PNI-BASED STRESS MANAGEMENT IN EARLY BREAST CANCER

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。本研究的总体目的是确定两种身心精神压力管理方法是否能提高240名早期乳腺癌（I期或II期）接受辅助化疗的妇女的心理社会功能、生活质量和身体健康。干预措施，重点是太极训练（TCHI）和精神成长小组（SPRT），旨在减少感知压力，提高适应性结果。目的1是比较TCHI和SPRT干预相互之间以及与无干预（标准护理）对照组（NoIX）对心理社会功能（感知压力、应对模式、灵性、社会支持、内在力量、抑郁症状、获益发现）、生活质量、神经内分泌调节（皮质醇、β -内啡肽、左脑啡肽）和身体健康（免疫状态、症状困扰和癌症相关健康状态，包括疲劳）的影响。AIM 2是通过检验基于pni的心理社会功能指标（感知压力、应对模式、精神、社会支持、内在力量、抑郁症状、获益发现）、生活质量、神经内分泌调节（皮质醇、β -内啡肽、左脑啡肽）和身体健康（免疫状态、症状困扰和癌症相关健康状态，包括疲劳）之间的预测关系，来检验本研究的理论模型。使用定性方法，AIM 3是通过对随机选择的研究参与者子集的半结构化访谈来评估参与干预的经验。这些数据将用于证实和扩大有关心理社会功能、生活质量、症状困扰和疲劳结果的定量数据。随着基于pni的研究的发展，社会心理、神经内分泌、免疫学和疾病特异性结果之间关联的科学证据不断积累。然而，就目前的科学状况而言，许多PNI机制仍不清楚，特别是在人类癌症及其治疗所呈现的复杂性背景下。此外，PNI在癌症领域的科学证据还远远没有趋同。这项研究将阐明某些假设的机制，并测试两种有希望的身心精神干预（太极和精神成长）在心理行为和生物结果方面的有效性

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The overall purpose of the proposed study is to determine whether two mind-body-spirit approaches for stress management will enhance psychosocial functioning, quality of life, and physical health among 240 women receiving adjuvant chemotherapy for early breast cancer (Stage I or II). The interventions, focused tai chi training (TCHI) and spiritual growth groups (SPRT), are designed to reduce perceived stress and enhance adaptational outcomes. AIM 1 is to compare the TCHI and SPRT interventions to each other and to a no-intervention (standard care) control group (NoIX) for effects on psychosocial functioning (perceived stress, coping patterns, spirituality, social support, inner strength, depressive symptoms, benefit finding), quality of life, neuroendocrine mediation (cortisol, beta-endorphin, leu-enkephalin), and physical health (immune status, symptom distress, and cancer-related health status, including fatigue). AIM 2 is to test the theoretical model for the study by examining the predicted relationships among the PNI-based indicators of psychosocial functioning (perceived stress, coping patterns, spirituality, social support, inner strength, depressive symptoms, benefit finding), quality of life, neuroendocrine mediation (cortisol, beta-endorphin, leu-enkephalin), and physical health (immune status, symptom distress, and cancer-related health status, including fatigue). Using qualitative methods, AIM 3 is to evaluate the experience of participating in the interventions through semi-structured interviews with a randomly selected subset of study participants. These data will be used to corroborate and amplify the quantitative data on psychosocial functioning, quality of life, symptom distress, and fatigue outcomes. As PNI-based research has grown, scientific evidence of associations among psychosocial, neuroendocrine, immunological, and disease-specific outcomes has continued to amass. However, the state-of-the-science is such that many PNI mechanisms remain unclear, particularly in the context of such complexity as is presented by human cancer and its treatments. Further, scientific evidence is far from convergence in the field of PNI in cancer. This study will shed light on certain hypothesized mechanisms as well as test the effectiveness of two promising mind-body-spirit interventions (Tai Chi and Spiritual Growth) on both psychobehavioral and biological outcomes