cancer; United States; Vocal Cord Paralysis; Woman; Work; analog; base; behavior test; behavioral economics; cancer diagnosis; cancer risk; cancer therapy; care costs; career; clinically significant; comparative; cost; design; disorder risk; effective intervention; effectiveness testing; experience; experimental study; improved; innovation; insight; mortality; multidisciplinary; overtreatment; peace; preference; psychologic; risk perception; simulation; skills; social; theories; treatment effect; tumor

PROJECT SUMMARY This K08 Career Development Award will address important gaps in the training of the applicant while simultaneously generating new knowledge about the role of emotions in cancer-related treatment decisions, a priority of the NCI. The incidence of thyroid cancer has increased at a rate faster than any other cancer, largely due to increased diagnosis of small, low-risk cancers ≤ 2 cm with a 10-year mortality close to zero. Overtreatment with total thyroidectomy occurs in the vast majority of these patients, resulting in significant harms, excess morbidity, and costs to both patients and society without a clear benefit. Currently, a lack of understanding about why patients prefer this extensive treatment limits our ability to reduce overtreatment of low-risk disease. The proposed research seeks to address this gap by investigating the impact of emotions on treatment decisions about small, low-risk thyroid cancer. The coordinated research and training proposal aims to: 1) characterize the emotional and cognitive communication between patients and surgeons during treatment decision making; 2) determine the relative value of treatment outcomes to patients undergoing total thyroidectomy at the time of the decision compared to one year postoperatively; and 3) test the extent to which increased emotionally supportive communication by surgeons is associated with decreased patient preference for total thyroidectomy. The central hypothesis is that is that emotions, such as fear and anxiety, influence patient-surgeon decision making about treatment for small, low-risk thyroid cancer leading to decisions that over treat. Completion of these aims will facilitate mentored-training in decision science that is vital to Dr. Pitt's career goals. The proposed training will fill key educational and experiential gaps in the psychology of decision making and behavioral economics, which will be accompanied by methodologic training in qualitative research, preference measurement, choice experimentation, and factorial design. The applicant will draw upon the strengths of a diverse group of nationally and internationally recognized mentors with multidisciplinary expertise in experimental psychology, surgical decision-making, behavioral economics, and thyroid cancer treatment. This mentored training will support the applicant in becoming a successful surgeon-scientist with unique research skills. The results of the proposed research will provide new understanding about the specific role of emotions and emotionally supportive communication in treatment decisions in a low-risk cancer. At the end of the proposed training period, Dr. Pitt will have the results and experience necessary to obtain R01 funding to adapt and test behavioral and educational interventions that incorporate emotional support, thus reducing the harms and costs of overtreatment.

项目摘要 这个K 08职业发展奖将解决申请人在培训方面的重要差距， 同时产生关于情绪在癌症相关治疗决策中的作用的新知识， NCI的优先级。甲状腺癌的发病率增长速度比任何其他癌症都快， 由于小于2 cm的小、低风险癌症的诊断增加，10年死亡率接近于零。 过度治疗与甲状腺全切除术发生在绝大多数这些患者，导致显着 危害，过度发病率，以及对患者和社会的成本，而没有明显的好处。目前，缺乏 了解为什么患者更喜欢这种广泛的治疗限制了我们减少过度治疗的能力。 低风险疾病。这项拟议中的研究试图通过调查情绪对大脑的影响来解决这一差距。 小的低风险甲状腺癌的治疗决定。协调的研究和培训建议旨在 目的：1）描述患者和外科医生之间在手术期间的情感和认知交流 治疗决策; 2）确定治疗结果对接受总治疗的患者的相对价值 决定时与术后一年相比的甲状腺切除术;以及3）测试 外科医生增加情感支持沟通与患者偏好降低相关 甲状腺全切除术核心假设是，情绪，如恐惧和焦虑， 患者-外科医生关于小的、低风险的甲状腺癌治疗的决策， 这些目标的完成将促进决策科学的指导培训，这对皮特博士的研究至关重要。 职业目标。拟议中的培训将填补决策心理学中关键的教育和经验空白 决策和行为经济学，这将伴随着定性研究的方法论培训， 偏好测量、选择实验和析因设计。申请人将利用 一个多元化的国家和国际公认的导师与多学科群体的优势 在实验心理学，手术决策，行为经济学和甲状腺癌方面的专业知识 治疗这种指导培训将支持申请人成为一个成功的外科医生，科学家， 独特的研究技能。该研究结果将为我们提供新的认识， 情绪和情感支持性沟通在低风险癌症治疗决策中的作用。在 建议的培训期结束后，Pitt博士将获得获得R 01所需的结果和经验 资助调整和测试包含情感支持的行为和教育干预措施， 减少过度治疗的危害和成本。