Gripsrud Birgitta Haga, Brassil Kelly J, Summers Barbara, Søiland Håvard, Kronowitz Steven, Lode Kirsten
Author Affiliations: Departments of Research (Drs Gripsrud and Lode) and Breast and Endocrine Surgery (Dr Søiland), Stavanger University Hospital, Stavanger; and Department of Clinical Science, University of Bergen, Bergen, Norway (Dr Søiland); Division of Nursing (Drs Brassil and Summers); and Department of Plastic Surgery (Dr Kronowitz), The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
Cancer Nurs. 2016 Jul-Aug;39(4):E51-60. doi: 10.1097/NCC.0000000000000300.
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.
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.
Seven participants enrolled to undertake 4 episodes of expressive writing at home, with semistructured interviews conducted afterward and analyzed using experiential thematic analysis.
Three themes emerged through analysis: writing as process, writing as therapeutic, and writing as a means to help others.
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.
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.
跨文化研究表明,表达性写作可改善乳腺癌患者的生活质量、缓解疲劳并减轻创伤后应激反应。了解该方法如何以及为何对患者有益,可提高对乳腺癌心理社会影响的认识,并加强针对这一人群的干预工作。对干预体验方面的定性研究可为理论理解提供参考,并为未来研究提出假设。
本研究旨在探索并描述乳腺癌患者在乳房切除术后即刻或延迟进行重建手术时进行表达性写作的体验及可行性。
七名参与者在家中进行了4次表达性写作,之后进行了半结构化访谈,并采用体验式主题分析法进行分析。
分析得出三个主题:写作即过程、写作即治疗、写作即帮助他人的方式。
研究结果揭示了表达性写作中的体验差异,以及故事讲述如何促使认知和情感压力得以释放,并将其留存于文本之中。该方法被认为能够处理情感,并捕捉与新出现的、令人难以承受的疾病状况相关的经历,因为印象通过写作转化为了表达。因此,表达性写作是医疗服务提供者可引入乳腺癌患者及其他潜在癌症患者护理计划中的一项宝贵工具。
本研究补充了现有证据,支持将表达性写作作为乳腺癌诊断后的一种干预措施的合理性。进一步的研究应评估其在癌症幸存者不同时间点的可行性。