Psychoneuroimmunology. Part I: Physiology.

Since its early days, nursing has appreciated the connection between mind and body. Even when the dualistic Descartesian perspective that the brain was separated from the rest of the body pervaded Western medicine during the majority of the 19th and 20th centuries, nursing embraced a holistic view of patient care. Florence Nightingale, in her Notes on Nursing published in 1862, eloquently wrote about the healing power of sensory stimulation and personal connection. During the past 30 years, scientific inquiry has led to a greater understanding of human physiology and the dynamic relationship between psychological, neuroendocrine, immunologic, and other physiologic processes. The purpose of this article is to provide an overview of the physiology of the connection between mind and body, referred to as psychoneuroimmunology (PNI). Oncology nurses will benefit from this information because it relates to the scientific basis for many of the integrated therapies and nonpharmacologic interventions that are integral to the care of patients with cancer. PNI is a growing and relatively new discipline. The term was coined in 1981 after Dr. Robert Ader and his colleagues identified serendipitous findings while they conducted classical behavioral conditioning experiments with rats (Ader, Felten, & Cohen, 1981). During conditioning experiments focused on vomiting, the researchers gave rats cyclophosphamide laced with sweetened water, then administered sweetened water alone. As hypothesized, the rats became conditioned to vomit when given sweetened water alone. Unexpectedly, however, young, healthy rats also were sicker and died much sooner than anticipated after receiving only sweetened water. Further inSusan M. Bauer-Wu, DNSc, RN, is director of The Phyllis F. Cantor Center at Dana-Farber Cancer Institute in Boston, MA. This article is one of a two-part series. Part I comprehensively reviews the principles of psychoneuroimmunology. In reader and Oncology Nursing Society member surveys, seasoned clinicians and advanced practice nurses have requested this advanced level of information. Part II, which will be published in an upcoming issue of the Clinical Journal of Oncology Nursing, will discuss the clinical application of this information.