Li Jiayuan, Gao Zhuoran, Li Siyu, Zhong Xia
Department of the First Clinical Medical College, Jinzhou Medical University, Jinzhou, China.
Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, China.
Cancer Med. 2025 Jan;14(1):1-12. doi: 10.1002/cam4.70595.
Expressive writing (EW) has emerged as an innovative strategy for improving mood and quality of life. Nevertheless, insufficient research has been conducted on the impact of offering EW to patients with HNC. Therefore, the purpose of this study was to investigate the effects of two forms of EW on anxiety, depression, nutrition, and sleep quality in HNC patients undergoing radiotherapy.
We conducted a single-blind, pretest, posttest, three-group randomized controlled trial. A total of 147 patients with HNC were randomly assigned to a benefit-finding writing group, neutral writing group, or control group. The intervention group patients performed EW during radiotherapy, with each writing session lasting 20 min, once a week for 4 consecutive weeks. Patient anxiety, depression, nutritional status, and sleep quality were measured at baseline (T0) and at the end of radiotherapy (T1).
After 4 weeks of intervention, patients in the BF and NW groups experienced improvements in anxiety, depression, and sleep (p < 0.05) compared with those in the CG group, but the intervention did not significantly affect patients' nutritional status (p > 0.05). Compared with those in the CG, anxiety in the BF and NW groups slowed down the trend of increasing anxiety, and repeated measures analysis revealed a significant group × time interaction (p = 0.017, F = 4.205, η = 0.059). Compared with those in the CG, the depression levels in the BF and NW groups were lower than those at baseline, and repeated measurement analysis revealed that the interaction effect between group × time was significant (p = 0.000, F = 16.262, η = 0.194). The sleep quality in the CG progressively worsened from T0 to T1 (p < 0.01), whereas in the BF, it progressively improved (p < 0.01).
This study provides preliminary evidence that two forms of EW are effective in alleviating anxiety and depression and improving sleep in patients with HNC but are not effective in improving their nutritional status.
ChiCTR2400084964.
表达性写作（EW）已成为一种改善情绪和生活质量的创新策略。然而，针对头颈部癌症（HNC）患者进行表达性写作的影响的研究尚不充分。因此，本研究的目的是调查两种形式的表达性写作对接受放疗的HNC患者的焦虑、抑郁、营养和睡眠质量的影响。
我们进行了一项单盲、前测、后测、三组随机对照试验。总共147例HNC患者被随机分配到益处发现写作组、中性写作组或对照组。干预组患者在放疗期间进行表达性写作，每次写作时长20分钟，每周一次，连续进行4周。在基线（T0）和放疗结束时（T1）测量患者的焦虑、抑郁、营养状况和睡眠质量。
干预4周后，与对照组相比，益处发现写作组和中性写作组患者的焦虑、抑郁和睡眠状况有所改善（p < 0.05），但干预对患者的营养状况没有显著影响（p > 0.05）。与对照组相比，益处发现写作组和中性写作组的焦虑减缓了焦虑增加的趋势，重复测量分析显示组×时间交互作用显著（p = 0.017，F = 4.205，η = 0.059）。与对照组相比，益处发现写作组和中性写作组的抑郁水平低于基线水平，重复测量分析显示组×时间的交互作用显著（p = 0.000，F = 16.262，η = 0.194）。对照组的睡眠质量从T0到T1逐渐恶化（p < 0.01），而在益处发现写作组中则逐渐改善（p < 0.01）。
本研究提供了初步证据，表明两种形式的表达性写作可有效减轻HNC患者的焦虑和抑郁并改善睡眠，但对改善其营养状况无效。
ChiCTR2400084964。
