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Mind-Body Medicine Psychoneuroimmunology

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Mind-Body Medicine Psychoneuroimmunology Powered By Docstoc
					     Mind-Body Medicine
Psychoneuroimmunology (PNI) :
       Nursing Therapy


       SOMPORN TRIAMCHAISRI
                 PhD
       ASSOCIATE PROFESSOR
      UCSF / MAHIDOL UNIVERSITY



         Triamchaisri S/San Jose State   1
         University/ November 7, 2002
                The truth
We are all IMMORTAL SPIRIT BEINGS who
have lived out THOUSANDS of other physical
lives here on earth before this one.
Each time we die, we return to the spirit world
and have a conference with wise counselors
who review our life's history and help us
decide on the best plan for our future and
continued SPIRITUAL GROWTH for our NEXT
physical lifetime.


            Triamchaisri S/San Jose State   2
            University/ November 7, 2002
               The truth
Curing is the actual eradication of a
disease.

Healing is a sense of wholeness and
completeness.




           Triamchaisri S/San Jose State   3
           University/ November 7, 2002
             The truth
Human" factors in healing

Closeness
Caring
Compassion
Empathy



         Triamchaisri S/San Jose State   4
         University/ November 7, 2002
MIND AND BODY MEDICINE
What is Mind/Body Medicine?
How do mind and body influence
each other?
What is The Mind/Body Connection ?
What are Mind/Body Techniques?




       Triamchaisri S/San Jose State   5
       University/ November 7, 2002
  MIND AND BODY MEDICINE
 Mind/body medicine is an approach
   to healing that uses the power of
 thoughts and emotions to influence
             physical health.
  As Hippocrates once wrote, "The
natural healing force within each one
 of us is the greatest force in getting
      well." This is the essence of
         mind/body medicine.

           Triamchaisri S/San Jose State   6
           University/ November 7, 2002
 MIND AND BODY MEDICINE
Mind-Body medicine works by
 recognizing the connections
between mind, body, spirit, and
  environment, and how each
element profoundly influences
        the other three.




        Triamchaisri S/San Jose State   7
        University/ November 7, 2002
  MIND AND BODY MEDICINE
How do mind and body influence
each other?
Physiology and Biochemistry of
Endocrine System:
· Energy Balance and Metabolism
· The Thyroid Gland
· Pancreas and Carbohydrate
Metabolism
·
         Triamchaisri S/San Jose State   8
         University/ November 7, 2002
  MIND AND BODY MEDICINE
How do mind and body influence
each other?
· The Adrenal Medulla and Adrenal
    Cortex
· Calcium Metabolism and Bones
· The Pituitary Gland
· The Gonads
   Other Endocrine Systems

         Triamchaisri S/San Jose State   9
         University/ November 7, 2002
What is The Mind/Body Connection ?




         Triamchaisri S/San Jose State   10
         University/ November 7, 2002
Mind and body interventions lead
patients to new ways of experiencing
and expressing their illness




          Triamchaisri S/San Jose State   11
          University/ November 7, 2002
  MIND AND BODY INTERVENTIONS
What are Mind/Body Techniques?
Biofeedback
Relaxation Techniques
  Autogenic training
  Progressive muscle relaxation
  Meditation
Hypnosis



         Triamchaisri S/San Jose State   12
         University/ November 7, 2002
  MIND AND BODY MEDICINE
You practice mind-body medicine
every-day--when you laugh, exercise,
or hug someone. We instinctively
know that doing these things makes
us feel better, more relaxed and less
stressed.




          Triamchaisri S/San Jose State   13
          University/ November 7, 2002
            EVIDENCES
Hundreds of scientific studies have
 shown that how we believe, think
and feel influences our bodies. Our
 thoughts and emotions affect the
 hormones, neurotransmitters, and
natural body chemicals that impact
our immune systems and every part
             of our body.



          Triamchaisri S/San Jose State   14
          University/ November 7, 2002
       University of Natural Medicine
       Body/Mind Integrative Studies
IS 400 Introduction to Body-Mind Integrative
Studies 3 credits
IS 401 Mental Constructs and the Body-Mind
Relationship 2 credits
IS 403 Imagery & Therapeutic Dialog 4 credits
IS 603 The Neurology of Self: The Body-Mind
Relationship
TH 410 and TH 510 Bachelor of Science Thesis 10
credits
TH 610 Doctor of Philosophy Dissertation 18-24
credits - Adjunct Faculty


             Triamchaisri S/San Jose State   15
             University/ November 7, 2002
PSYCHONEUROIMMUNOLOGY

represents an interdisciplinary
 area in science, psychology,
 neurology, and immunology,
 which aims at elucidating the
   nature of the relationship
    between psychological
  characteristics and illness.
PSYCHONEUROIMMUNOLOGY

represents an interdisciplinary
 area in science, psychology,
 neurology, and immunology,
 which aims at elucidating the
   nature of the relationship
    between psychological
  characteristics and illness.
PSYCHONEUROIMMUNOLOGY

represents an interdisciplinary
 area in science, psychology,
 neurology, and immunology,
 which aims at elucidating the
   nature of the relationship
    between psychological
  characteristics and illness.
PSYCHONEUROIMMUNOLOGY

represents an interdisciplinary
 area in science, psychology,
 neurology, and immunology,
 which aims at elucidating the
   nature of the relationship
    between psychological
  characteristics and illness.
PSYCHONEUROIMMUNOLOGY
         PNI
What is PNI?
  Psychoneuroimmunology
  (PNI) is a discipline which
  studies physiological and
 pathobiological interactions
between the central nervous
  system (CNS) and immune
            system
PSYCHONEUROIMMUNOLOGY
         PNI
What is PNI?
Psychoneuroimmunology (PNI) is gaining
greater acceptance in the mainstream medical
world (Benowitz, 1996) and is defined by
Lovejoy & Sisson (1989) as "the study of the
interactions among the mind, immune system,
and the neurological system that modulate
susceptibility to disease or its progression"
PSYCHONEUROIMMUNOLOGY

represents an interdisciplinary
 area in science, psychology,
 neurology, and immunology,
 which aims at elucidating the
   nature of the relationship
    between psychological
  characteristics and illness.
PSYCHONEUROIMMUNOLOGY

 What are the mind-body links?
     1.Hormonal links via
   hypothalamus-pituitary-
      adrenal axis (HPA).
  HPA plays a central role in
affecting immune responses,
is a key part of the mindbody
PSYCHONEUROIMMUNOLOGY

What are the mind-body links?
2. Nervous system wiring .
Nerves innervate lymphoid
  tissue -for example, the
   thymus, spleen, bone
 marrow, and lymph nodes
PSYCHONEUROIMMUNOLOGY

  Two way communications.
The brain talks to white cells,
 and it seems they talk back
              via
     neurotransmitters
          cytokines
PSYCHONEUROIMMUNOLOGY

   Two way communications.
   Many regions of the brain
    change in response to an
  immune challenge, such as
reticular formation, amygdala,
 limbic system, medial frontal
        cortex, and the
        hypothalamus.
PSYCHONEUROIMMUNOLOGY

 The mindbody interaction:
 stressors and antistressors
 Stress" impacts on immune
     function and disease
         susceptibility.
  Psychological factors can
 affect reactivation of latent
        viral infections.
PSYCHONEUROIMMUNOLOGY
       Herpes simplex virus
         Epstein-Barr virus
         Cytomegalovirus
                HIV
     Immune function is also
   influenced by anxiety, sleep
  deprivation, abortion, divorce,
 family illness, academic stress,
 anticipation of HIV test results,
     unemployment, and war.
PSYCHONEUROIMMUNOLOGY

  Many other internal and external
 factors have been shown to affect
  the immune system and disease,
 including personality, psychiatric
    illness, coping style, positive
   attitudes, relaxation, hypnosis,
     meditation, guided imagery,
     humour, and social support.
PSYCHONEUROIMMUNOLOGY
       PNI studied from 1976-
80                   .
60
40
20
0
     -1976-1986   1987   1988   1989
     1990         1991   1992   1993
     1994         1995   1996   1997
     1998         1999   2000   2001
     2002
Facilitation of Buddhist Meditation
Training to Relieve Anxiety among
    colorectal Cancer Patients
       Somporn Triamchaisri * **
         Apatcha PongYart *
         Payom Eusawas ***
          Mahidol   University /** UCSF
              *** Naresaun University


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           University/ November 7, 2002
Triamchaisri S/San Jose State University/   32
          November 7, 2002
Triamchaisri S/San Jose State University/   33
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          November 7, 2002
Effects of Self Healing on Anxiety
and Side Effects of chemotherapy
        of Leukemic Child
     : Biofeedback Training

    Somporn K Triamchaisri`*
   Chatsiri Mekwiwatanawong**
   Mahidol University`**/UCSF*

       Triamchaisri S/San Jose State   37
       University/ November 7, 2002
                            RESULTS
   Testing        Experimental group Control group ( n = 10)
                       ( n = 10 )
                  Time 4     Time 5   Time4       Time 5
                Mean SD Mean SD Mean SD Mean SD
Anxiety         57.6 10.04 53.6 4.10 74.0 7.42 77.7 4.43
Side effects of 19.3 4.27 41.8 5.45 21.0 5.85 48.7 6.67
chemotherapy
Skin             82.1    1.37 82.6       1.0     78.8 1.24 79.5   1.35
temperature
Pulse rate       93.9    6.31 92.9 8.14 101.5 8.65 103.9 10.73
Respiratory      24.8    1.99 22.4 2.80 26.6 3.78 24.0 1.89
rate
Blood
pressure
  Systolic      110.20 8.83 105.5 9.73 114.90 9.20 117.10 6.20
  Diastolic     70.40 10.67 68.0 10.78 73.30 9.98 78.30 9.35
Time 4-5 = Day 1 and 4 of a 4 – day session
                        Triamchaisri S/San Jose State               38
                        University/ November 7, 2002
                                RESULTS

                Experimental group (Time 4) Experimental group (Time 5)

  Outcomes         Time 4           Time 5           Time 4          Time 5
    Mean
                Mean     SD      Mean     SD     Mean       SD     Mean   SD

Anxiety         65.5    4.30     52.0     5.12    61.3      2.54   48.1   3.07


Side effects of 20.6    3.66     20.7     3.97    45.5      6.49   41.8   5.65
chemotherapy




Time 4-5 = Day 1 and 4 of a 4 – day session




                            Triamchaisri S/San Jose State                        39
                            University/ November 7, 2002
                                  RESULTS
 Outcomes       Time 1        Time 2         Time 3            Time 4        Time 5

   Mean        Pre   Post   Pre    Post    Pre    Post     Pre     Post    Pre    Post

Skin         79.2 79.0 77.4 78.1 78.6           78.8   78.6   82.1 79.5 82.6
temperature (1.39) (1.27) (1.21) (1.15) (0.95) (1.20) (1.28) (1.37) (1.32) (1.00)

Pulse rates    96.8 94.8 94.2 95.8 101.2 96.6              97.6    93.0 92.8 88.2
              (8.91) (9.53) (9.05) (8.29) (12.96) (12.52) (13.28) (13.17) 12.98) (12.45)

Respiratory 24.40 22.60 25.80 25.60 25.40 23.20 24.60 22.40 24.80 22.20
rates       (1.58) (1.90) (1.99) (2.07) (2.50) (3.16) (2.50) (2.80) (1.93) (2.90)

Blood
pressure
  Systolic    114.5 109.1 125.0 122.4 120.2 109.0 118.0 109.5 110.6 99.8
              (5.45) (4.78) (9.73) (5.09) (4.98) (7.75) (5.36) (5.67) (6.47) (6.47)

  Diastolic    76.4 75.6 76.0 75.6 72.4           65.3   70.6   66.2 64.8 59.6
              (5.73) (4.97) (6.94) (6.86) (6.07) (8.51) (8.14) (7.89) (8.72) (8.15)

Time 1-3 = Day 1,3,5 ( a 5-day session)
Time 4-5 = Day 1 and 4 ( a 4-day session)
                               Triamchaisri S/San Jose State                          40
                               University/ November 7, 2002
                                     RESULTS
         Outcomes              Experimental    Control      U       Z      P value
           Mean                   group         group
                                Mean rank     Mean rank
Anxiety scores
       Time 4                      9.45         11.55     39.50   -0.806   0.420
       Time 5                      7.20         12.80     22.00   -2.090   0.036*
Side effects of chemotherapy
       Time 4                      9.15         11.15     36.00   -1.025   0.307
       Time 5                      7.70         12.60     23.00   -1.927   0.048*
Finger temperature
       Time 4                      6.25         9.75      37.00   -1.012   0.312
       Time 5                      7.20          9.4      22.00   -2.140   0.032*
Pulse rate
       Time 4                      8.75         12.25     32.50   -1.325   0.185
       Time 5                      7.75         13.25     22.50   -2.082   0.038*
Respiratory rate
       Time 4                      9.60         11.40     41.00   -0.638   0.497
       Time 5                      8.40         12.80     23.50   -2.040   0.041*
Blood pressure
       Time 4
              Systolic             8.70         12.30     32.00   -1.366   0.172
              Diastolic           11.45          9.55     41.50   -0.683   0.496
       Time 5
              Systolic             8.20         11.80     20.00   -2.051   0.040*
              Diastolic            9.15          8.25     21.50   -1.965   0.049*
    Antiemetic drug use
       Time 5                      8.75         12.35     32.00   -1.364   0.172
Time 1-3 = Day 1,3,5 ( a 5-day session)
Time 4-5 = Day 1 and 4 ( a 4-day session)


                                Triamchaisri S/San Jose State                        41
                                University/ November 7, 2002
                              RESULTS
         Outcomes        n             Mean Rank           Z      P value
            Mean                   -Rank       +Rank
Anxiety scores
     E                   10         0          5.00      -2.670   0.008*
      C                  10        4.50        9.00      -1.606   0.108
Side effects
     E                   10         0          4.50      -2.828   0.005*
     C                   10         0          5.00      -2.680   0.007 *
Finger temperature
     E                   10        3.50        6.05      -2.183   0.029*
     C                   10        4.38        6.25      -1.401   0.161
Pulse rates
     E                   10        3.25        6.06      -2.148   0.032*
     C                   10        4.38        6.25      -1.021   0.307
Respiratory rates
     E                   10        1.00        5.0       -2.404   0.016*
     C                   10        2.50        5.17      -1.846   0.065
Blood pressure
     E
          Systolic       10        3.67        5.50      -2.814   0.005*
          Diastolic      10        6.35        8.25       2.005   0.035*
     C
          Systolic       10        6.00        5.38      -1.585   0.113
          Diastolic      10        4.85        6.15      -0.360   0.718
E = Experimental group
C = Control group



                         Triamchaisri S/San Jose State                      42
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Triamchaisri S/San Jose State University/   43
          November 7, 2002
Triamchaisri S/San Jose State University/   44
          November 7, 2002
          Discussion
 Results are consistent with other
 studies that demonstrated the self
hypnosis coupled with the used of
guide imagery impacted positively
    on the nausea and vomiting,
     anorexia, soremouth, and
     abdominal pain, diarrhea,
   constipation, fever and fatigue
induced by chemotherapy infusion
   (Kaufman, 1989 ; Burish, 1987;
            LaBaw, 1975)
           Triamchaisri S/San Jose State   45
           University/ November 7, 2002
Mind Body Medicine, PNI, and
 Nursing Therapy in Thailand
Hypertenstion
 Anapanassti Buddhist Meditation
 Qigong Meditation Exercise
 Vipassana Meditation




          Triamchaisri S/San Jose State   46
          University/ November 7, 2002
Mind Body Medicine, PNI, and
 Nursing Therapy in Thailand
Burn Pain & Anxiety
    Appamunya 4
Caesarean section & Anxiety
    Beep breathing exercise
Rheumatoid Arthritis & Anxiety
    Apamunya 4
Diabetes Mellitus & Sleep problem
     Qigong Meditation Exercise47
           Triamchaisri S/San Jose State
             University/ November 7, 2002
Mind Body Medicine, PNI, and
 Nursing Therapy in Thailand
Cancer & Anxiety
 Anapanassti Buddhist Meditation
 Biofeedback Training
Menopausal syndrome
  Walking Meditation
Insomnia
 Anapanassti Buddhist Meditation
          Triamchaisri S/San Jose State   48
          University/ November 7, 2002

				
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