Psychoneuroimmunological Outcomes in Dementia Caregiver Intervention Studies: An Idea Whose Time Has Come?

PURPOSE: Mounting evidence indicates that the chronic stress of family caregiving has physiological effects and that caregiver stress may be associated with changes in the caregiver's physical health. Existing caregiver behavioral intervention studies have focused on caregiver stress and psychological distress outcomes. To date, no known caregiver intervention studies have included psychoneuroimmunological (PNI) outcome measures. Two bodies of literature were reviewed to determine if the current state-of-the-science supports the development of caregiver intervention studies that examine PNI outcomes--first, dementia caregiver PNI studies; and second, cognitive behavioral PNI intervention studies conducted with other clinical populations. CONCLUSIONS: If this line of research is pursued, the following issues need to be addressed: a) sampling strategies and study designs; b) measurement issues; and c) the need for multidisciplinary collaborative research teams. IMPLICATIONS: Nurses' preparation in the biomedical and behavioral sciences establishes a knowledge base that enables nurses to apply a PNI model in clinical situations. Their preparation and access to family caregivers put them in a unique position to design and implement improved caregiver interventions that focus on caregiver psychological, physiological, and physical health outcomes.