The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled Trial

ABSTRACT Background 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 t...

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Main Authors: Jiayuan Li, Zhuoran Gao, Siyu Li, Xia Zhong
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70595
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author Jiayuan Li
Zhuoran Gao
Siyu Li
Xia Zhong
author_facet Jiayuan Li
Zhuoran Gao
Siyu Li
Xia Zhong
author_sort Jiayuan Li
collection DOAJ
description ABSTRACT Background 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. Methods 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). Results 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, η2 = 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, η2 = 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). Conclusions 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. Trial Registration: ChiCTR2400084964
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spelling doaj-art-c265ea2de763432285a58269fbdaa4f12025-01-13T13:22:39ZengWileyCancer Medicine2045-76342025-01-0114111210.1002/cam4.70595The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled TrialJiayuan Li0Zhuoran Gao1Siyu Li2Xia Zhong3Department of the First Clinical Medical College Jinzhou Medical University Jinzhou ChinaDepartment of Radiation Oncology The First Hospital of China Medical University Shenyang ChinaDepartment of Radiation Oncology The First Hospital of China Medical University Shenyang ChinaDepartment of Radiation Oncology The First Hospital of China Medical University Shenyang ChinaABSTRACT Background 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. Methods 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). Results 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, η2 = 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, η2 = 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). Conclusions 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. Trial Registration: ChiCTR2400084964https://doi.org/10.1002/cam4.70595expressive writinghead and neck cancermental healthnutritional statussleep quality
spellingShingle Jiayuan Li
Zhuoran Gao
Siyu Li
Xia Zhong
The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled Trial
Cancer Medicine
expressive writing
head and neck cancer
mental health
nutritional status
sleep quality
title The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled Trial
title_full The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled Trial
title_fullStr The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled Trial
title_full_unstemmed The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled Trial
title_short The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled Trial
title_sort effect of expressive writing on the experiences of head and neck cancer patients undergoing radiotherapy a randomized controlled trial
topic expressive writing
head and neck cancer
mental health
nutritional status
sleep quality
url https://doi.org/10.1002/cam4.70595
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