The feasibility and effectiveness of expressive writing for rural and urban breast cancer survivors

Oncol Nurs Forum. 2010 Nov;37(6):749-57. doi: 10.1188/10.ONF.749-757.


Purpose/objectives: To determine the feasibility and effectiveness of implementing an in-home expressive-writing intervention among breast cancer survivors living in urban and rural areas.

Design: Women who had completed radiation therapy were selected to participate in either expressive writing or a usual-care control condition.

Setting: All materials were completed in the privacy of participants' homes.

Sample: Of the 57 breast cancer survivors recruited, 40 participated in the writing intervention. An additional 40 women were assigned to the control group.

Methods: Participants completed measures of physical and psychological health at two time points prior to writing and at two follow-up time points three and nine months after writing.

Main research variables: Participation rates and physical and psychological health.

Findings: Results showed that engaging in a single in-home writing session for women with breast cancer was feasible and showed significant improvements in physical and psychological health compared to control three months (but not nine months) after writing. Although no difference was found in effectiveness of the intervention between women living in urban versus rural areas, rural women showed slightly higher participation rates.

Conclusions: The results illustrate the utility of employing remotely administered expressive-writing interventions for breast cancer survivors.

Implications for nursing: Healthcare professionals who wish to use writing to facilitate improvements in their patients may suggest that patients write at multiple time points, offer for the intervention to be completed at home, and target rural populations in particular.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Breast Neoplasms / nursing
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / radiotherapy
  • Feasibility Studies
  • Female
  • Humans
  • Mental Health*
  • Middle Aged
  • Oncology Nursing
  • Psychological Tests
  • Radiotherapy / nursing
  • Radiotherapy / psychology
  • Rural Population
  • Survivors / psychology*
  • Urban Population
  • Writing*