Dose effects of relaxation practice on immune responses in women newly diagnosed with breast cancer: an exploratory study.

PURPOSE/OBJECTIVES To determine the dose effects of relaxation practice on immune responses and describe the types of relaxation techniques preferred and the extent of relaxation practice over 10 months. DESIGN Descriptive, prospective, repeated measures. SETTING An interdisciplinary breast clinic at a university-affiliated comprehensive cancer center in the United States. SAMPLE 49 women with newly diagnosed breast cancer and undergoing adjuvant therapy who participated in a stress management intervention. METHODS Relaxation practice was assessed twice a month for 10 months with immune measurements (e.g., natural killer cell activity; lymphocyte proliferation; interferon [IFN]-γ; interleukin [IL]-2, -4, -6, and -10) at the beginning and end of 10-month practice. MAIN RESEARCH VARIABLES Relaxation practice (representing the concepts of stress and adherence), relaxation technique, and immune response. FINDINGS After adjusting for covariates, the extent of relaxation practice significantly contributed to the variance of natural killer cell activity, lymphocyte proliferation, IL-4, and IL-10 responses in a positive direction; the higher the relaxation practice, the higher the immune responses. In comparison, IFN-γ, IL-2, and IL-6 responses were not affected. The deep-breathing method was most preferred by participants, followed by progressive relaxation and imagination or visualization. The mean weekly frequency of relaxation practice was 5.29 (SD = 3.35), and the mean duration of relaxation practice was 19.16 (SD = 10.81) minutes per session. CONCLUSIONS Persistent relaxation practice may have positive effects on multiple immune responses in a dose-dependent manner. IMPLICATIONS FOR NURSING Allowing the choice of preferred techniques and emphasizing the importance of long-term adherence, a relaxation program may need to be routinely offered to women under high stress.