Expressive Writing and Wound Healing in Older Adults

Abstract

Australian New Zealand Clinical Trials Registry (trial number 343095).

The effects of expressive writing before or after punch biopsy on wound healing

“…Similar to this study, previous studies have also found that expressive writing does not reduce perceived stress, but still had an effect on wound healing (Koschwanez et al, 2013, Weinman et al, 2008). An alternative explanation is that the perceived stress scale used in all three of these studies is not sensitive enough to detect subtle changes in stress or the scale may not assess aspects of stress relevant to expressive writing.…”

“…It is thought that writing about stressful or traumatic events and upsetting emotions can help a person process the event, which in turn can decrease stress and rumination (Pennebaker, 1997). Expressive writing has been shown to have beneficial effects on the healing of punch biopsy wounds compared to writing factually about a neutral topic (Weinman, Ebrecht, Scott, Walburn and Dyson, 2008;Koschwanez et al, 2013). Consistent with these studies, a systematic review showed that emotional disclosure has significant effects on immune parameters (Frattaroli, 2006).…”

“…Ethics approval was obtained from The University of Auckland Human Participants Ethics Committee (UAHPEC). Previous research found the effect of expressive writing on wound healing to be moderate, Cramer's V = .35 (Koschwanez et al, 2013). With power set at .80 and a two tailed significance level of α = .05, the total sample size required for an ANCOVA analysis with four groups was calculated using G*Power to be 120 (30 participants per group).…”

“…Previous research 5 found that expressive writing performed prior to wounding significantly improved healing assessed ten to twelve days after the biopsy, and 90% of all wounds were healed by day 14 (Koschwanez et al, 2013). Therefore, the primary endpoint for this study was whether wounds were healed or not at ten days post-biopsy.…”

“…The previous two studies on emotional disclosure and wound healing both administered the intervention two weeks prior to wounding with instructions to write over the following three consecutive days (Weinman et al, 2008;Koschwanez et al, 2013). However, administering a writing intervention prior to surgery may be impractical in some situations, such as when emergency surgery is performed, when the date of surgery is 4 scheduled at late notice or surgery is postponed.…”