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A Systematic Review of Spiritually Based Interventions and Psychoneuroimmunological Outcomes in Breast Cancer Survivorship
Open accessAbstract
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.
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“A systematic review showed that mindfulness intervention can improve individual’s mental health and lead to positive biomarker outcomes such as decreased interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) (55).”
From Mindfulness-based online intervention on mental health among undergraduate nursing students during coronavirus disease 2019 pandemic in Beijing, China: A randomized controlled trial (2022) · cites this paper as [55]
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“In this case, the positive effect of mindfulness intervention on anxiety and stress has its biological basis.”
From Mindfulness-based online intervention on mental health among undergraduate nursing students during coronavirus disease 2019 pandemic in Beijing, China: A randomized controlled trial (2022) · cites this paper as [55]
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Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0013
Koh, H. K. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.002.0006
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0028
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0022
Studies on Religion and Health
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.005.0001
Personality and Psychoneuroimmunology: Patient Perspectives on Mind-Body Health
Lee, A., Wong, Y., & Neo, X. S. (2023) · Journal of Personality and Psychosomatic Research · doi:10.61838/kman.jppr.1.3.6 · Cited by 1
Graves, K. D., Fall‐Dickson, J. M., Reeve, B. B., Lin, L., Ahn, J., Pan, W., & Potosky, A. L. (2025) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000183
Metadata
- Authors
- Hulett, J. M., & Armer, J. M.
- Affiliations
- University of Utah (US)
- University of Missouri (US)
- Corresponding author
- Hulett, Jennifer M.
- Venue
- Integrative Cancer Therapies
- Publisher
- SAGE Publications
- Published
- 2016-07-26
- Volume
- 15
- Issue
- 4
- Pages
- 405-423
- ISSN
- 1534-7354 (ISSN-L)
- 1552-695X
- PMC
- PMC5125023
- OpenAlex
- W2346863221
- Cited by
- 105
- References
- 121
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 3 · 2023: 46 · 2022: 10 · 2021: 4 · 2020: 11 · 2019: 8 · 2018: 5 · 2017: 7
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Integrative Cancer Therapies (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- University of Missouri
- University of Utah
- National Institutes of Health
- National Institute of Nursing Research (T32NR013456)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- breast cancer survivorship, psychoneuroimmunology, mindfulness-based stress reduction, cortisol, home-based intervention
- MeSH terms
- Breast Neoplasms, Female, Humans, Psychoneuroimmunology, Quality of Life, Outcome Assessment, Health Care, Survivors, Mind-Body Therapies, Spirituality
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