Marcella Niehoff School of Nursing, Department of Health Promotion, Loyola University Chicago, Health Science Division, 2160 South First Ave., Maywood, IL 60153, United States.
Marcella Niehoff School of Nursing, Department of Health Promotion, Loyola University Chicago, Health Science Division, 2160 South First Ave., Maywood, IL 60153, United States.
Brain Behav Immun. 2019 Aug;80:358-373. doi: 10.1016/j.bbi.2019.04.012. Epub 2019 Apr 3.
Women newly diagnosed with breast cancer experience psychological distress, accompanied by reduced Natural Killer Cell Activity (NKCA) and altered levels of cytokines, which may compromise cancer control. Few studies have evaluated psycho-immune outcomes of mindfulness-based stress reduction (MBSR) for women newly diagnosed with breast cancer in comparison to an active control condition.
The purpose of this study was to determine whether MBSR benefits psychological, behavioral, and immunological function in women recently diagnosed with breast cancer.
After confirmation of breast cancer staging, women diagnosed with early-stage breast cancer (n = 192) were randomized to an 8-week MBSR program or an 8-week active control condition (ACC). The ACC consisted of a series of cancer recovery and health education classes. Both MBSR and the ACC were administered in group format.
Women completed psychometric instruments and provided blood for NKCA and cytokine levels at pre-, mid-, and completion of program, as well as at 1- and 6-months post-program. One hundred and twenty four women completed all five-assessments (MBSR, n = 63; ACC, n = 61). Hierarchical linear modeling was used to analyze trajectories of outcomes over time and between groups.
Compared to the ACC group, women randomized to MBSR exhibited decreasing trajectories of perceived stress, fatigue, sleep disturbance, and depressive symptoms. Further, compared to women randomized to ACC, MBSR women exhibited trajectories demonstrating significantly more rapid restoration of NKCA, accompanied by lower circulating TNF-alpha levels, lower IL-6 production, and greater IFN-gamma production.
These results demonstrate early provision of MBSR for women newly diagnosed with breast cancer provides not only psychological benefit, but also optimizes immune function supportive of cancer control.
新诊断出患有乳腺癌的女性会经历心理困扰,同时伴随着自然杀伤细胞活性 (NKCA) 的降低和细胞因子水平的改变,这可能会影响癌症的控制。很少有研究比较基于正念的减压 (MBSR) 和积极对照组对新诊断为乳腺癌的女性的心理-免疫结果。
本研究旨在确定 MBSR 是否有益于新近诊断为乳腺癌的女性的心理、行为和免疫功能。
在确认乳腺癌分期后,将新诊断为早期乳腺癌的女性 (n = 192) 随机分为 8 周的 MBSR 计划或 8 周的积极对照组 (ACC)。ACC 由一系列癌症康复和健康教育课程组成。MBSR 和 ACC 都以小组形式进行。
女性在方案前、中、结束时以及方案结束后 1 个月和 6 个月完成心理计量学工具,并提供 NKCA 和细胞因子水平。共有 124 名女性完成了所有 5 项评估 (MBSR,n = 63;ACC,n = 61)。分层线性模型用于分析随时间和组间的结果轨迹。
与 ACC 组相比,随机分配到 MBSR 的女性表现出感知压力、疲劳、睡眠障碍和抑郁症状的下降轨迹。此外,与随机分配到 ACC 的女性相比,MBSR 女性表现出的轨迹显示 NKCA 恢复更快,伴随 TNF-α 水平降低、IL-6 产生减少和 IFN-γ产生增加。
这些结果表明,为新诊断为乳腺癌的女性早期提供 MBSR 不仅提供了心理益处,而且优化了支持癌症控制的免疫功能。