Predicting Surgical Decisions of High-Risk UC Patients

预测高危 UC 患者的手术决策

• 批准号: 7273676
• 负责人: Christine Rini
• 金额: $ 13.49万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7273676
• 关键词: Academic Career Award; Address; Adenomatous Polyps; Adult; Affect; Area; Attitude; Award; Behavior; Belief; Biology; Cancer Prevention, Control and Population Sciences Career Development Award (K07); Cancerous; Cells; Characteristics; Chronic Disease; Clinical; Colitis; Colon; Colon, Rectum; Colonoscopy; Colorectal Cancer; Commit; Complex; Conflict (Psychology); Costs and Benefits; Couples; Cross-Sectional Studies; Daily; Data; Decision Making; Detection; Disease; Disease remission; Dysplasia; Employee Strikes; Ensure; Excision; Fertility; Fright; Gastroenterologist; General Population; Genus Cola; Goals; Hand; Happiness; Health; Intervention; Knowledge; Lead; Left; Life; Longitudinal Studies; Malignant Neoplasms; Measures; Medical; Medical Surveillance; Mental Health; Mentors; Methods; Modeling; Morbidity - disease rate; Nature; Operative Surgical Procedures; Outcome; Participant; Patients; Personality; Physicians; Play; Population; Premalignant; Procedures; Process; Psychologist; Psychosocial Factor; Recommendation; Relative (related person); Research; Research Personnel; Research Training; Rest; Retrospective Studies; Risk; Risk-Taking; Role; Severities; Sexuality; Site; Social Aspects of Cancer; Stretching; Sum; Symptoms; Time; Training; Training Programs; Ulcerative Colitis; Woman; base; cancer prevention; cancer risk; career; clinically relevant; colorectal cancer screening; day; diaries; experience; family influence; fetal; gastrointestinal symptom; health belief; innovation; insight; men; mortality; programs; prospective; psychosocial; skills; social

DESCRIPTION (provided by applicant): This 5-year K07 award application describes a program of training and research that will provide the applicant, a social/health psychologist with a background in psychosocial research on maternal-fetal health, with mentoring and "protected time" to build skills and knowledge relevant to a research career in cancer prevention and control. Emphasis is on building knowledge of cancer (e.g., biology, psychosocial issues), methods for the study of close relationship processes, and advanced statistical skills for analysis of longitudinal data. At the conclusion of training, the applicant will have developed sufficient expertise to be a fully-established, independent investigator at the forefront of research exploring how medical and psychosocial factors together influence cancer prevention and control. The proposed training includes formal and informal didactics and a complementary program of innovative research. This research applies knowledge and skills gained during the training period to a theoretically-based, clinically-relevant study of how ulcerative colitis (UC) patients at high risk for colorectal cancer (CRC) make the difficult decision to accept a physician's recommendation for surgical removal of their colon and rectum after detection of pre-cancerous cell change, indicating high short-term risk for CRC. To address the lack of research on this high-risk population, the proposed research progresses logically from a qualitative study, to a retrospective, cross-sectional study, to a prospective, longitudinal study using "daily diary" methods. Three key influences on the surgical decision are investigated: 1) medical factors, 2) health beliefs, and 3) romantic partners. UC patients* dispositional tendency to take risks will also be explored as a potential influence on their decision. Findings will assist clinical efforts to ensure that UC patients referred for surgery are able to make an informed decision, with the overarching goals of helping to reduce CRC morbidity and mortality in this population. Theoretical advances include extension of decision-making models to include irreversible, life-altering decisions as well as interpersonal/family influences. The study will be conducted at Mount Sinai, a primary referral site for UC, and supported by an experienced mentor who is a distinguished gastroenterologist and a team of psychological and health researchers who will serve as co-mentors. The award will be instrumental to the applicant in achieving her short-term goal of becoming an independent investigator of medical and psychosocial influences on cancer prevention and control outcomes, as well as her longer-term objective of conducting innovative research capable of helping to reduce cancer mortality and morbidity.

描述（由申请人提供）：这份为期 5 年的 K07 奖申请描述了一项培训和研究计划，该计划将为申请人（一名具有母胎健康心理社会研究背景的社会/健康心理学家）提供指导和“受保护的时间” “培养与癌症预防和控制研究生涯相关的技能和知识。 重点是建立癌症知识（例如生物学、心理社会问题）、密切关系过程的研究方法以及纵向数据分析的高级统计技能。 培训结束时，申请人将具备足够的专业知识，成为一名成熟的独立研究者，处于研究的最前沿，探索医学和社会心理因素如何共同影响癌症预防和控制。 拟议的培训包括正式和非正式的教学法以及创新研究的补充计划。 这项研究将培训期间获得的知识和技能应用于一项基于理论的临床相关研究，研究结直肠癌 (CRC) 高风险的溃疡性结肠炎 (UC) 患者如何做出接受医生手术切除建议的艰难决定检测到癌前细胞变化后，对结肠和直肠进行检查，表明结直肠癌的短期风险很高。 为了解决缺乏对这一高危人群的研究的问题，拟议的研究顺理成章地从定性研究发展到回顾性横断面研究，再到使用“每日日记”方法的前瞻性纵向研究。研究了对手术决定的三个关键影响：1) 医疗因素，2) 健康信念，3) 浪漫伴侣。 UC 患者* 的冒险倾向也将被探讨为对其决策的潜在影响。 研究结果将有助于临床工作，确保转诊接受手术的 UC 患者能够做出明智的决定，总体目标是帮助降低该人群的 CRC 发病率和死亡率。 理论进步包括决策模型的扩展，将不可逆转的、改变生活的决策以及人际/家庭影响纳入其中。 该研究将在西奈山（UC 的主要转诊地点）进行，并由一位经验丰富的杰出胃肠病学家导师和一组心理和健康研究人员作为共同导师提供支持。 该奖项将有助于申请人实现成为癌症预防和控制结果的医学和心理社会影响的独立研究者的短期目标，以及进行能够帮助减少癌症的创新研究的长期目标死亡率和发病率。