Implementing a comprehensive approach to the study of health dynamics using the psychoneuroimmunology paradigm

Abstract

This article addresses psychoneuroimmunology (PNI) as an integrative paradigm for advancing both theoretical and empirical knowledge of physiological patterns that contribute to the dynamics of health. We depict relationships among relevant psychobehavioral and physiological components in a PNI-based framework. We then provide examples of how this framework guided 2 clinical trials designed to assess the effectiveness of selected nursing interventions to reduce stress and enhance coping, one in persons with human immunodeficiency viral disease and the other in persons with cancer. The examples address disease-specific measures for assessing the components of the PNI-based framework.

Figure 1

Generic model of the PNI-based theoretical framework.

Figure 2

PNI-based model in HIV disease. DIS: Stress indicates Dealing with Illness Scale: Stress subscale; DIS: Coping, Dealing with Illness Scale: Coping subscale; SPS, Social Perspectives Scale; SWBS, Spiritual Well-being Scale; SpPS, Spiritual Perspectives Scale; DHEA, dehydroepiandrosterone; IFN-γ, interferon-gamma; TNF-α, tumor necrosis factor-alpha; IES, Impact of Event Scale; FAHI, Functional Assessment of HIV Infection Scale; CDC, Centers for Disease Control and Prevention, HIV Disease Classification; and rHCMSS, Revised HIV Center Medical Staging Scale.

Figure 3

PNI-based model in cancer. IES indicates Impact of Event Scale; WAYS, Ways of Coping Questionnaire; SpPS, Spiritual Perspectives Scale; SPS, Social Perspectives Scale; ISQ, Inner Strength Questionnaire; SWBS, Spiritual Well-being Scale; IFN-γ, interferon-gamma; TNF-α, tumor necrosis factor-alpha; CES-D, Center for Epidemiological Studies-Depression Scale; BFS, Benefit Finding Scale; FACT-B, Functional Assessment of Cancer Therapy-Breast Scale; SES, Symptom Experience Scale; and PFS, Piper Fatigue Scale.