Expressive Writing and Adjustment to Metastatic Breast Cancer

表达性写作和转移性乳腺癌的调整

• 批准号: 7616188
• 负责人: Catherine E Mosher
• 金额: $ 4.68万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-21 至 2010-09-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7616188
• 关键词: Adherence; Advanced Malignant Neoplasm; Age; Anxiety; Anxiety Disorders; Cancer Patient; Cessation of life; Clinical; Cognitive; Condition; Daily; Data; Demographic Impact; Dependence; Depth; Diagnosis; Diagnostic Neoplasm Staging; Disclosure; Distress; Emotional; Emotions; Event; Exhibits; Fatigue; Feeling; Future; Goals; Grant; Health; Health Benefit; Health Professional; Individual; Instruction; Intervention; Laboratories; Life; Life Experience; Love; Malignant Neoplasms; Medical; Medical Education; Mental Health; Metastatic Neoplasm to the Breast; Methods; Minority; Mission; Moods; Morbidity - disease rate; National Cancer Institute; Nature; Outcome; Pain; Participant; Patient Self-Report; Patients; Perception; Personal Satisfaction; Population; Process; Psychological adjustment; Public Health; Publishing; Purpose; Randomized; Rate; Recommendation; Relative (related person); Research; Sampling; Severities; Sleep; Sleep disturbances; Staging; Stress; Symptoms; Telephone; Thinking; Time; Trauma; Uncertainty; Visit; Week; Well in self; Woman; Writing; coping; cost; depressive symptoms; design; desire; emotional disclosure; emotional disclosure intervention; end of life; experience; expressive writing; follow-up; functional disability; immune function; indexing; malignant breast neoplasm; medical appointment; peace; psychologic; social; stressor

DESCRIPTION (provided by applicant): Nearly two decades of research with primarily healthy samples have documented that writing about one's emotions associated with negative events over several brief sessions can enhance physical and psychological well-being. Promising studies with predominantly early-stage cancer patients suggest that expressive writing produces health benefits such as reduced pain and medical visits for cancer-related morbidities. Research to date has not examined the potential benefits of expressive writing for women with metastatic breast cancer who confront a growing dependence on others, cognitive and physical decline, and the ultimate prospect of death. Data suggest that most advanced cancer patients desire to share their cancer-related thoughts and feelings with others and view emotional and existential concerns as very important. Yet, some patients feel constrained in discussing their cancer-related experiences, and very few formal interventions have been developed to help cancer patients cope with end-of-life concerns. In this study, 74 women with Stage IV breast cancer will be randomly assigned to one of two conditions: 1) emotional disclosure writing intervention, or 2) control writing. Women in the emotional disclosure writing condition will write about their deepest thoughts and feelings regarding their breast cancer experience, whereas women in the control writing condition will write about their daily activities in a detailed manner. Women in both conditions will be asked to complete four, 20-minute writing sessions that are administered via telephone. Assessments will be conducted before the intervention and at 8 weeks post- intervention. Primary outcomes include indices of distress (i.e., depressive symptoms and demoralization), and secondary outcomes include a sense of meaning in life and peace, pain severity, sleep disturbance, fatigue, and functional impairment. We hypothesize that women assigned to the emotional disclosure writing condition will experience better psychological and physical health at follow-up relative to controls. We also hypothesize that the writing intervention will be most beneficial for women who feel constrained in discussing their cancer experience with others. This study will provide new information regarding the feasibility and utility of a telephone- administered expressive writing intervention for advanced cancer patients. Consistent with the mission of the National Cancer Institute, this research aims to promote public health by reducing adverse outcomes of cancer and its treatment and enhancing patients' well-being. Results of this project have the potential to inform future studies of emotional disclosure interventions for cancer patients and clinical practice.

描述（由申请人提供）：近二十年的研究，主要是健康的样本已经证明，写一个人的情绪与负面事件在几个简短的会议可以提高身体和心理健康。对主要是早期癌症患者的有希望的研究表明，表达性写作产生健康益处，例如减少疼痛和癌症相关疾病的医疗访问。迄今为止的研究还没有研究表达性写作对转移性乳腺癌女性的潜在益处，这些女性面临着对他人的依赖性增加，认知和身体下降，以及最终的死亡前景。数据表明，大多数晚期癌症患者希望与他人分享他们与癌症相关的想法和感受，并将情感和存在的担忧视为非常重要的。然而，一些患者在讨论他们与癌症相关的经历时感到受到限制，并且很少有正式的干预措施被开发出来以帮助癌症患者科普临终关怀。在这项研究中，74名患有IV期乳腺癌的女性将被随机分配到两种情况之一：1）情绪披露写作干预，或2）控制写作。在情绪表露写作条件下的女性会写下她们对乳腺癌经历的最深的想法和感受，而在控制写作条件下的女性会详细地写下她们的日常活动。这两种情况下的女性将被要求完成四个20分钟的写作会议，通过电话进行管理。将在干预前和干预后8周进行评估。主要结果包括痛苦指数（即，抑郁症状和士气低落），次要结果包括生活与和平的意义感、疼痛严重程度、睡眠障碍、疲劳和功能障碍。我们假设，女性分配到情绪披露写作条件将经历更好的心理和身体健康在后续相对于控制。我们还假设，写作干预对那些在与他人讨论癌症经历时感到受限的女性最有益。这项研究将提供新的信息有关的可行性和效用的电话管理的表达性写作干预晚期癌症患者。与国家癌症研究所的使命一致，这项研究旨在通过减少癌症及其治疗的不良后果和提高患者的福祉来促进公共健康。该项目的结果有可能为癌症患者和临床实践的情绪披露干预措施的未来研究提供信息。