A Systematic Review of Spiritually Based Interventions and Psychoneuroimmunological Outcomes in Breast Cancer Survivorship

Abstract

Objective This is a review of spiritually based interventions (eg, mindfulness-based stress reduction) that utilized psychoneuroimmunological (PNI) outcome measures in breast cancer survivors. Specifically, this review sought to examine the evidence regarding relationships between spiritually based interventions, psychosocial-spiritual outcomes, and biomarker outcomes in breast cancer survivors. Methods A systematic search of 9 online databases was conducted for articles of original research, peer-reviewed, randomized and nonrandomized control trials from 2005–2015. Data were extracted in order to answer selected questions regarding relationships between psychosocial-spiritual and physiological measures utilized in spiritually based interventions. Implications for future spiritually based interventions in breast cancer survivorship are discussed. Results Twenty-two articles were reviewed. Cortisol was the most common PNI biomarker outcome studied. Compared with control groups, intervention groups demonstrated positive mental health outcomes and improved or stable neuroendocrine-immune profiles, although limitations exist. Design methods have improved with regard to increased use of comparison groups compared with previous reviews. There are few spiritually based interventions that specifically measure religious or spiritual constructs. Similarly, there are few existing studies that utilize standardized religious or spiritual measures with PNI outcome measures. Findings suggest that a body of knowledge now exists in support of interventions with mindfulness-breathing-stretching components; furthermore, these interventions appear to offer potential improvement or stabilization of neuroendocrine-immune activity in breast cancer survivors compared to control groups. Conclusion From a PNI perspective, future spiritually based interventions should include standardized measures of religiousness and spirituality in order to understand relationships between and among religiousness, spirituality, and neuroendocrine-immune outcomes. Future research should now focus on determining the minimum dose and duration needed to improve or stabilize neuroendocrine-immune function, as well as diverse setting needs, including home-based practice for survivors who are too ill to travel to group sessions or lack economic resources.

Spirituality and Quality of Life in Black Patients With Cancer Pain

“…52 Because spirituality contributes to QOL in black patients with cancer who experience pain, interventions aimed at enhancing spirituality care may be useful in improving overall QOL in this population. Future research should further examine the relationship between spirituality and QOL by investigating spiritual care interventions (e.g., spiritual counseling, meaning-focused meditation, mindfulness-based stress reduction, and mindfulness-based cognitive therapies) 53,54 that may improve both cancer pain relief and QOL in black patients. This study had several limitations.…”

Complementary religious and spiritual interventions in physical health and quality of life: A systematic review of randomized controlled clinical trials

“…Hulett and Armer [ 65 ] also assessed psychoneuroimmunological outcomes in survivors of cancer and argued that RSIs improve or stabilize the outcomes despite their designs limitations. In our review, studies that investigated cortisol, daily activity and management of chronic diseases exhibited very small effect sizes.…”

Mindful Eating: Connecting With the Wise Self, the Spiritual Self

“…To the extent that mindfulness can lead to spiritual engagement ( Kristeller and Jordan, 2018 ), it is expected that health benefits likely accrue in part due to improved psycho-biological regulation (for review, see Hulett and Armer, 2016 ). These improvements may also interact with improved behaviors that are associated with health.…”