PNI-BASED STRESS MANAGEMENT IN EARLY BREAST CANCER

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 这项拟议研究的总体目的是确定两种心理-身体-精神压力管理方法是否会改善240名接受早期乳腺癌辅助化疗(I期或II期)的妇女的心理社会功能、生活质量和身体健康。这些干预措施，重点是太极训练(Tchi)和精神成长小组(SPRT)，旨在减少感知的压力和增强适应结果。 目的1是比较TCHI和SPRT干预措施之间以及与非干预(标准护理)对照组(NOIX)对心理社会功能(感知压力、应对模式、精神、社会支持、内在力量、抑郁症状、受益发现)、生活质量、神经内分泌调节(皮质醇、β-内啡肽、亮氨酸脑啡肽)和身体健康(免疫状况、症状困扰和癌症相关健康状况，包括疲劳)的影响。 目的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、灵性、社会支持、内在力量、抑郁症状、利益发现)、生活质量、神经内分泌调节(皮质醇、β-内啡肽、亮氨酸脑啡肽)和身体健康(免疫状况、症状苦恼和癌症相关健康状况，包括疲劳)之间的预测关系，来检验研究的理论模型。 使用定性方法，目标3是通过对随机选择的研究参与者子集进行半结构化访谈来评估参与干预的经验。这些数据将被用来证实和放大关于心理社会功能、生活质量、症状苦恼和疲劳结果的量化数据。 随着基于PNI的研究的发展，心理社会、神经内分泌、免疫学和疾病特异性结果之间的关联的科学证据继续积累。然而，目前的科学状况是这样的，许多PNI机制仍然不清楚，特别是在人类癌症及其治疗所呈现的复杂性的背景下。此外，在癌症的PNI领域，科学证据远未趋同。这项研究将阐明某些假设的机制，并测试两种有希望的心理-身体-精神干预(太极和精神成长)对心理行为和生物结果的有效性。

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