Journal List > J Korean Acad Nurs > v.42(2) > 1002803

TOOLS
Park and Yi: Development and Effectiveness of Expressive Writing Program for Women with Breast Cancer in Korea
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2012; 42(2): 269-279.

Published online: 30 April 2012

DOI: https://doi.org/10.4040/jkan.2012.42.2.269

Development and Effectiveness of Expressive Writing Program for Women with Breast Cancer in Korea

Eun Young Park1, Mungsun Yi2

1Associate Professor, College of Nursing, Gachon University, Incheon, Korea.

2Professor, College of Nursing, Seoul National University, Seoul, Korea.

Address reprint requests to: Park, Eun Young. College of Nursing, Gachon University, Incheon. Korea, 191 Hambacmoi-ro, Yeonsu-dong, Yeonsu-gu, Incheon 406-812. Tel: +82-32-820-4207, 010-5035-1305, FAX: +82-32-820-4201, parkeunyoung@gachon.ac.kr

Received 8 August 2011       Accepted 26 April 2012

© 2012 Korean Society of Nursing Science

Abstract

Purpose

To develop a expressive writing program for women with breast cancer and to identify its effects on stress physical symptom, cancer symptom, anxiety, depression, and QOL.

Methods

A non-equivalent control pre-post design was used. Participants were recruited from self-help groups in six hospitals and were assigned to the experimental group (29) or control group (29). Data were collected before, after, and at four weeks after the intervention program. Changes in the variables were evaluated to test effects of the developed program, using χ2-test, Fisher's exact test, repeated measures ANOVA, and paired t-test.

Results

The expressive writing program was developed for women with breast cancer based on Pennebaker's expressive writing. Significant differences were found between the two groups for stress related to physical symptoms (p<.00) and quality of life (p=.024). No significant differences were found in cancer symptoms, anxiety, or depression between the two groups.

Conclusion

The results indicate that the expressive writing program designed to express cancer-related deep thoughts and emotions helps in decreasing physical symptoms and improving QOL. Further studies are needed to identify the effect on emotions such as anxiety and depression for women with breast cancer with above average levels of anxiety and depression.

Keywords: Expressed emotion, Breast neoplasms, Writing, Women, Intervention studies

Figures and Tables

Figure 1
Conceptual framework of this study.
jkan-42-269-g001
Table 1
Contents of the Expressive Writing Program
jkan-42-269-i001
Table 2
Homogeneity Test of Sociodemographic and Medical Characteristics
jkan-42-269-i002

*Fisher's exact test.

Exp.=Experimental group; Cont.=Control group.

Table 3
Differences and Repeated Measures ANOVA of Expressive Writing on Variables between Experimental and Control Group (N=58)
jkan-42-269-i003

Exp.=Experimental group; Cont.=Control group; PILL=Pennebaker's Inventory of Limbic Languidness; MDASI=M.D. Anderson Symptom Inventory; C-QOL=Cancer-Quality of Life.

Notes

This article is base on a part of the first author's doctoral thesis from Seoul National University.

References

1. Burgess C., Cornelius V., Love S., Graham J., Richards M., Ramirez A. Depression and anxiety in women with early breast cancer: Five year observational cohort study. British Medical Journal. 2005. 330:702–705. http://dx.doi.org/10.1136/bmj.38343.670868.D3.
2. Cleeland C.S., Mendoza T.R., Wang X.S., Chou C., Harle M.T., Morrissey M., et al. Assessing symptom distress in cancer patients: The M.D. Anderson symptom inventory. Cancer. 2000. 89:1634–1646. http://dx.doi.org/10.1046/j.1533-2500.2001.01023-30.x.
3. Collie K., Bottorff J.L., Long B.C. A narrative view of art therapy and art making by women with breast cancer. Journal of Health Psychology. 2006. 11:761–775. http://dx.doi.org/10.1177/1359105306066632.
4. Davidson K., Schwatz A.R., Sheffield D., Moord R.S., Lepore S.J., Gerin W.. Lepore S.J., Smyth J, editors. Expressive writing and blood pressure. The writing cure. 2003. Washington, DC: American Psychological Association;17–30.
5. Frisina P.G., Borod J.C., Lepore S.J. A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. The Journal of Nervous and Mental Disease. 2004. 192:629–634.
6. Kim B.R., Kim Y.H., Kim J.S., Jeong I.S., Kim J.S. A study to the coping patterns of cancer patients. Journal of Korean Academy of Nursing. 2003. 33:321–330.
7. Kim E.S., Lee M.K., Choi J.M. In : Sung Y.S, editor. Personality trait and anger expression in cancer patients. Annual Symposium; 2006, August; Seoul: Korean Psychological Association.
8. Kim H.J., Kwon J.H., Kim J.N., Lee R., Lee K.S. Posttraumatic growth and related factors in breast cancer survivors. Korean Journal of Health Psychology. 2008. 13:781–799.
9. Kim S.H., Jun E.Y., Lee W.H. The factors influencing depression in patients with breast cancer. Journal of Korean Oncology Nursing. 2006. 6:133–142.
10. Laccetti M. Expressive writing in women with advanced breast cancer. Oncology Nursing Forum. 2007. 34:1019–1024. http://dx.doi.org/10.1188/07.ONF.1019-1024.
11. Lazarus R.S. Rice V.H, editor. Evolution of a model of stress, coping, and discrete emotions. Handbook of stress, coping, and health: Implications for nursing research, theory, and practice. 2000. Thousand Oaks, CA: Sage;195–222.
12. Lee E.H. Development and psychometric evaluation of a quality of life scale for Korean patients with cancer (C-QOL). Journal of Korean Academy of Nursing. 2007. 37:324–333.
13. Low C.A., Stanton A.L., Bower J.E., Gyllenhammer L. A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer. Health Psychology. 2010. 29(4):460–466. http://dx.doi.org/10.1037/a0020153.
14. Martin D. Kim M., Kam K, editors. Doing psychology experiments. 2008. 7th ed. Seoul: Sigma Press;(Original work published 2008).
15. Ministry of Health & Welfare and National Cancer Center. Publication No. NCCI-09-1-7-7. Cancer fact and figures: In the Republic of Korea. 2009. Seoul: Author.
16. Oh S.M., Min K.J., Park D.B. A study on the standardization of the hospital anxiety and depression scale for Koreans. Journal of Korean Neuropsychiatric Association. 1999. 38:289–296.
17. Park E.Y., Yi M.S. Illness experience of women with breast cancer in Korea: Using feminist phenomenology. Journal of Korean Academy of Adult Nursing. 2009. 21:504–518.
18. Pennebaker J.W. Writing about emotional experiences as a therapeutic process. Psychological Science. 1997. 8:162–166.
19. Pennebaker J.W. B.H Lee . Writing to Heal. 2007. Seoul: Hakjisa;(Original work published 2004).
20. Pennebaker J.W., Seagal J.D. Forming a story: The health benefits of narrative. Journal of Clinical Psychology. 1999. 55:1243–1254.
21. Rosenberg H.J., Rosenberg S.D., Ernstoff M.S., Wolford G.L., Amdur R.J., Elshamy M.R., et al. Expressive disclosure and health outcomes in a prostate cancer population. International Journal of Psychiatry in Medicine. 2002. 32:37–53. http://dx.doi.org/10.2190/AGPF-VB1G-U82E-AE8C.
22. Shim E.J., Mehnert A., Koyama A., Cho S.J, Inui H., Paik N.S., et al. Health-related quality of life in breast cancer: A cross-cultural survey of German, Japanese, and South Korean patients. Breast Cancer Research and Treatment. 2006. 99:341–350. http://dx.doi.org/10.1007/s10549-006-9216-x.
23. Shin H.K., Won H.T. A study on the development of the Korean alexithymia scale. Korean Journal of Clinical Psychology. 1997. 16:219–231.
24. Shin S.R., Kim N. The effects of dance/movement therapy on the body image and depression of breast cancer patients with breast resection. Journal of Psychotherapy. 2009. 9:143–166.
25. Smith S., Anderson-Hanley C., Langrock A., Compas B. The effects of journaling for women with newly diagnosed breast cancer. Psycho-Oncology. 2005. 14:1075–1082. http://dx.doi.org/10.1002/pon.912.
26. Smyth J. Written emotional expression: Effect sizes, outcome types, and moderating values. Journal of Consulting and Clinical Psychology. 1998. 66:174–184.
27. Spiegel D., Giese-Davis J. Depression and cancer: Mechanisms and disease progression. Biological Psychiatry. 2003. 54:269–282. http://dx.doi.org/10.1016/S0006-3223(03)00566-3.
28. Stanton A.L., Danoff-Burg S., Sworowski L.A., Collins C.A., Branstetter A.D., Rodriguez-Hanley A., et al. Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology. 2002. 20:4160–4168. http://dx.doi.org/10.1200/JCO.2002.08.521.
29. Yun Y.H., Mendoza T.R., Kang I.O., You C.H., Roh J.W., Lee C.G., et al. Validation study of the Korean version of the MD Anderson symptom inventory. Journal of Pain and Symptom Management. 2006. 31:345–352.
30. Zigmond A.S., Snaith R.P. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983. 67:361–370.
TOOLS
Similar articles