The Effects of Expressive Writing Interventions for Patients With Cancer: A Meta-Analysis.

PURPOSE/OBJECTIVES To evaluate the effects of expressive writing (EW) interventions in patients with cancer.
. DATA SOURCES Electronic databases searched included both international and Korean databases through January 2015.
. DATA SYNTHESIS Of the 20 trials that met the eligibility criteria of this review, a meta-analysis was conducted of 14 articles involving 13 randomized and 1 nonrandomized trials with 1,718 patients with cancer. EW interventions were compared with a neutral writing intervention or usual care (no writing). A significant small effect was noted on relieving cancer symptoms; however, the effects on psychological and cognitive outcomes were not significant. When subgroup analysis by control condition was performed, a significant effect on health-related quality of life was found between the EW intervention group and the usual care group. 
. CONCLUSIONS EW had significant small effects only on cancer symptoms. The findings suggest that the traditional EW intervention protocol may need to be intensified to confirm its effect on patients with cancer.
. IMPLICATIONS FOR NURSING Current evidence for EW as a nursing intervention for improving physical, psychological, and cognitive outcomes among patients with cancer is promising, but not conclusive.