Effects of Expressive Writing on Psychosocial Symptoms and Quality of Life in Patients With Breast Cancer: A Systematic Review and Meta-Analysis.

PROBLEM IDENTIFICATION: Breast cancer (BC) affects women's physical and psychological well-being. Expressive writing (EW) interventions show promise for BC symptoms but have inconclusive impacts on quality of life (QOL). This review evaluated the effect of EW interventions in patients with BC on QOL, intrusive thoughts, benefit finding, post-traumatic stress disorder symptoms, anxiety, and depression.

LITERATURE SEARCH: Seven English and two Chinese databases were searched for articles published through August 2023. Two researchers reviewed studies, extracted data, and evaluated risk of bias.

DATA EVALUATION: The review included 24 studies (22 in meta-analysis). EW significantly improved QOL, benefit finding, intrusive thoughts, anxiety, and depression but had no effect on post-traumatic stress disorder symptoms. Subgroup analysis showed that longer-term follow-up, as well as certain types of EW intervention, had better effects. EW had better effects for BC survivors than patients receiving chemotherapy.

SYNTHESIS: EW interventions positively affect QOL in patients with BC.

IMPLICATIONS FOR PRACTICE: This study provides evidence for using EW interventions in patients with BC.