Expressive writing in early breast cancer survivors

J Adv Nurs. 2013 Feb;69(2):305-15. doi: 10.1111/j.1365-2648.2012.06008.x. Epub 2012 Apr 11.


Aims: This article is the report of a study aimed at determining whether or not expressive writing improves the quality-of-life of early breast cancer survivors. An additional aim is the investigation of whether or not the type of writing prompt makes a difference in results.

Background: The risk of distress can extend well beyond the time of a breast cancer diagnosis. Emotional expression may assist in dealing with this.

Design: Randomized controlled study.

Methods: Participants (n = 120) were randomized into one of four groups: a control group (no writing) or one of three expressive writing groups: breast cancer trauma, any self-selected trauma and facts related to breast cancer. Participants wrote 20 minutes a day for 4 consecutive days. Their quality-of-life was measured, using the 'Functional Assessment of Cancer Therapy-Breast Cancer Version', at baseline and at 1 month and 6 months after writing. Paired t-tests, multivariate analysis of variance and multiple regression were used to analyse the data of the 97 participants who completed the journaling assignment and at least the first assessment, collected in 2006. Intention-to-treat analysis was used.

Results/findings: Expressive writing about one's breast cancer, breast cancer trauma and facts related to breast cancer, significantly improved the quality-of-life outcome.

Conclusion: Expressive writing, focusing the instructions on writing about one's living and dealing with a diagnosis of breast cancer, is recommended for early breast cancer survivors as a feasible and easily implemented treatment approach to improve quality-of-life.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Analysis of Variance
  • Breast Neoplasms / psychology*
  • Emotions
  • Female
  • Humans
  • Middle Aged
  • Prognosis
  • Quality of Life*
  • Stress, Psychological / prevention & control
  • Survivors / psychology*
  • Writing*