The impact of an expressive writing intervention on quality of life among Chinese breast cancer patients undergoing chemotherapy

Background: Expressive writing interventions are shown to confer physical and psychological benefits for Caucasian cancer survivors. This study evaluated the health benefits of an expressive writing intervention among breast cancer patients in mainland China. Methods: Stage I-III Chinese breast cancer survivors undergoing chemotherapy were recruited in Shanghai, China. They (n = 90) were randomly assigned to one of three conditions: a positive thinking group (PTC) to write about the positive aspects of their cancer experience; a self-regulation condition (SRC) to write about their stress and coping efforts, deepest feelings, and positive aspects of their cancer experience; or a cancer-fact group (CFC) to write about facts relevant to their cancer experience. All groups wrote for 30 min every week for 4 weeks. Quality of life (QOL) was assessed using the FACT-B at baseline and 1- and 2-month follow-ups. Linear mixed effects models were used to test the hypotheses that the SRC and PTC would improve QOL compared to the CFC. Results: QOL improved overtime in the whole sample. Contrary to hypotheses, the CFC had increased QOL compared with the SRC from baseline to both the 1- and 2-month follow-ups (ΔQOL = 9.31, p = 0.01, d = 0.44; ΔQOL = 9.45, p = 0.025, d = 0.49). The PTC did not differ from cancer-fact writing but had increased QOL compared with the SRC from baseline to both the 1- and 2-month follow-ups (ΔQOL = 7.44, p = 0.04, d = 0.35; ΔQOL = 11.72, p = 0.06, d = 0.61). Conclusion: Interventions through expressive writing about positive experience and cancer facts are feasible and can benefit Chinese cancer patients undergoing chemotherapy.