Notions of time and medical decision-making

对决策的科学研究已经证实，紧迫性和风险等概念在个人之间和不同文化之间差别很大。医疗决策取决于患者和护理人员如何理解相关概念。本研究考察了时间和时间尺度的不同文化概念如何影响医疗决策，以糖尿病相关并发症为案例研究，质疑时间的解释如何影响健康决策和结果。这项研究是由时间的人类学理论提供和推进的。该项目还培训美国本科生。该项目将调查社会、文化和人口因素如何影响时间观念，以及这些因素反过来如何影响医疗风险。糖尿病并发症通常从平淡无奇的症状开始，迅速发展成戏剧性的、改变生活的事件。通过访谈和参与者观察，本研究调查了糖尿病患者如何从多种来源寻求护理，以及与疾病的急性和慢性表现的关系。以患者为中心的数据将通过与医疗保健提供者的访谈和糖尿病诊所的参与者观察进一步具体化。研究人员将提供以下证据：1)为什么以及何时选择特定提供商或提供商组；2)这些护理人员的时间观念如何与糖尿病并发症相互作用，从而影响医疗决策和结果。了解不同利益相关者的观点将通过将焦点从个人生命过程转移到多代人和社区的观点，为医疗决策理论提供信息。该奖项反映了美国国家科学基金会的法定使命，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。

Scientific studies of decision-making have established that concepts such as urgency and risk vary widely among individuals and across cultures. Medical decision-making depends on how associated concepts are interpreted by both the sick and their caretakers. This research examines how distinct cultural notions of time and timescale shape medical decision making, using diabetes-related complications as a case study to question how interpretations of time influence health decisions and outcomes. The research is informed by and advances anthropological theories of temporality. The project also trains U.S. undergraduate students. This project will investigate how social, cultural, and demographic factors affect notions of time and how these, in turn, shape medical risk. Diabetes complications often begin with mundane symptoms that rapidly develop into dramatic, life changing events. Using interviews and participant observation, this study examines how people living with diabetes seek care from multiple sources and in relation to acute versus chronic manifestations of the disease. Patient-centered data will further be contextualized by interviews with healthcare providers and participant observation in diabetes clinics. The researcher will provide evidence of 1) why and when specific providers or sets of providers are selected; and 2) how these caretakers' notions of time interact with diabetes complications to affect medical decision-making and outcomes. Understanding diverse stakeholder perspectives will inform theories of medical decision-making by shifting the focus from the individual life-course to incorporate multi-generational and community perspectives.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.