The effects of expressive writing intervention in cancer patients and survivors: A rapid umbrella review

Abstract

Objectives: Numerous primary studies and systematic reviews, both with and without meta-analyses, examined the effects of expressive writing intervention (EWI), yielding mixed and inconsistent findings. The purpose of this review was to assess the effects of EWI on health outcomes in cancer patients using systematic reviews with or without meta-analyses. Materials and Methods: Google Scholar, Google, and Yahoo search engines and the Cochrane databases of systematic reviews published between 1986 and October 2019 were used to conduct the searches. Five studies met all of the criteria for inclusion. According to the AMSTAR tool, 80% of the included studies achieved a moderate level of methodological quality, while the remaining 20% achieved a low level of methodological quality. Results: There were no consistent or robust findings regarding expressive writing effects, with some studies (40%, n = 2) indicating that expressive writing has no general effectiveness. In comparison, others (40%, n = 2) indicated that expressive writing affects only physical health outcomes, and only one study (20%, n = 1) indicated that expressive writing has a general effect. In addition, several studies (40%, n = 2) discovered a moderating effect. Conclusion: In summary, the findings of this narrative overview indicate that there are mixed or inconsistent findings and several moderators regarding expressive writing effects in the cancer population, implying that substantial clinical heterogeneity and deviation from Pennebaker and Beal’s, 1986, initial experiment, as well as some moderating variables, may account for this finding. Thus, future primary and review studies should employ a more rigorous methodology and greater homogeneity, notably similar to that of Pennebaker and Beal’s original study in 1986, to replicate their initial findings.