Effect of creative writing on mood in patients with cancer

Abstract

ObjectiveTo determine the feasibility of conducting creative writing workshops (CWW) for patients with cancer to promote improvement in mood.MethodWe piloted a prospective study to determine the feasibility of conducting CWW over a 4-week period. Patients were randomised 2:1 to either an intervention arm (IA) or to standard of care (SOC). Patients in the IA attended four 2-hour long weekly CWW × 4 weeks, whereas those receiving SOC did not participate in the CWW. We used a validated emotion thermometer scale (ETS) to assess changes in patient’s mental health before and after intervention. Patients with metastatic or unresectable cancer were included.Primary endpoint(1) Feasibility and (2) mood scores before and after CWW using ETS.ResultsA total of 16 patients were enrolled: 11 in the IA vs 5 in SOC. Seven out of 11 (63%) patients enrolled in the IA attended at least 75% of classes. Patients in the IA showed a trend towards mood improvement relative to the SOC when comparing initial and final ETS scores. Within the IA group significantly lower postclass total ETS scores were observed relative to preclass ETS scores. Also, a significant decreasing trend over time was observed in the preclass total ETS scores for participants in the IA group.ConclusionsIt is feasible for patients with cancer to attend CWW. Our results also show a positive effect on mood in the CWW arm. Further prospective clinical studies are needed to evaluate the effect of this intervention in patients with cancer.

Emotional disclosure in palliative care: A scoping review of intervention characteristics and implementation factors

“…Six trials investigated interventions using general trauma or negative experiences as at least one of the disclosure topics. Of these, studies reported a significant improvement in existential and spiritual wellbeing, 63 pain, 64 depressive symptoms, and anxiety 65 compared to control. Two did not find any significant effects on any measure (although they were not powered to do so).…”

“… 35 , 52 – 56 , 59 , 62 , 63 , 67 – 77 Eight studies investigated written disclosure. 57 , 58 , 60 , 61 , 65 , 66 , 78 , 79 Two studies explored flexible interventions, which gave participants the option of whether to speak or write, 25 , 33 Table 2 gives a description of the nature of these interventions.…”

“…RCTs testing spoken interventions reported significant effects on quality of life, 67 depression, 35 cancer-related distress, 68 pain, 64 self-compassion, 67 existential/spiritual wellbeing, 63 and interpersonal relationships. 62 , 67 Five RCTs investigating written interventions also reported significant effects compared to control on anxiety, 65 sleep, 61 uptake of mental health services, 57 intrusive thoughts, 58 somatic symptoms, 58 and quality of life. 60 Of the two RCTs that investigated a flexible intervention, one reported a significant improvement in psychological wellbeing 3 months post-intervention.…”

“…The majority of studies ( n = 19) investigated short-term interventions (classified as 2–8 sessions) delivered over a time period of up to 2 months. 25 , 33 , 53 , 56 – 63 , 65 – 68 , 72 , 73 , 75 , 78 , 79 Four studies investigated one-off interventions, two of which were RCTs that reported significant improvements in the emotional disclosure group compared to control (one on pain and one on depression). 35 , 64 The other two studies (one case study, and one that did not report on efficacy) investigated longer term interventions delivered on an ongoing weekly or monthly basis and no defined number of sessions.…”

“…75 And others suggested that the increased patient contact for people at an advanced stage of illness may in fact increase retention compared to those at an earlier stage of disease. 65 Ensuring a safe environment for disclosure. The importance of creating an environment where people feel comfortable to share difficult feelings was frequently highligh ted.…”