SynthesisPloS one2015
Effect of Expressive Writing Intervention on Health Outcomes in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Efficacy of expressive writing versus positive writing in different populations: Systematic review and meta-analysis.Nursing open · 2023Pooled it
- The experience of patients with cancer on narrative practice: A systematic review and meta-synthesis.Health expectations : an international journal of public participation in health care and health policy · 2020Pooled it
- Expressive writing as a therapeutic intervention for people with advanced disease: a systematic review.BMC palliative care · 2019Pooled it
- Research studies on patients' illness experience using the Narrative Medicine approach: a systematic review.BMJ open · 2016Pooled it
- Narrative medicine in patients with cancer during intravenous antiblastic therapy: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Trial
- Effects of expressive helping writing during stem cell transplant: Randomized controlled trial.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2025Trial
- Cancer and aging: Reflections for elders- Expressive writing intervention: A pilot study.Journal of geriatric oncology · 2022Trial
- Effect of prolonged expressive writing on health outcomes in breast cancer patients receiving chemotherapy: a multicenter randomized controlled trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Trial
- Suffering in Advanced Cancer: A Randomized Control Trial of a Narrative Intervention.Journal of palliative medicine · 2018Trial
- Trajectories and predictors of benefit finding among patients with colorectal cancer undergoing chemotherapy: A longitudinal observational study.Asia-Pacific journal of oncology nursing · 2025Article
- Letter-writing to the deceased among family caregivers of individuals living with dementia: exploring the role of technology-based interventions.Frontiers in medicine · 2025Article
- Article
- Writing cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Review
- Emotional disclosure in palliative care: A scoping review of intervention characteristics and implementation factors.Palliative medicine · 2021Article
- Better Together: Long-term Behaviors and Perspectives after a Practitioner-Family Writing Intervention in Clinical Practice.The Permanente journal · 2021Article
- The benefits of expressive writing among newly diagnosed mainland Chinese breast cancer patients.Journal of behavioral medicine · 2020Article
- Emotional disclosure as a therapeutic intervention in palliative care: a scoping review protocol.BMJ open · 2019Article
- Written reflection in an eHealth intervention for adults with type 2 diabetes mellitus: a qualitative study.Patient preference and adherence · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNumerous randomized controlled trials (RCTs) have arrived at conflicting conclusions on expressive writing (EW) as an intervention for breast cancer (BC) patients, but there has been no meta-analysis of these studies to assess the effectiveness of EW in BC population.
methodsPubMed, Web of Science, The Cochrane Library, EMBASE, and CINAHL and the www.clinicaltrial.gov database on ongoing clinical trials were searched to identify all the RCTs investigating efficacy of EW on the physical and psychological health in BC patients. The risk of bias of the original studies was assessed using the Cochrane Collaboration's tool. Our primary outcomes for physical and psychological health were respectively negative somatic symptoms and negative mood which were stratified by emotional, benefit-finding and multiple prompts in sub-group analyses. The data were analyzed using Review Manager 5.2 and Stata version 12.0 statistical software.
resultsOf the 5,232 titles screened, we identified 11 RCTs with a total of 1,178 participants. The pooled results showed a significant effect of EW using either an emotional prompt or a benefit-finding prompt on reducing negative somatic symptoms in BC patients in the ≤3-month follow-up group [Mean Difference (MD), -13.03, 95% CI, -19.23 to -6.83, P<0.0001; MD, -9.18, 95% CI, -15.57 to -2.79, P = 0.005]. There was no significant effect of EW on physical health in the >3-month follow-up group. There were no significant differences regarding psychological health indexes between EW intervention and control groups at any of the follow-up time-points (P>0.05).
conclusionThis systematic review and meta-analysis reveals that EW intervention may have a significantly positive impact on the physical health but not the psychological health in BC patients, but this benefit may not last long. However, further high-quality studies with more homogeneity are needed to confirm the current findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.