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 该K08职业发展奖将解决申请人培训的重要差距 同样，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。甲状腺癌的事件的速度比任何其他癌症都要快，在很大程度上 由于增加了小型，低风险癌症≤2cm的诊断，其死亡率接近零。 在这些患者的绝大多数患者中，过度治疗进行了总甲状腺切除术，导致显着 危害，超出发病率，对患者和社会的成本，没有明显的收益。目前，缺乏 了解为什么患者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。拟议的研究试图通过调查情绪对 关于小型，低危甲状腺癌的治疗决定。协调的研究和培训建议的目标 至：1）表征患者和外科医生之间的情感和认知交流 治疗决策； 2）确定治疗结果与接受总患者的相对价值 决定时甲状腺切除术，而术后一年； 3）测试在多大程度上 外科医生情绪支持的沟通增加与患者偏好减少有关 总甲状腺切除术。中心假设是情绪，例如恐惧和焦虑，影响 病人 - 海峡对小型低风险甲状腺癌的治疗做出决策，导致决策 过度治疗。这些目标的完成将促进对皮特博士至关重要的决策科学培训 职业目标。拟议的培训将填补决策心理学的关键教育和专家差距 制造和行为经济学将通过定性研究的方法学培训来实现 偏好测量，选择实验和阶乘设计。申请人将利用 拥有多学科的国家和国际认可的导师的潜水者群体的优势 实验心理学，外科决策，行为经济学和甲状腺癌方面的专业知识 治疗。这项重要的培训将支持申请人成为成功的外科医生科学家 独特的研究技能。拟议研究的结果将为特定提供新的了解 情绪和情感支持在低风险癌症治疗决策中的沟通的作用。在 拟议培训期的结束，皮特博士将获得获得R01所需的结果和经验 资金以适应和测试包含情感支持的行为和教育干预措施，因此 减少过度治疗的危害和成本。