4.5 Article

Capturing the Experience Reflections of Women With Breast Cancer Engaged in an Expressive Writing Intervention

Journal

CANCER NURSING
Volume 39, Issue 4, Pages E51-E60

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/NCC.0000000000000300

Keywords

Breast cancer; Breast neoplasms; Cancer; Emotions; Intervention studies; Mastectomy; Narration; Posttraumatic stress; Qualitative research; Stress disorders; Writing

Funding

  1. Folke Hermansen Cancer Research Foundation
  2. Inge Steensland Foundation, Stavanger, Norway
  3. National Institutes of Health through M. D. Anderson's cancer center [CA016672]

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Background: Expressive writing has been shown to improve quality of life, fatigue, and posttraumatic stress among breast cancer patients across cultures. Understanding how and why the method may be beneficial to patients can increase awareness of the psychosocial impact of breast cancer and enhance interventional work within this population. Qualitative research on experiential aspects of interventions may inform the theoretical understanding and generate hypotheses for future studies. Aim: The aim of the study was to explore and describe the experience and feasibility of expressive writing among women with breast cancer following mastectomy and immediate or delayed reconstructive surgery. Methods: Seven participants enrolled to undertake 4 episodes of expressive writing at home, with semistructured interviews conducted afterward and analyzed using experiential thematic analysis. Results: Three themes emerged through analysis: writing as process, writing as therapeutic, and writing as a means to help others. Conclusions: Findings illuminate experiential variations in expressive writing and how storytelling encourages a release of cognitive and emotional strains, surrendering these to reside in the text. The method was said to process feelings and capture experiences tied to a new and overwhelming illness situation, as impressions became expressions through writing. Expressive writing, therefore, is a valuable tool for healthcare providers to introduce into the plan of care for patients with breast cancer and potentially other cancer patient groups. Implications for Practice: This study augments existing evidence to support the appropriateness of expressive writing as an intervention after a breast cancer diagnosis. Further studies should evaluate its feasibility at different time points in survivorship.

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