Watson Jowan, Peng Cynthia S, Desir Marie, Mate-Cole Manfred Nathan, Amonoo Hermioni
Harvard Medical School, Boston, MA, USA.
Department of Psychiatry, McLean Hospital, Belmont, MA, USA.
Palliat Support Care. 2025 Jul 21;23:e132. doi: 10.1017/S1478951525100394.
Expressive writing interventions (EWIs) are associated with important psychological and physical outcomes in patients with cancer. However, EWIs have not been widely integrated into routine psychosocial care of cancer populations. A review of the current literature on EWIs' impact on the cancer patient experience, including qualitative analyses of patient perspectives, will increase our understanding of barriers and facilitators to adoption in clinical settings.
To bridge existing gaps in the literature by examining quantitative and qualitative studies on EWIs for patients with cancer. To present recent data examining the benefits of EWI's for patients with cancer.To provide strategies for clinicians engaging in EWI's for their patients.
Informed by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we completed a scoping review of relevant quantitative and qualitative articles published from 2015 to 2025 to assess the impact of EWIs on health-related outcomes (e.g., physical symptoms and quality of life [QOL]) as well as approaches to improve their use in patients with cancer.
Of the 28 studies with 3527 patients that we analyzed, 24 were quantitative and 4 were qualitative. Most studies were conducted in the USA (42.8%) or China (28.6%) and included patients with breast cancer (71.4%) or only included women (71.4%). Of the patients in the studies, 46.8% identified as White, 42.8% as Asian, 5.5% as Black, and 4.5% as Latino. Twenty-one of the quantitative studies found that EWIs were positively associated with cancer patients' QOL and/or physical health outcomes. Of the 4 qualitative studies, themes of narrative reconstruction, cultural disclosure norms, and intervention delivery format emerged. The characteristics of EWI methods can be tailored to maximize therapeutic benefits through cultural adaptation, timing, and privacy.
Despite promising associations between EWIs and health-related outcomes in patients with cancer, EWIs for cancer populations are heterogeneous and randomized clinical trials are limited. Larger trials that establish the efficacy of EWIs in diverse cancer populations are warranted.
表达性写作干预（EWIs）与癌症患者重要的心理和生理结果相关。然而，EWIs尚未广泛纳入癌症患者的常规心理社会护理中。回顾当前关于EWIs对癌症患者体验影响的文献，包括对患者观点的定性分析，将增进我们对临床环境中采用EWIs的障碍和促进因素的理解。
通过审查关于癌症患者EWIs的定量和定性研究，弥合现有文献中的差距。呈现近期关于EWIs对癌症患者益处的数据。为临床医生为其患者开展EWIs提供策略。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南，我们对2015年至2025年发表的相关定量和定性文章进行了范围审查，以评估EWIs对健康相关结果（如身体症状和生活质量[QOL]）的影响，以及改善其在癌症患者中应用的方法。
在我们分析的2涉8项研究、3527名患者中，24项为定量研究，4项为定性研究。大多数研究在美国（42.8%）或中国（28.6%）进行，纳入了乳腺癌患者（71.4%）或仅纳入女性（71.4%）。在研究中的患者中，46.8%为白人，42.8%为亚洲人，5.5%为黑人，4.5%为拉丁裔。21项定量研究发现EWIs与癌症患者的QOL和/或身体健康结果呈正相关。在4项定性研究中，出现了叙事重建、文化披露规范和干预实施形式等主题。EWI方法的特点可以通过文化适应、时机和隐私进行调整，以最大限度地提高治疗效果。
尽管EWIs与癌症患者的健康相关结果之间存在有前景的关联，但针对癌症人群开展的EWIs是异质性的，随机临床试验有限。有必要开展更大规模的试验，以确定EWIs在不同癌症人群中的疗效。
