Narrowing the gap: the effects of an expressive writing intervention on perceptions of actual and ideal emotional support in women who have completed treatment for early stage breast cancer

Objective: To assess the effects of an expressive writing (EW) intervention on perceptions of emotional support in women completing treatment for early stage breast cancer. Methods: Women were recruited to the study during their final week of treatment. Of 260 eligible patients, 104 (40%) agreed to participate, and 93 were randomised. Women in the writing group wrote for 20 min on four consecutive days. The control group received normal care. Women's perceptions of emotional support, quality of life (QOL), mood, and healthcare utilisation were assessed at baseline, I month, 3 months and 6 months. Interviews were conducted to explore women's experience of writing. Results: Eighty participants completed all follow-ups. There was a significant effect of group on women's perceptions of social support with those in the intervention group being more satisfied with the emotional support they received (p<0.05). Satisfaction with emotional support was negatively correlated with depression/dejection (p<0.05) and anger/hostility (p<0.05) and positively correlated with social and family well-being (p<0.001) 6 months post intervention. There were no significant effects of the intervention on mood, QOL or healthcare utilisation. Most participants found writing valuable and did not report any long-term negative effects. Conclusion: EW was associated with a higher level of satisfaction with emotional support compared with controls. Given the existing evidence supporting the importance of social support in adjustment to breast cancer, it seems feasible to suggest that EW may be a cost effective accessible treatment that could be incorporated into the ongoing care of women. Copyright (C) 2009 John Wiley & Sons, Ltd.