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The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis

OBJECTIVE: This study aimed to evaluate the effectiveness of expressive writing intervention (EWI) for improving psychological and physical health in cancer patients and survivors. METHODS: We searched databases and existing reviews for randomized controlled studies published between 1986 and 2014 t...

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Autores principales: Zachariae, Robert, O'Toole, Mia S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680178/
https://www.ncbi.nlm.nih.gov/pubmed/25871981
http://dx.doi.org/10.1002/pon.3802
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author Zachariae, Robert
O'Toole, Mia S.
author_facet Zachariae, Robert
O'Toole, Mia S.
author_sort Zachariae, Robert
collection PubMed
description OBJECTIVE: This study aimed to evaluate the effectiveness of expressive writing intervention (EWI) for improving psychological and physical health in cancer patients and survivors. METHODS: We searched databases and existing reviews for randomized controlled studies published between 1986 and 2014 that evaluated the effects of EWI on psychological and physical health outcomes. We computed and combined effect sizes and examined the role of methodological characteristics. RESULTS: From 223 unique citations, we identified 16 independent randomized controlled trials published from 1999 to 2014, examining the effect of EWI on a range of psychological and physical health outcomes. No statistically significant effects were found for any of the individual or combined psychological (Hedges's g: 0.04; 95% CI, −0.06 to 0.14; p = 0.42), physical (0.08; 95% CI, −0.05 to 0.20; p = 0.22), or quality‐of‐life outcomes (0.09; 95% CI, −0.05 to 0.24; p = 0.22). The results were unaffected by differences in study characteristics, for example, type of control condition, study setting, cancer type, and overall study quality ratings. Results from a subset of studies indicated a possible moderating effect of social constraints, suggesting that participants experiencing low levels of emotional support may be more likely to benefit from EWI. CONCLUSIONS: Our results do not support the general effectiveness of EWI in cancer patients and survivors. However, given the practical and inexpensive intervention, it is possible that even small effects in subgroups of patients could be clinically relevant, and future studies are recommended to test the effects of potential moderators, including pre‐intervention distress levels and context‐dependent factors such as emotional support. © 2015 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd.
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spelling pubmed-66801782019-08-09 The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis Zachariae, Robert O'Toole, Mia S. Psychooncology Review Articles OBJECTIVE: This study aimed to evaluate the effectiveness of expressive writing intervention (EWI) for improving psychological and physical health in cancer patients and survivors. METHODS: We searched databases and existing reviews for randomized controlled studies published between 1986 and 2014 that evaluated the effects of EWI on psychological and physical health outcomes. We computed and combined effect sizes and examined the role of methodological characteristics. RESULTS: From 223 unique citations, we identified 16 independent randomized controlled trials published from 1999 to 2014, examining the effect of EWI on a range of psychological and physical health outcomes. No statistically significant effects were found for any of the individual or combined psychological (Hedges's g: 0.04; 95% CI, −0.06 to 0.14; p = 0.42), physical (0.08; 95% CI, −0.05 to 0.20; p = 0.22), or quality‐of‐life outcomes (0.09; 95% CI, −0.05 to 0.24; p = 0.22). The results were unaffected by differences in study characteristics, for example, type of control condition, study setting, cancer type, and overall study quality ratings. Results from a subset of studies indicated a possible moderating effect of social constraints, suggesting that participants experiencing low levels of emotional support may be more likely to benefit from EWI. CONCLUSIONS: Our results do not support the general effectiveness of EWI in cancer patients and survivors. However, given the practical and inexpensive intervention, it is possible that even small effects in subgroups of patients could be clinically relevant, and future studies are recommended to test the effects of potential moderators, including pre‐intervention distress levels and context‐dependent factors such as emotional support. © 2015 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd. John Wiley and Sons Inc. 2015-11 2015-04-14 /pmc/articles/PMC6680178/ /pubmed/25871981 http://dx.doi.org/10.1002/pon.3802 Text en © 2015 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review Articles
Zachariae, Robert
O'Toole, Mia S.
The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis
title The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis
title_full The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis
title_fullStr The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis
title_full_unstemmed The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis
title_short The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis
title_sort effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta‐analysis
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680178/
https://www.ncbi.nlm.nih.gov/pubmed/25871981
http://dx.doi.org/10.1002/pon.3802
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