PNI-BASED STRESS MANAGEMENT IN EARLY BREAST CANCER

这个子项目是众多研究子项目之一

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