title: Expressive writing in early breast cancer survivors.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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
  Expressive writing about one's breast cancer, breast cancer trauma and facts related to breast cancer, significantly improved the quality-of-life outcome.
  
  
  CONCLUSIONS
  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.
authors.affiliation: College of Nursing at the University of Oklahoma Health Sciences Center, OK, USA. melissa-craft@ouhsc.edu
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Craft
authors.forename: Gail C
authors.initials: GC
authors.lastname: Davis
authors.forename: René M
authors.initials: RM
authors.lastname: Paulson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D013315:Stress, Psychological / Q000517:prevention & control; D017741:Survivors / Q000523:psychology*; D014956:Writing