Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Janet K. Harrison, EdD, RN, Chairperson; Mary Jo Clark, PhD, RN; Lee S. Berk, DrPH, FACSM, CHES


Cancer, Chemotherapy, Neuroimmune responses, mental health, nursing, relaxation, Stress management


Chemotherapy can be considered both a physiologic and a psychological stressor. Anxiety, nausea, emesis, and immunosuppression are commonly associated with chemotherapy, and may adversely affect the outcome or the process of treatment. Chemotherapy-related anxiety can exacerbate negative side-effects. Some psychological stressors, such as anxiety, can result in down-regulation of certain immune functions. Studies have demonstrated that behavioral interventions, such as specific relaxation strategies, can modify stress-related immune modulation. These behavioral interventions have also been shown to decrease the degree of nausea and vomiting associated with chemotherapy. The purpose of this study was to examine whether a relaxation intervention would result in decreased anxiety, decreased nausea and vomiting, and decreased immune modulation in persons undergoing chemotherapy for breast cancer. A baseline neuro-immune assessment, including immune function tests, state and trait anxiety, and serum catecholamines, was performed on 12 women diagnosed with breast cancer and slated to undergo four cycles of Adriamycin/Cytoxan (AC) chemotherapy. Subjects were assigned to an experimental or a control group. The control group underwent chemotherapy according to the prescribed AC regimen. The experimental group underwent the same chemotherapy and a relaxation intervention. The neuro-immune assessment was repeated just before subjects received the third and fourth chemotherapy infusions, with the addition of assessment of nausea and emesis. Study findings revealed that state anxiety was significantly lower at measure two for the experimental group (t = 3.20, p = 0.02). No significant difference in anticipatory nausea and vomiting was found between groups. Evaluation of immune function tests was inconclusive. These findings suggest that a relaxation intervention may lower anxiety in individuals who are undergoing chemotherapy. Future research efforts should continue to explore whether relaxation interventions can modify the degree of side effects associated with chemotherapy, and potentially improve the quality of life for persons requiring the treatment.

Document Type

Dissertation: Open Access



Included in

Nursing Commons