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Read RK, Mason OJ, Jones CJ. A randomised controlled trial (RCT) exploring the impact of a photography intervention on wellbeing and posttraumatic growth during the COVID-19 pandemic. Arts Health 2023; 15:275-291. [PMID: 35918101 DOI: 10.1080/17533015.2022.2107033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 07/22/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Emerging evidence points to rising levels of psychological distress resulting from the COVID-19 pandemic. There is a need for self-administered, low-cost, and accessible interventions that facilitate wellbeing and growth. METHODS This study used a randomised controlled trial (RCT) design to investigate the effects of a two-week positivity-oriented photography intervention on wellbeing and posttraumatic growth in comparison to a control group. Participants were adults between the ages of 21 and 80 living in the UK recruited between May and August 2020 (n = 109). RESULTS After adjusting for baseline wellbeing, both wellbeing and PTG were significantly higher in the intervention group compared to the control group following intervention completion, with this effect remaining similar at one-month follow-up. CONCLUSIONS The study offers preliminary evidence that a brief self-administered photography intervention could hold therapeutic value.
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Affiliation(s)
- Rebecca K Read
- School of Psychology, University of Surrey, Guildford, UK
| | - Oliver J Mason
- School of Psychology, University of Surrey, Guildford, UK
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2
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Caring for Carers (C4C): Results from a feasibility randomised controlled trial of positive written disclosure for older adult carers of people with psychosis. PLoS One 2022; 17:e0277196. [DOI: 10.1371/journal.pone.0277196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/06/2022] [Indexed: 11/11/2022] Open
Abstract
Background
Older adult carers of people who experience psychosis are at increased risk of developing physical and mental health problems due to the compounding factors of supporting their care-recipient and the health changes associated with ageing. Effective interventions exist but can be difficult to access and maintain prolonged engagement. Self-directed writing therapies, frequently referred to as Written Emotional Disclosure (WED), might be a suitable alternative intervention to improve the wellbeing of carers.
Methods
This study aimed to determine the feasibility (recruitment, retention and primary outcome completion) and acceptability of a specific WED intervention known as Positive Written Disclosure (PWD). Informal carers of people with psychosis were randomised to PWD, neutral writing or no writing. Quantitative outcomes including positive and negative affect, carer wellbeing, quality of life, depression, anxiety, stress, self-efficacy, leisure time satisfaction as well as health care utilisation were collected at baseline, 1-, 3-, and 6-month assessments. Qualitative feedback was also collected via questionnaire and semi-structured interviews from those randomised to either writing group.
Results
We successfully met our progression criteria, recruiting to target and within timeframes whilst attaining 97% retention and 84% primary outcome data completed at 6 months. Carers randomised to the positive writing group described the intervention as enabling them to have a more positive attitude and focus on activities for themselves. Both writing groups described their tasks as providing distraction from caring responsibilities. However, some carers found the narrow positive emotion focus challenging.
Conclusions
PWD is a feasible and acceptable intervention for older adult carers of people with psychosis within a community setting. Further refinement of the writing protocol to include choice in type of emotion disclosed in addition to screening for some level of need may be required in future trials to reduce floor/ceiling effects of outcomes which may explain the lack of change observed.
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3
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Dadkhahtehrani T, Khalili M, Torabi F, Heidari Z. The effect of expressive writing on fear of childbirth among nulliparous pregnant women: A randomized controlled trial. Nurs Midwifery Stud 2022. [DOI: 10.4103/nms.nms_20_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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4
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Oishi A. Positive Expressive Writing as a Stress Management Strategy for Japanese Students: Willingness to Engage in Expressive Writing. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2021.1963902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ayano Oishi
- Graduate School Of Humanities And Sciences, Ochanomizu University, Tokyo, Japan
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5
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Alschuler L, Chiasson AM, Horwitz R, Sternberg E, Crocker R, Weil A, Maizes V. Integrative medicine considerations for convalescence from mild-to-moderate COVID-19 disease. Explore (NY) 2020; 18:140-148. [PMID: 33358750 PMCID: PMC7756157 DOI: 10.1016/j.explore.2020.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 12/13/2022]
Abstract
The majority of individuals infected with SARS-CoV-2 have mild-to-moderate COVID-19 disease. Convalescence from mild-to-moderate (MtoM) COVID-19 disease may be supported by integrative medicine strategies. Integrative Medicine (IM) is defined as healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. Integrative medicine strategies that may support recovery from MtoM COVID-19 are proposed given their clinically studied effects in related conditions. Adoption of an anti-inflammatory diet, supplementation with vitamin D, glutathione, melatonin, Cordyceps, Astragalus and garlic have potential utility. Osteopathic manipulation, Qigong, breathing exercises and aerobic exercise may support pulmonary recovery. Stress reduction, environmental optimization, creative expression and aromatherapy can provide healing support and minimize enduring trauma. These modalities would benefit from clinical trials in people recovering from COVID-19 infection.
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Affiliation(s)
- Lise Alschuler
- University of Arizona, College of Medicine, United States; Andrew Weil Center for Integrative Medicine, United States.
| | - Ann Marie Chiasson
- University of Arizona, College of Medicine, United States; Andrew Weil Center for Integrative Medicine, United States
| | - Randy Horwitz
- University of Arizona, College of Medicine, United States; Andrew Weil Center for Integrative Medicine, United States
| | - Esther Sternberg
- University of Arizona, College of Medicine, United States; Andrew Weil Center for Integrative Medicine, United States
| | - Robert Crocker
- University of Arizona, College of Medicine, United States; Andrew Weil Center for Integrative Medicine, United States
| | - Andrew Weil
- Andrew Weil Center for Integrative Medicine, United States; University of Arizona, United States
| | - Victoria Maizes
- University of Arizona, College of Medicine, United States; Andrew Weil Center for Integrative Medicine, United States
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Davis PA, Gustafsson H, Callow N, Woodman T. Written Emotional Disclosure Can Promote Athletes' Mental Health and Performance Readiness During the COVID-19 Pandemic. Front Psychol 2020; 11:599925. [PMID: 33329269 PMCID: PMC7728796 DOI: 10.3389/fpsyg.2020.599925] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/02/2020] [Indexed: 12/17/2022] Open
Abstract
The widespread effects of the coronavirus disease 2019 (COVID-19) pandemic have negatively impacted upon many athletes’ mental health and increased reports of depression as well as symptoms of anxiety. Disruptions to training and competition schedules can induce athletes’ emotional distress, while concomitant government-imposed restrictions (e.g., social isolation, quarantines) reduce the availability of athletes’ social and emotional support. Written Emotional Disclosure (WED) has been used extensively in a variety of settings with diverse populations as a means to promote emotional processing. The expressive writing protocol has been used to a limited extent in the context of sport and predominantly in support of athletes’ emotional processing during injury rehabilitation. We propose that WED offers an evidence-based treatment that can promote athletes’ mental health and support their return to competition. Research exploring the efficacy of the expressive writing protocol highlights a number of theoretical models underpinning the positive effects of WED; we outline how each of these potential mechanisms can address the multidimensional complexity of the challenging circumstances arising from the COVID-19 pandemic (e.g., loss of earnings, returning to training and competition). Considerations and strategies for using WED to support athletes during the COVID-19 pandemic are presented.
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Affiliation(s)
- Paul A Davis
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Henrik Gustafsson
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.,Norwegian School of Sport Sciences, Oslo, Norway
| | - Nichola Callow
- School of Sport, Health, and Exercise Sciences, Bangor University, Bangor, United Kingdom
| | - Tim Woodman
- School of Sport, Health, and Exercise Sciences, Bangor University, Bangor, United Kingdom
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7
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Wu Y, Liu L, Zheng W, Zheng C, Xu M, Chen X, Li W, Xie L, Zhang P, Zhu X, Zhan C, Zhou C. Effect of prolonged expressive writing on health outcomes in breast cancer patients receiving chemotherapy: a multicenter randomized controlled trial. Support Care Cancer 2020; 29:1091-1101. [PMID: 32601853 DOI: 10.1007/s00520-020-05590-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/23/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aims to evaluate the effects of prolonged expressive writing on health outcomes in breast cancer patients undergoing chemotherapy to help understand how the dosage of an expressive writing intervention might moderate its effects. METHODS A total of 112 breast cancer patients undergoing chemotherapy were randomly allocated to the expressive writing group (n = 56) or the prolonged expressive writing group (n = 56). The expressive writing group received the standard expressive writing intervention based on Pennebaker's prompt to write for at least 20 min over four consecutive days (4 sessions). The prolonged expressive writing group used a modified prompt: write for at least 20 min 3 times a week over a 4-week period (12 sessions); patients could choose whether to write on consecutive days or not. All participants were required to write about their stressor-related upsetting or traumatic feelings about breast cancer. Outcomes were assessed and compared at baseline, as well as 1 month, 3 months, and 6 months postintervention. RESULTS There was no significant difference in the patients' quality of life, or physical and psychological wellbeing between the expressive writing group and the prolonged expressive writing group at any time point (all p > .05). The quality of life of breast cancer patients significantly decreased in the two groups over time (F = 40.64, p < .001). CONCLUSION Our findings suggest that the writing dosage does not moderate the effects of expressive writing on breast cancer patients undergoing chemotherapy. TRIAL REGISTRATION ChiCTR1800016278.
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Affiliation(s)
- Yanni Wu
- Nanfang Hospital, Southern Medical University, NO.1838 North Guangzhou Avenue, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Liping Liu
- Nanfang Hospital, Southern Medical University, NO.1838 North Guangzhou Avenue, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Wanting Zheng
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Chunrao Zheng
- Shenzhen People's Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Min Xu
- Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaohong Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Wenji Li
- Nanfang Hospital, Southern Medical University, NO.1838 North Guangzhou Avenue, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Lijun Xie
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Pengyan Zhang
- Shenzhen People's Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Xiaoli Zhu
- Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Chuanglian Zhan
- The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Chunlan Zhou
- Nanfang Hospital, Southern Medical University, NO.1838 North Guangzhou Avenue, Baiyun District, Guangzhou City, Guangdong Province, China.
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McNatt ZZ, Freels PE, Chandler H, Fawad M, Qarmout S, Al-Oraibi AS, Boothby N. "What's happening in Syria even affects the rocks": a qualitative study of the Syrian refugee experience accessing noncommunicable disease services in Jordan. Confl Health 2019; 13:26. [PMID: 31210780 PMCID: PMC6567402 DOI: 10.1186/s13031-019-0209-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 05/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Humanitarian actors and host-countries in the Middle East and North Africa region are challenged with meeting the health needs of Syrian refugees and adjusting the response to contemporary humanitarian conditions - urban-based refugees, stressed host-country health systems and high NCD prevalence. Although several studies have explored NCD prevalence, utilization of services and barriers to access, these analyses took place prior to dramatic shifts in Jordanian health policy and did not account for nuances in health seeking and utilization behaviors or operational barriers. Accordingly, we aimed to understand the depth and nuances of Syrian refugees' experiences accessing NCD services in urban and semi-urban settings in Jordan. METHODS A qualitative study was conducted to explore the healthcare experiences of Syrian refugees in Jordan. The study team conducted 68 in-depth interviews with Syrian refugees in urban and semi-urban locations in central and northern Jordan. RESULTS The findings indicated four themes key to understanding the healthcare experience: (1) emotional distress is a central concern and is frequently highlighted as the trigger for a non-communicable disease or its exacerbation; (2) service provision across all sectors - government, NGO, private - is complex, inadequate, expensive and fragmented, making engagement with the health sector physically and financially burdensome; (3) given financial constraints, participants make harmful decisions that further damage their health in order to reduce financial burdens, and (4) host-community members actively exhibit solidarity with their refugee neighbors and specifically do so during emergency health episodes. The findings from this study can be used to inform program design for forcibly displaced persons with NCDs and identify points of entry for effective interventions. CONCLUSIONS Opportunities exist for humanitarian and host-country actors to provide more comprehensive NCD services and to improve the relevance and the quality of care provided to Syrian refugees in Jordan. Global and national funding will need to align with front-line realities and foster better coordination of services between host-country health systems, private actors and non-governmental organizations.
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Affiliation(s)
- Zahirah Zahrah McNatt
- Columbia University Mailman School of Public Health, 60 Haven Avenue, B4, New York, NY 10032 USA
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Michailidis E, Cropley M. Testing the benefits of expressive writing for workplace embitterment: a randomized control trial. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2019. [DOI: 10.1080/1359432x.2019.1580694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Mark Cropley
- School of Psychology, University of Surrey, Guildford, UK
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10
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Smyth JM, Johnson JA, Auer BJ, Lehman E, Talamo G, Sciamanna CN. Online Positive Affect Journaling in the Improvement of Mental Distress and Well-Being in General Medical Patients With Elevated Anxiety Symptoms: A Preliminary Randomized Controlled Trial. JMIR Ment Health 2018; 5:e11290. [PMID: 30530460 PMCID: PMC6305886 DOI: 10.2196/11290] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/14/2018] [Accepted: 09/16/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Positive affect journaling (PAJ), an emotion-focused self-regulation intervention, has been associated with positive outcomes among medical populations. It may be adapted for Web-based dissemination to address a need for scalable, evidence-based psychosocial interventions among distressed patients with medical conditions. OBJECTIVE This study aimed to examine the impact of a 12-week Web-based PAJ intervention on psychological distress and quality of life in general medical patients. METHODS A total of 70 adults with various medical conditions and elevated anxiety symptoms were recruited from local clinics and randomly assigned to a Web-based PAJ intervention (n=35) or usual care (n=35). The intervention group completed 15-min Web-based PAJ sessions on 3 days each week for 12 weeks. At baseline and the end of months 1 through 3, surveys of psychological, interpersonal, and physical well-being were completed. RESULTS Patients evidenced moderate sustained adherence to Web-based intervention. PAJ was associated with decreased mental distress and increased well-being relative to baseline. PAJ was also associated with less depressive symptoms and anxiety after 1 month and greater resilience after the first and second month, relative to usual care. CONCLUSIONS Web-based PAJ may serve as an effective intervention for mitigating mental distress, increasing well-being, and enhancing physical functioning among medical populations. PAJ may be integrated into routine medical care to improve quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT01873599; https://clinicaltrials.gov/ct2/show/NCT01873599 (Archived by WebCite at http://www.webcitation.org/73ZGFzD2Z).
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Affiliation(s)
- Joshua M Smyth
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States.,Department of Medicine, Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Jillian A Johnson
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
| | - Brandon J Auer
- Department of Medicine, Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Erik Lehman
- Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Giampaolo Talamo
- Department of Medicine, Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Christopher N Sciamanna
- Department of Medicine, Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, United States
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11
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Schmidt S, Hahm S, Freitag S. Writing interventions in older adults and former children of the World War II: impact on quality of life and depression. Aging Ment Health 2018; 22:1017-1024. [PMID: 28581335 DOI: 10.1080/13607863.2017.1334036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The aim of the current study was to analyze whether biographical writing interventions have an impact on depression and QoL compared to daily diary writing. We also wanted to investigate differential effects between structured and unstructured interventions. METHOD In two Northern regions of Germany, 119 older adults aged 64-90 were randomly assigned to three different types of narrative writing interventions: written structured and unstructured biographical disclosure as well as daily diary writing. Depression (PHQ-9), QoL (SF-12, EUROHIS) and trauma-related symptoms (PCL-C) were obtained pre- and post-interventions as well as at three-month follow-up. RESULTS Follow-up measures were obtained from 85 participants (29% loss to follow-up; mean age = 73.88; 68.2% female). Results of repeated measurement analysis demonstrated a significant effect on depression with the daily diary writing group showing lower depressive symptoms than structured biographical writing. We did not find a significant impact on QoL. Post-hoc analyses showed that posttraumatic symptoms lead to increases in depressive symptoms. CONCLUSION In a non-clinical sample of community-dwelling older adults, biographical writing interventions were not favorable to daily diary writing concerning the outcomes of the study. This might be related to the association of traumtic reminiscences of former children of World War II and outcome measures.
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Affiliation(s)
- Silke Schmidt
- a Department Health and Prevention, Institute of Psychology , Ernst-Moritz-Arndt-University of Greifswald , Greifswald , Germany
| | - Stefanie Hahm
- a Department Health and Prevention, Institute of Psychology , Ernst-Moritz-Arndt-University of Greifswald , Greifswald , Germany
| | - Simone Freitag
- a Department Health and Prevention, Institute of Psychology , Ernst-Moritz-Arndt-University of Greifswald , Greifswald , Germany
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12
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Tonarelli A, Cosentino C, Tomasoni C, Nelli L, Damiani I, Goisis S, Sarli L, Artioli G. Expressive writing. A tool to help health workers of palliative care. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:35-42. [PMID: 30038202 PMCID: PMC6357597 DOI: 10.23750/abm.v89i6-s.7452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 11/23/2022]
Abstract
Background and aims: From a previous study (1) was highlighted that Expressive writing is an important strategy for preventing and managing the effects of compassion fatigue (2). It helps educate caregivers in recognising these feelings and providing them with a “space” and a time for their reflection. This, in turn, results in significant positive repercussions on the quality of service, reducing burnout risk, implementing coping strategies, and increasing perceived work satisfaction. Reflecting occasionally in writing about ambiguous and emotionally charged situations helps in many ways: it facilitates clarification and problem-solving, and makes one more spontaneous and present in social situations, more in tune with others and available to interact. People begin to interact differently with others and see themselves in a new light after writing about an emotional subject. The objective of thi study is ascertain and confirm the results of the previous study using a reduced methodological approach. Infact, the difference from the previous research is the use of only two expressive writing sessions. Methods: A comparison was made between the expressive writing and neutral writing of two randomized groups of health care professionals of palliative care. They were evaluated pre- and post-intervention using several scales and an ad hoc questionnaire. Results: After analyzing the texts, this study confirm previous results, using only two sessions.
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13
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Shen L, Yang L, Zhang J, Zhang M. Benefits of expressive writing in reducing test anxiety: A randomized controlled trial in Chinese samples. PLoS One 2018; 13:e0191779. [PMID: 29401473 PMCID: PMC5798770 DOI: 10.1371/journal.pone.0191779] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 01/11/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose To explore the effect of expressive writing of positive emotions on test anxiety among senior-high-school students. Methods The Test Anxiety Scale (TAS) was used to assess the anxiety level of 200 senior-high-school students. Seventy-five students with high anxiety were recruited and divided randomly into experimental and control groups. Each day for 30 days, the experimental group engaged in 20 minutes of expressive writing of positive emotions, while the control group was asked to merely write down their daily events. A second test was given after the month-long experiment to analyze whether there had been a reduction in anxiety among the sample. Quantitative data was obtained from TAS scores. The NVivo10.0 software program was used to examine the frequency of particular word categories used in participants’ writing manuscripts. Results Senior-high-school students indicated moderate to high test anxiety. There was a significant difference in post-test results (P < 0.001), with the experimental group scoring obviously lower than the control group. The interaction effect of group and gender in the post-test results was non-significant (P > 0.05). Students’ writing manuscripts were mainly encoded on five code categories: cause, anxiety manifestation, positive emotion, insight and evaluation. There was a negative relation between positive emotion, insight codes and test anxiety. There were significant differences in the positive emotion, anxiety manifestation, and insight code categories between the first 10 days’ manuscripts and the last 10 days’ ones. Conclusions Long-term expressive writing of positive emotions appears to help reduce test anxiety by using insight and positive emotion words for Chinese students. Efficient and effective intervention programs to ease test anxiety can be designed based on this study.
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Affiliation(s)
- Lujun Shen
- School of Psychology, Xinxiang Medical University, Xinxiang City, Henan Province, P. R. China
- * E-mail:
| | - Lei Yang
- School of Psychology, Xinxiang Medical University, Xinxiang City, Henan Province, P. R. China
| | - Jing Zhang
- School of Psychology, Xinxiang Medical University, Xinxiang City, Henan Province, P. R. China
| | - Meng Zhang
- School of Psychology, Xinxiang Medical University, Xinxiang City, Henan Province, P. R. China
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Hazell CM, Jones CJ, Hayward M, Bremner SA, O'Connor DB, Pinfold V, Smith HE. Caring for Caregivers (C4C): study protocol for a pilot feasibility randomised control trial of Positive Written Disclosure for older adult caregivers of people with psychosis. Pilot Feasibility Stud 2017; 3:63. [PMID: 29201390 PMCID: PMC5697360 DOI: 10.1186/s40814-017-0206-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 10/31/2017] [Indexed: 12/02/2022] Open
Abstract
Background The caregivers of people who experience psychosis are themselves at risk of developing physical and mental health problems. This risk is increased for older adult caregivers who also have to manage the lifestyle and health changes associated with ageing. As a consequence, older adult caregivers are in particular need of support; we propose a Written Emotional Disclosure (WED) intervention, called Positive Written Disclosure (PWD). Methods/design This is a pilot randomised controlled trial of PWD compared to a neutral writing control and a no writing condition. We aim to recruit 60 participants, 20 in each arm. This study will utilise a mixed-methods approach and collect quantitative (questionnaires) and qualitative (interviews) data. Quantitative data will be collected at baseline and 1, 3, and 6 months post baseline. Participants who complete a writing task (PWD or neutral writing control) will be invited to complete an exit interview to discuss their experiences of the intervention and study. The study is supported by a patient and public involvement group. Discussion The results of this trial will determine whether a definitive trial is justified. If so, the quantitative and qualitative findings will be used to refine the intervention and study protocols. Trial registration ISRCTN, ISRCTN79116352. Registered on 23 January 2017 Electronic supplementary material The online version of this article (10.1186/s40814-017-0206-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cassie M Hazell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, BN1 9PH UK
| | - Christina J Jones
- Department of Clinical Medicine, Royal Alexandra Children's Hospital, University of Sussex, Eastern Road, Brighton, BN2 5BE UK
| | - Mark Hayward
- Sussex Partnership NHS Foundation Trust, Research and Development Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ UK
| | - Stephen A Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, BN1 9PH UK
| | | | - Vanessa Pinfold
- The McPin Foundation, 32-36 Loman Street, London, SE1 0EH UK
| | - Helen E Smith
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, BN1 9PH UK.,Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Novena Campus, 11 Mandalay Road, Singapore, 308232 Singapore
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15
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Jones CJ, Hayward M, Brown A, Clark E, Bird D, Harwood G, Scott C, Hillemann A, Smith HE. Feasibility and Participant Experiences of a Written Emotional Disclosure Intervention for Parental Caregivers of People with Psychosis. Stress Health 2016. [PMID: 26223511 DOI: 10.1002/smi.2644] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Caregivers are at increased risk of poor health but often cannot engage with health care because of practical constraints. Writing therapies such as written emotional disclosure (WED) might represent an accessible therapy for this population. This study aimed to determine whether WED is a suitable therapy for caregivers of people with psychosis. Data were collected from a feasibility trial comparing WED with a neutral writing task. Twenty four participants completed writing tasks; the content was analysed using the Linguistic Inquiry Word Count (LIWC) programme. Twenty one participants provided feedback about the writing task, and data were analysed using Burnard's thematic content analysis. WED was feasible to implement in caregivers of people with psychosis. All participants ascribed benefit to writing tasks, the majority describing a cathartic effect, enjoying time to oneself or distraction from caregiving. Quantitative comparison indicated differences in emotional content between intervention and control writing. However, qualitative analysis showed that control participants found it challenging to write neutrally, the majority citing the care-recipient in their writing. Community-based WED is a feasible therapy for caregivers of people with psychosis. The need for refinement of the control writing task for use in caregivers is discussed. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Christina J Jones
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, Brighton, BN1 9PH, UK
| | - Mark Hayward
- Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Millview Hospital Site, Nevill Avenue, Hove, BN3 7HZ, UK.,School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Abigail Brown
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, Brighton, BN1 9PH, UK
| | - Elizabeth Clark
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Daniel Bird
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Gina Harwood
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Crystyn Scott
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Angela Hillemann
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Helen E Smith
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, Brighton, BN1 9PH, UK
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Kew KM, Nashed M, Dulay V, Yorke J. Cognitive behavioural therapy (CBT) for adults and adolescents with asthma. Cochrane Database Syst Rev 2016; 9:CD011818. [PMID: 27649894 PMCID: PMC6457695 DOI: 10.1002/14651858.cd011818.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND People with asthma have a higher prevalence of anxiety and depression than the general population. This is associated with poorer asthma control, medication adherence, and health outcomes. Cognitive behavioural therapy (CBT) may be a way to improve the quality of life of people with asthma by addressing associated psychological issues, which may lead to a lower risk of exacerbations and better asthma control. OBJECTIVES To assess the efficacy of CBT for asthma compared with usual care. SEARCH METHODS We searched the Cochrane Airways Group Specialised Register, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also searched reference lists of all primary studies and review articles and contacted authors for unpublished data. The most recent searches were conducted in August 2016. SELECTION CRITERIA We included parallel randomised controlled trials (RCTs) comparing any cognitive behavioural intervention to usual care or no intervention. We included studies of adults or adolescents with asthma, with or without comorbid anxiety or depression. We included studies reported as full text, those published as abstract only, and unpublished data. DATA COLLECTION AND ANALYSIS Two or more review authors independently screened the search results, extracted data, and assessed included studies for risk of bias. We analysed dichotomous data as odds ratios (ORs) and continuous data as mean differences (MDs) or standardised mean differences (SMD) where scales varied across studies, all using a random-effects model. The primary outcomes were asthma-related quality of life and exacerbations requiring at least a course of oral steroids. We rated all outcomes using GRADE and presented our confidence in the results in a 'Summary of findings' table. MAIN RESULTS We included nine RCTs involving 407 adults with asthma in this review; no studies included adolescents under 18. Study size ranged from 10 to 94 (median 40), and mean age ranged from 39 to 53. Study populations generally had persistent asthma, but severity and diagnostic measures varied. Three studies recruited participants with psychological symptomatology, although with different criteria. Interventions ranged from 4 to 15 sessions, and primary measurements were taken at a mean of 3 months (range 1.2 to 12 months).Participants given CBT had improved scores on the Asthma Quality of Life Questionnaire (AQLQ) (MD 0.55, 95% confidence interval (CI) 0.17 to 0.93; participants = 214; studies = 6; I2 = 53%) and on measures of asthma control (SMD -0.98, 95% CI -1.76 to -0.20; participants = 95; studies = 3; I2 = 68%) compared to people getting usual care. The AQLQ effect appeared to be sustained up to a year after treatment, but due to its low quality this evidence must be interpreted with caution. As asthma exacerbations requiring at least a course of oral steroids were not consistently reported, we could not perform a meta-analysis.Anxiety scores were difficult to pool but showed a benefit of CBT compared with usual care (SMD -0.38, 95% CI -0.73 to -0.03), although this depended on the analysis used. The confidence intervals for the effect on depression scales included no difference between CBT and usual care when measured as change from baseline (SMD -0.33, 95% CI -0.70 to 0.05) or endpoint scores (SMD -0.41, 95% CI -0.87 to 0.05); the same was true for medication adherence (MD -1.40, 95% CI -2.94 to 0.14; participants = 23; studies = 1; I2 = 0%).Subgroup analyses conducted on the AQLQ outcome did not suggest a clear difference between individual and group CBT, baseline psychological status, or CBT model. The small number of studies and the variation between their designs, populations, and other intervention characteristics limited the conclusions that could be drawn about these possibly moderating factors.The inability to blind participants and investigators to group allocation introduced significant potential bias, and overall we had low confidence in the evidence. AUTHORS' CONCLUSIONS For adults with persistent asthma, CBT may improve quality of life, asthma control, and anxiety levels compared with usual care. Risks of bias, imprecision of effects, and inconsistency between results reduced our confidence in the results to low, and evidence was lacking regarding the effect of CBT on asthma exacerbations, unscheduled contacts, depression, and medication adherence. There was much variation between studies in how CBT was delivered and what constituted usual care, meaning the most optimal method of CBT delivery, format, and target population requires further investigation. There is currently no evidence for the use of CBT in adolescents with asthma.
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Affiliation(s)
- Kayleigh M Kew
- St George's, University of LondonPopulation Health Research InstituteCranmer TerraceLondonUKSW17 0RE
| | - Marina Nashed
- Faculty of Medicine, Ain Shams University10 Abdeer streetEL ZietonCairoEgypt11724
| | - Valdeep Dulay
- University of SouthamptonPrimary Care ResearchSouthamptonUK
| | - Janelle Yorke
- Jean McFarlane Building, University of ManchesterSchool of Nursing, Midwifery & Social WorkOxford RoadManchesterUKM13 9PL
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Riddle J, Smith H, Jones C. Does written emotional disclosure improve the psychological and physical health of caregivers? A systematic review and meta-analysis. Behav Res Ther 2016; 80:23-32. [DOI: 10.1016/j.brat.2016.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 03/17/2016] [Accepted: 03/17/2016] [Indexed: 11/24/2022]
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