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Capturing the Experience: Reflections of Women With Breast Cancer Engaged in an Expressive Writing Intervention

Gripsrud, Birgitta Haga PhD; Brassil, Kelly J. PhD, RN; Summers, Barbara PhD, RN, FAAN; Søiland, Håvard PhD, MD; Kronowitz, Steven MD; Lode, Kirsten PhD, RN

doi: 10.1097/NCC.0000000000000300
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Background: Expressive writing has been shown to improve quality of life, fatigue, and posttraumatic stress among breast cancer patients across cultures. Understanding how and why the method may be beneficial to patients can increase awareness of the psychosocial impact of breast cancer and enhance interventional work within this population. Qualitative research on experiential aspects of interventions may inform the theoretical understanding and generate hypotheses for future studies.

Aim: The aim of the study was to explore and describe the experience and feasibility of expressive writing among women with breast cancer following mastectomy and immediate or delayed reconstructive surgery.

Methods: Seven participants enrolled to undertake 4 episodes of expressive writing at home, with semistructured interviews conducted afterward and analyzed using experiential thematic analysis.

Results: Three themes emerged through analysis: writing as process, writing as therapeutic, and writing as a means to help others.

Conclusions: Findings illuminate experiential variations in expressive writing and how storytelling encourages a release of cognitive and emotional strains, surrendering these to reside in the text. The method was said to process feelings and capture experiences tied to a new and overwhelming illness situation, as impressions became expressions through writing. Expressive writing, therefore, is a valuable tool for healthcare providers to introduce into the plan of care for patients with breast cancer and potentially other cancer patient groups.

Implications for Practice: This study augments existing evidence to support the appropriateness of expressive writing as an intervention after a breast cancer diagnosis. Further studies should evaluate its feasibility at different time points in survivorship.

Author Affiliations: Departments of Research (Drs Gripsrud and Lode) and Breast and Endocrine Surgery (Dr Søiland), Stavanger University Hospital, Stavanger; and Department of Clinical Science, University of Bergen, Bergen, Norway (Dr Søiland); Division of Nursing (Drs Brassil and Summers); and Department of Plastic Surgery (Dr Kronowitz), The University of Texas M. D. Anderson Cancer Center, Houston, Texas.

Funding for this research was partly provided by Folke Hermansen Cancer Research Foundation and Inge Steensland Foundation, Stavanger, Norway. This research was also partly supported by the National Institutes of Health through M. D. Anderson’s cancer center support grant CA016672.

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.cancernursingonline.com).

Correspondence: Birgitta Haga Gripsrud, PhD, Department of Research, Stavanger University Hospital, PO Box 8100, 4068 Stavanger, Norway (ripsgrud@yahoo.com).

Accepted for publication March 16, 2015.

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