Randomised controlled trial of expressive writing and quality of life in men and women treated for colon or rectal cancer

Abstract

Objective: This randomised trial tested (i) whether a home-based expressive writing (EW) intervention improves quality of life in patients with colorectal cancer (CRC) and (ii) whether the intervention is more beneficial for men or for people who feel constrained in disclosing cancer-related concerns and feelings.

Design: Patients treated for CRC were randomised to an EW (n = 101) or control writing (CW; n = 92) group. Assessments were completed at 1 month pre- and post-intervention. Sex and perceived social constraints on disclosure were evaluated as moderators.

Main outcome measures: Primary outcomes were depressive symptoms, sleep problems and quality of life indicators.

Results: Eighty-one per cent of participants completed all writing assignments. Consistent with hypotheses, relative to the CW group, participants in the EW group expressed more negative emotion in writing and rated their writings as more meaningful, personal and emotionally revealing. There were no significant main effects of EW or moderating effects of sex or social constraints on outcomes.

Conclusions: Although EW is feasible to use with persons who have CRC, it was not effective as a stand-alone psychotherapeutic intervention. Neither was it more effective for men nor for people who felt they could not freely disclose cancer-related concerns and feelings.

Keywords:

• cancer
• colorectal
• quality of life
• psychological distress
• expressive writing
• social constraints

Additional information

Funding

Funding. This work was supported by the National Institutes of Health under [grant number CA107428]. The authors thank the patients, physicians and research assistants who made this work possible.