Psychological Influences in Critical Care: Perspectives From Psychoneuroimmunology

Despite increasing knowledge, including the recent breakthrough in gene mapping in the Human Genome Project, much is still unknown or not understood about the human body. Although hundreds, even thousands, of complex clinical problems might occur during a patient’s stay in a critical care unit, common problems occur on an on-going basis. Some of those problems have their roots in a neuroendocrine response to illness. Authors of epidemiological studies propose what many critical care nurses have known for some time: psychological stress is a component of many of these problems, including, among others, hypertension and hypotension, pain, cardiac disorders, dyspnea, respiratory diseases, fever, infections, and tachycardia. Data suggest a probable link between psychological states and host resistance, and substantial evidence indicates an association between psychological stress and the immune response.¹ 

Chronic stress may increase susceptibility to disease; however, large individual differences exist in psychological responses to stress. Psychoneuroimmunology, the...