title: [The use of expressive writing in the course of care for cancer patients to reduce emotional distress: analysis of the literature].
abstract: OBJECTIVE
  The emotional distress represents one of the symptoms most frequently reported in the cancer patient in therapy, increasing the risk of developing a disease depressive. Through the analysis of the literature we want to assess whether the use of expressive writing on cancer patients in their care pathway compared to the use of writing neutral reduces emotional distress.
  
  
  METHODS
  The bibliographic search was conducted using the databases CINAHL, PubMed, Cochrane Library and PsycInfo.
  
  
  RESULTS
  The results of research conducted on 7 randomized controlled trials, including 3 pilot studies have shown after expressive writing sessions (experimental group) versus neutral writing (control group) a significant reduction in distress in the experimental group early stages of cancer (p = 0,0183); in patients with a diagnosis of metastatic assigned to the group expressive writing there was a statistically significant relevance in the reduction of mood disorders (p = 0,03).Were determined statistically significant group differences also with respect to some measure on the quality of sleep (p = 0,04). The expressive writing did not produce significant reductions in psychological distress and improvements in physical health (p > 0,20) in patients diagnosed with metastatic disease of long duration and, in the palliative care there have been results of feasibility for poor adherence at follow-up.
  
  
  CONCLUSIONS
  From the results it is evident that the strategies of expressive writing improves the management of the disease, reduce the physical and psychological symptoms related to the tumor while reducing the emotional distress in patients at an early stage of the disease.
authors.affiliation: Collaboratore Professionale Sanitario Esperto Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino Correspondence: isabella_gallo@libero.it - isotta.gallo@libero.it.
authors.forename: Isabella
authors.initials: I
authors.lastname: Gallo
authors.affiliation: Ricercatore in Scienze Infermieristiche, Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torin.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Garrino
authors.affiliation: Professore associato in Scienze Infermieristiche, Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino.
authors.forename: Valerio
authors.initials: V
authors.lastname: Di Monte
mesh_terms: D001943:Breast Neoplasms / Q000451:nursing; D019317:Evidence-Based Medicine; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D019964:Mood Disorders / Q000451:nursing* / Q000517:prevention & control; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological / Q000451:nursing*; D014956:Writing