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The impact of an expressive writing intervention on quality of life among Chinese breast cancer patients undergoing chemotherapy

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Abstract

Background

Expressive writing interventions are shown to confer physical and psychological benefits for Caucasian cancer survivors. This study evaluated the health benefits of an expressive writing intervention among breast cancer patients in mainland China.

Methods

Stage I-III Chinese breast cancer survivors undergoing chemotherapy were recruited in Shanghai, China. They (n = 90) were randomly assigned to one of three conditions: a positive thinking group (PTC) to write about the positive aspects of their cancer experience; a self-regulation condition (SRC) to write about their stress and coping efforts, deepest feelings, and positive aspects of their cancer experience; or a cancer-fact group (CFC) to write about facts relevant to their cancer experience. All groups wrote for 30 min every week for 4 weeks. Quality of life (QOL) was assessed using the FACT-B at baseline and 1- and 2-month follow-ups. Linear mixed effects models were used to test the hypotheses that the SRC and PTC would improve QOL compared to the CFC.

Results

QOL improved overtime in the whole sample. Contrary to hypotheses, the CFC had increased QOL compared with the SRC from baseline to both the 1- and 2-month follow-ups (ΔQOL = 9.31, p = 0.01, d = 0.44; ΔQOL = 9.45, p = 0.025, d = 0.49). The PTC did not differ from cancer-fact writing but had increased QOL compared with the SRC from baseline to both the 1- and 2-month follow-ups (ΔQOL = 7.44, p = 0.04, d = 0.35; ΔQOL = 11.72, p = 0.06, d = 0.61).

Conclusion

Interventions through expressive writing about positive experience and cancer facts are feasible and can benefit Chinese cancer patients undergoing chemotherapy.

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Acknowledgments

We would like to thank all participants and nurses at the Fudan University Shanghai Cancer Center involved in the study and acknowledge the vital contributions of study researchers in the University of Houston and Fudan University.

Contributors

Author contributions include conception and design (Q.L., Y.H.), acquisition of data (L.D, J.L.H, Y.H.), data analysis and interpretation (Q.L., I.W., J.Y.), drafting (Q.L., J.Y.), or revising article (Q.L., I.W.) for intellectual content, and approval of the final draft (Q.L., L.D., I.W., J.Y., J.L.H., Y.H.).

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Correspondence to Qian Lu or Yan Hu.

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The authors declare that they have no competing interests.

Informed Consent statement

The human investigations were performed after approval by an institutional review board. The investigators obtained informed consent from each participant.

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Lu, Q., Dong, L., Wu, I.H.C. et al. The impact of an expressive writing intervention on quality of life among Chinese breast cancer patients undergoing chemotherapy. Support Care Cancer 27, 165–173 (2019). https://doi.org/10.1007/s00520-018-4308-9

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