Purpose. Psychological interventions are efficacious in reducing emotional distress for cancer patients. However, it is not clear whether psychological improvements are, in turn, related to improved health. A clinical trial tests whether a psychological intervention for cancer patients can do so, and also tests two routes to achieve better health: (a) reducing patients' Emotional Distress, and/or (b) enhancing their functional immunity. Methods. Post-surgery, 227 breast cancer patients were randomized to intervention or assessment only Study Arms. Conducted in small groups, intervention sessions were offered weekly for 4 months and followed by monthly sessions for 8 months. Measures included psychological (distress), biological (immune), and health outcomes (performance status and evaluations of patient's symptomatology, including toxicity from cancer treatment, lab values) collected at baseline, 4 months, and 12 months. Results. A path model revealed that intervention participation directly improved health (p < .05) at 12 months. These effects remained when statistically controlling for baseline levels of distress, immunity, and health as well as sociodemographic, disease, and cancer treatment variables. Regarding the mechanisms for achieving better health, support was found for an indirect effect of distress reduction. That is, by specifically lowering intervention patients' distress at 4 months, their health was improved at 12 months (p < .05). Although the intervention simultaneously improved patients' T-cell blastogenesis in response to phytohemagglutinin (PHA), the latter increases were unrelated to improved health. Conclusion. A convergence of biobehavioral effects and health improvements were observed. Behavioral change, rather than immunity change, was influential in achieving lower levels of symptomatology and higher functional status. Distress reduction is highlighted as an important mechanism by which health can be improved.

The study of immune status and biobehavioral measures is limited in professional nursing. The purpose of the pre-pilot study was to describe levels of cytokines prior to, during, and after dialysis, examine changes in cytokine levels from immediate pre-dialysis to immediate post-dialysis, and to compare cytokine patterns prior to and after dialysis. A within subject descriptive study was conducted as part of a larger pilot study to describe levels of cytokines prior to, during, and after dialysis, examine changes in cytokine levels from immediate pre-dialysis to immediate post-dialysis, and to compare cytokine patterns prior to and after dialysis. Serum cytokine samples were collected pre-dialysis and every 30 minutes during the dialysis treatment and immediately post-dialysis from a convenience sample of 10 patients. Mean age of subjects was 53.5 years and 60% were African American. The sample was equally divided between female and male. Statistical analysis using a nonparametric paired difference test showed that only MIP-1β showed a significant increase from pre-dialysis to post-dialysis. Based on the results of this study, a second descriptive study was conducted. The purpose of the second study was to examine the relationships among disease related factors, perceived stress, depressive symptoms, immune indicators, and HRQOL among patients requiring hemodialysis for ESRD using a PNI framework. Using a descriptive design, participants completed the Perceived Stress Scale (PSS), the Center for Epidemiologic Studies Depression Scale (CES-D), and one quality of life measure, the Functional Assessment of Cancer Therapy-General scale (FACT-G), during the first hour of the dialysis treatment. In addition, blood samples were collected immediately prior to dialysis for cytokine measurement and demographic information was collected from the medical record. The sample included 75 adults with ESRD requiring dialysis who consented and were enrolled in the study. Regression analysis showed significant correlations among the psychosocial variables (p = <0.0001, r = 0.65). Negative correlations were found between perceived stress and health-related quality of life (p = 0.024) and depressive symptoms with health-related quality of life (p = 0.0003). MIP-1 ß was the only cytokine significantly (and positively) correlated with health-related quality of life ( p = 0.0419). Principal component analysis of the cytokine data revealed three factors. A three-factor solution described the cytokine data; Factors 1 and 3 represented a pro-inflammatory response and Factor 2 represented a mixture of pro-inflammatory and anti-inflammatory responses. There was a significant correlation between Factor 1 and depressive symptoms (p = 0.0069). Significant differences in the distributions of Factors 2 and 3 were associated with the presence of cardiovascular disease (CVD) (Chi-square = 4.0, df = 1, p = 0.047), (Chi-square = 4.1, df = 1, p = 0.043), respectively, and Factor 3 with hypertension (HTN) (Chi-square = 7.6. df = 1, p = 0.006). However no relationships were found between the cytokine factors and QOL, PSS, and other variables. Findings suggest that there are relationships among psychosocial variables and possibly biological interactions that may affect perceptions of health-related quality of life among persons with ESRD on hemodialysis.

Romantic relationship factors have been linked to both physical and mental health outcomes. Previous research has lacked attention not only on associations among these constructs, but on ways by which gender attitudes and beliefs impact romantic heterosexual relationships. The Biobehavioral Family Model (BBFM) is a biopsychosocial approach to health that integrates couple/family emotional climate, biobehavioral reactivity (emotion regulation), and physical health outcomes into one comprehensive model. The present study was conducted to examine the ability of the BBFM to explain connections between couple processes and health while integrating an additional construct of gender attitudes and beliefs. The sample consisted of 595 adults (age range 18-65+ years) who have been in committed romantic relationships for at least two years. Data were collected through online surveys which asked participants about their relationship satisfaction, mental health symptoms, physical health, and attitudes and beliefs about gender in relationships. Confirmatory factor analyses were used to test measures of romantic partner emotional climate, gender attitudes and beliefs, biobehavioral reactivity, and disease activity. Structural equation modeling was used to test associations among all constructs. Results demonstrated some support for the BBFM in explaining health quality for the sample. Specifically, romantic partner emotional climate was positively associated with biobehavioral reactivity, and gender attitudes and beliefs were significantly associated with both biobehavioral reactivity and disease activity. Applying the BBFM while incorporating gender attitudes and beliefs through a feminist lens demonstrates ways by which couple processes affect the mental and physical health of these individuations. Recommendations for future research and clinical implications are discussed.

No description available.

Breast cancer is one of the leading causes of morbidity and mortality among women. A diagnosis of cancer is a stressful event that requires an individual to adapt to new stressors. The purpose of this qualitative study was to better understand the perceptions of mana'olana/hope and living with breast cancer among Native Hawaiian women. The conceptual framework of this phenomenological study was positive psychology. Data collection included in-depth interviews with 5 Native Hawaiian women who had been diagnosed with breast cancer. Data coding and analysis resulted in identification of 8 themes. The themes included: (a) mana'olana /hope is the essence of my being, (b) family strengthens me and gave me mana'olana/hope, (c) my relationship with God and Jesus promoted mana'olana/hope in me, (d) my religious affiliation promoted mana'olana/hope in me, (e) the cancer support group promoted mana'olana/hope in me, (f) the cancer treatment team promoted mana'olana/hope in me, (g) treatment options; Allopathic, Osteopathic, Naturopathic, Alternative medicine, and herbal remedies promoted mana'olana/hope in me, and (h) nature's beauty and the arts promoted mana'olana/hope in me. Results may be used by health psychologists, cancer treatment practitioners, and the field of biobehavioral oncology to support and improve the well-being and health outcomes of women diagnosed with breast cancer.

<p>Sustained attention, the ability to direct and maintain attentional focus on tasks and stimuli, emerges during infancy and undergoes rapid development throughout early childhood. Abnormal patterns of sustained attention are implicated in several childhood psychological disorders. Improving our measurement of infant sustained attention may clarify how child psychopathology develops and inform targeted prevention and early intervention efforts. While several behavioral and psychophysiological measures index infant sustained attention, previous studies have employed these measures in isolation, focused on analyses at short timescales of milliseconds to a few seconds, and examined synchronous associations among these measures. Therefore, the associations and temporal relationships across multiple, concurrent behavioral and psychophysiological measures of infant sustained attention remain unclear, particularly at long timescales. The present study assessed sustained attention in 12-month-old infants using behavioral (looking), cardiac (heart rate), and neural (theta and alpha oscillations) measures to investigate two temporal aspects of infant sustained attention. First, we examined whether associations among infant sustained attention measures were similar or different across short (1-second) and long (10-second) timescales. Covariation analyses indicated largely similar association patterns among these measures across the two timescales. Second, we evaluated whether specific infant sustained attention measures temporally preceded other measures. Cross-correlation analyses broadly revealed that short-timescale measures exhibited asynchronous temporal relationships, such that looking behaviors preceded neural oscillations that in turn preceded cardiac responses. Our findings highlight the value of considering the temporal dimension when studying and measuring infant sustained attention. Additional multimodal research may yield greater insights into dynamic biobehavioral processes that underlie infant sustained attention and enhance clinical interventions aimed at promoting optimal outcomes for young children with abnormalities in sustained attention.</p>

No description available.