Why Nurses Should Know About Psychoneuroimmunology
Published: 29 October 2016
Published: 29 October 2016
It is well known that a person’s thoughts and emotions have a big impact on their sense of wellbeing. Nurses know that to provide holistic care, paying attention to a person’s psychological state is essential.
Psychoneuroimmunology (PNI) is the study of the interactions that occur between the neurological, endocrine, and immune systems. PNI focuses on the links that exist between a person’s emotion and behaviour and their relationship with immune-mediated disease. The science underpinning PNI reveals that stress is an immunosuppressant. In other words, PNI identifies the direct links between psychological distress and illness.
Stress can suppress immune function. It disrupts the intimate communication between neural, hormonal and immune signals. This leads to increased susceptibility to inflammatory and chronic diseases. The inflammatory process is involved in many major, modern conditions such as depression, posttraumatic stress disorder and diabetes. As a result, the negative impact of stress cannot be ignored.
There are clear relationships between stress and conditions such as sleep disorders, pain, depression, HIV and cancer. There is also strong evidence that psychological distress worsens the progression of breast cancer after diagnosis.
Patients experience stress due to ill health, and these stress levels are often compounded by hospitalisation, surgery, pain or incapacitation. Therefore, reducing the effects of distress is an important part of nursing care.
Relaxation therapy can reduce sympathetic nervous responses and enhance parasympathetic nervous system activity. Relaxation decreases a person’s heart rate and blood pressure. It reduces the production of corticosteroids, which in turn, reduces cortisol-induced immunosuppression. Techniques such as massage therapy, diaphragmatic breathing, guided imagery and progressive muscle relaxation can increase wound healing, promote anti-inflammatory responses and decrease hospital length of stay. Increasingly, sophisticated research now shows that relaxation therapy can also decrease pain, anxiety, fatigue, depression and inflammation across a range of medical conditions.
Clinical applications of PNI therefore include bio-behavioural therapies such as relaxation. Relaxation therapies are evidence-based, simple, non-invasive and easy to learn. Techniques such as deep diaphragmatic breathing can be easily taught to patients. They can also be taught to patients’ family members and carers to decrease their own distress. PNI provides evidence for nurses who want to implement efficacious relaxation treatments to improve patients’ immune responses and wellbeing.
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