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The Korean Journal of Health Psychology

The Effect of Expressive Writing Therapy on Family Cancer Caregiver’s Care-Burden and Psychological Wellbeing

The Korean Journal of Health Psychology / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2014, v.19 no.3, pp.655-672
https://doi.org/10.17315/kjhp.2014.19.3.002


Abstract

The purpose of this study was to investigate the effect of expressive writing therapy on care-burden and psychological wellbeing on individuals who had been caring for family member battling cancer. Thirty-four family caregivers were assigned to two groups; an expressive writing therapy(EWT) group and a control group with no interventions. EWT group wrote about topics related to their care-giving experiences, including thoughts and feelings four times for at least 15 minutes. Repeated measure ANOVA was conducted to analyze the treatment effect. The results showed that the EWT group had significant reduction in care-burden and improvement in psychological wellbeing after the treatment compared to the control group. This study suggests that writing about the care-giving experience, emotion and thought allowed caregivers to partly cope with the care-burden and to gain psychological wellbeing. Lastly, the limitation and the significance of this study was discussed.

keywords
암환자 가족, 돌봄부담감, 심리적 안녕감, 글쓰기 치료, 자기노출, 자기노출, Cancer caregiver, Care-burden, Psychological wellbeing, Expressive writing therapy, Disclosure

Reference

1.

국민건강보험공단 (2011). 2011년 상반기 건강보험주요통계.

2.

김교헌 (1994). 자기노출과 분노억제 경향에 따른 생리, 정서 및 자기이해 효과. 성균관대학교 대학원 박사학위 청구논문.

3.

김교헌, 한덕웅 (1996). 자기 노출의 목표, 자발성 및 분노억제경향이 생리적 각성, 정화 및 평가에 미치는효과. 한국건강심리학회지: 건강, 1(1), 66-88.

4.

김명소, 김혜원, 차경호 (2001). 심리적 안녕감의 구성개념 분석: 한국 성인 남녀를 대상으로. 한국심리학회지: 사회 및 성격, 15(2), 19-40.

5.

김명소, 김혜원, 차경호, 임지영, 한영석 (2003). 한국 성인의 행복한 삶의 구성요인 탐색 및 척도개발. 한국심리학회지: 건강, 8(2), 415-442.

6.

김미영, 홍기순 (2002). 항암 화학요법을 받는 암환자를돌보는 가족원이 지각한 스트레스와 건강상태. 간호과학논집, 7(1), 1-18.

7.

박선형 (2005). 암환자를 돌보는 보호부담이 가족원의우울에 미치는 영향에 관한 연구. 이화여자대학교석사학위논문.

8.

박연환, 유수정, 김신미, 이윤정 (2006). 뇌졸중 노인을돌보는 주 가족간호자의 안녕감 예측 요인. 대한간호학회지, 36(2), 373-380.

9.

박효정, 홍창희 (2010). 글쓰기 용서치료가 대인외상경험자의 심리적 적응에 미치는 효과. 한국심리학회지: 임상, 29, 83-107.

10.

백정미, 이민규 (2010). 스트레스 예방 훈련적 글쓰기를통한 자기 노출이 외상경험에 미치는 효과. 한국심리학회지: 임상, 29(1), 125-145.

11.

보건복지가족부 (2008). 61개 암종/성별 암발생자수, 상대빈도, 조발생률, 연령표준화발생률.

12.

양광희, 송미령, 김은경 (1998). 항암 화학요법을 받는환자가족의 스트레스와 적응에 관한 연구. 간호학논집, 12(1), 118-132.

13.

양무희, 윤경자 (2012). 암환자 및 그 가족의 가족레질리언스 강화 프로그램 개발과 효과성 검증. 대한가정학회지, 50(1), 121-139.

14.

오가실 (1997). 사회적 지지모임이 발달지연아 어머니의부담과 안녕에 미치는 영향. 대한간호학회지. 27(2), 389-400.

15.

오현자, 김교헌 (2009). 가출청소년의 외상경험에 대한자기노출이 부적정서와 침입 경험에 미치는 효과. 한국심리학회지: 건강, Vol.14, No.1, 89-106.

16.

유용식, 노승현 (2010). 성인 지적장애인 아버지와 어머니의 심리적 안녕감. 사회복지연구, 41(4), 247-276.

17.

이숙자 (1993). 노인입원 환자 가족이 인지한 부담감정도에 대한 연구. 전남대학교 석사학위논문.

18.

이영선 (2009). 사회적 지지와 암환자 가족의 삶의 질의관계에서 돌봄 부담감과 내적성장의 매개효과. 대한사회복지학, 61(2), 325-348.

19.

이용승, 원호택 (1999). 사고억제(Thought Suppression)와 통제 방략에서의 개인차에 관한 연구. 한국심리학회지: 임상, 18(1), 37-58.

20.

인현정, 김교헌 (2002). 약물 남용자의 자기노출이 부적정서와 신체병리 경험 및 약물에 대한 태도에 미치는 효과. 한국심리학회지: 건강, 7(1), 111-124.

21.

전혜진 (2009). 암환자 client 부부의 응집력 향상을 위한 노래심리치료. 이화여자대학교 석사학위논문.

22.

조계화, 김명자 (1997). 입원한 암환자와 재가 암환자의 가족지지, 희망, 삶의 질 정도에 관한 연구. 대한간호학회지, 27(2), 353-363.

23.

한덕웅, 박준호 (2005). 스트레스 사건에 관한 생각억제와 자기노출이 행복과 건강에 미치는 영향. 한국심리학회지: 건강, 10(2), 183-209.

24.

한덕웅, 박준호, 김교헌 (2004). 스트레스 사건에 관한자기노출, 반복생각 및 정서 경험이 신체건강에 미치는 영향. 한국심리학회지: 건강, 9(1), 99-130.

25.

Adams, K. (2006a). 저널치료의 실제. 서울: 학지사.

26.

Adams, K. (2006b). 저널치료: 자아를 찾아가는 나만의저널쓰기. 서울: 학지사.

27.

Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Journal of Continuing Professional Development, 11, 338-346.

28.

Barclay, L. J. & Sharlicki, D. P. (2009). Healing the wounds of organizational injustice: examining the benefits of expressive writing. Journal of Applied Psychology, 94, 511-523.

29.

Baumgarten, M., Battista, R. N., Infrante-Rivard, C., Hanley, J. A., Becker, R., & Gauthier. S. (1992). The psychological and physical health of family members caring for and elderly with dementia. Journal of Clinical Epidemiology, 45, 61-70.

30.

Brewin, C. R. & Lennard, H. (1999). Effects of mode of writing on emotional narratives. Journal of Traumatic Stress, 12, 355-361.

31.

Campbell, R. S. & Pennebaker, J. W. (2003). The secret life of pronouns: Flexibility in writing style and physical health. Psychological Science, 14, 60-65.

32.

Edward, B. & Clarke, V. (2004). The psychological impact of a cancer diagnosis on families: The influence of family functioning and patients'illness characteristics on depression and anxiety. Psycho-Oncology, 13, 562-576.

33.

Evance, R. & Thomas, F. (2009). Emotional interactions and an ethics of care: Caring relations in families affected by HIV and AIDS. Emotion, Space and Society, 2, 111-119.

34.

Foa, E. B. & Kozak, M. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35.

35.

Frisina, P. G., Borod, J. C., & Lepore, S. J. (2004). A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. Journal of Nervous & Mental Disease, 192, 629-634.

36.

Galloway, A. (1990). Young adult's reaction of the death of a parent. Oncology Nursing Forum, 17, 899-904.

37.

Given, C. W., Stommel, M., Given, B., Osuch, J., Kurtz, M. E., & Kurtz, J. C. (1993). The influence of cancer patients' symptoms and functional states on patients' depression and family caregivers' reaction and depression. Health Psychology, 12(4), 277-285.

38.

Graf, M. C., Gaudiano, B. A., & Geller, P. A. (2008). Written emotional disclosure: A controlled study of the benefits of expressive writing homework in outpatient psychotherapy. Psychotherapy Research, 18(4), 389-399.

39.

Iwamitsu, Y., Simoda, K., Hajime, A., Tani, T., Kodama, M., & Okawa, M. (2003). Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression. Psychiatry and Clinical Neurosciences, 57, 289-294.

40.

Kahn, J. H. & Garrison, A. M. (2009). Emotional self-disclosure and emotional avoidance: Relations with symptoms of depression and anxiety. Journal of Counseling Psychology, 56(4), 573–584.

41.

Konig, A., Eonta, A., Dyal, S. R., & Vrana, S.R. (2014). Enhancing the benefits of written emotional disclosure through response training. Behavior Therapy, 45, 344-357.

42.

Lepore, S. J. (1997). Expressive writing moderates the relation between intrusive thoughts and depressive symptoms. Journal of Personality and Social Psychology, 73, 1030-1037.

43.

Lieberman, M. A. & Goldstein, B. A. (2006). Not all negative emotions are equal: The role of emotional expression in online support groups for women with breast cancer. Psycho-Oncology, 15, 160-168.

44.

Lieberman, M. A. (2007). The role of insightful disclosure in outcomes for women in peer-directed breast cancer groups: A replication study. Psycho-oncology, 16, 961–964.

45.

Novak, M. N., & Guest, C. (1989). Application of a multidimensional caregiver burden inventory, The Gerontologist, 29(6), 798-803.

46.

Oberst, M. T., Thomas, S. E., Gass, K. A., & Ward, S. E. (1989). Caregiving demands and appraisal of stress among family caregivers. Cancer Nursing, 12(4), 209-215.

47.

Owen, J. E., Klapow, J. C., Roth, D. L., Shuster, J. L., Bellis, J., & Meredith, R. (2005). Randomized pilot of a self-guided internet coping group for women with early-stage breast cancer. Annals of Behavioral Medicine, 30, 54–64.

48.

Pantchenko, T., Lawson, M., & Joyce, M. R. (2003). Verbal and non-verbal disclosure of recalled negative experiences: Relation to well-being. Psychology and Psychotherapy: Theory, Research and Practice, 76, 251-265.

49.

Park, C. L. & Blumberg, C. J. (2002) Disclosing trauma through writing: testing the meaning-making hypothesis. Cognitive Therapy and Research, 26, 597-616.

50.

Pennebaker, J. W. (1989). Confession, inhibition and disease. Advances in Experimental Social Psychology, 22, 211-244.

51.

Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8(3), 162-166.

52.

Pennebaker, J. W. (2007). 글쓰기 치료. 서울: 학지사.

53.

Pennebaker, J. W. & Beall, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology. 95(3), 274-281.

54.

Pennebaker, J. W., Hughes, C. F., & O'Heeron, R. C. (1987). The psychophysiology of confession:Linking inhibitory and psychosomatic process. Journal of Personality & Social Psychology, 52, 781-793.

55.

Pennebaker, J. W., Kiecolt-Glaser, J. K., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56(2), 239-245.

56.

Pennebaker J. W. & O'Heeron, R. C. (1984). Confiding in others and illness rate among spouses of suicide and accidental-death victims. Journal of Abnormal Psychology, 93(4), 473-476.

57.

Pennebaker, J. W. & Seagal, J. D. (1999). Forming a story: The health benefits of narrative. Journal of Clinical Psychology, 55(10), 1243–1254.

58.

Pruchno, R. A., Parick, J. H., & Burant, C. J. (1996). Aging woman and their children with chronic disabilities: Perceptions of sibling involvement and effects on well-being. Family Relations, 45(3), 318-326.

59.

Pruchno, R. A. & Potashnik, S. L. (1989). Caregiving spouses: Physical and mental health in perspective. Journal of the American Geriatrics Society, 37, 697-705.

60.

Ruini, C., Ottolini, F., Rafanelli, C., Tossani, E., Ryff, C. D., & Fava, G. A. (2003). The relationship of psychological wellbeing to distress and personality. Psychotherapy and Psychosomatics, 72, 268-275.

61.

Shim, M., Cappella, J. N., & Han, J. Y. (2011). How does insightful and emotional disclosure bring potential health benefits? Study based on online support groups for women with breast cancer. Journal of Communication, 61, 432-454.

62.

Sloan, D. M. & Marx, B. P. (2004a). Taking pen to hand: evaluating theories underlying the written disclosure paradigm. Clinical Psychology: Science and Practice, 11, 121–137.

63.

Sloan, D. M. & Marx, B. P. (2004b). A closer examination of the structured written disclosure procedure. Journal of Consulting and Clinical Psychology, 72, 165–175.

64.

Smyth, J. M. (1998). Written emotional expression:Effect sizes, outcome types and moderating variables. Journal of Consulting and Clinical Psychology, 66, 174–184.

65.

Smyth, J. M., True, N., & Souto, J. (2001). Effects of writing about traumatic experiences: The necessity for narrative structuring. Journal of Social and Clinical Psychology, 20, 161–172.

66.

Stull, D. E., Kosloski, K., & Kercher, K. (1994). Caregiver burden and generic well-being:Opposite sides of the same coin? The Gerontologist, 34(1), 88-94.

67.

Ullrich, P. M. & Lutgendorf, S. K. (2002). Journaling about stressful events: Effects of cognitive processing and emotional expression. Annals Behavioral Medicine, 24(3), 244–250.

68.

Veksler, A. E. (2010). Does communication matter?:Testing the effects of expressive writing on stress in a college student sample. Unpublished doctoral dissertation, Arizona State University, AZ.

69.

Ward, M., Doherth, D. T., & Moran, R. (2007). It's good to talk: distress disclosure and psychological wellbeing. HRB Research series 1. Dublin: Health Research Board.

70.

Wegner, D. M., Schneider, D. J., Carter, S. R., & White, T. (1987). Paradoxical effects of thought suppression. Journal of Personality and Psychology, 53, 5-13.

71.

Wortman, C. B. & Dunkel-Schetter, C. (1979). Interpersonal relationships and cancer: A theoretical analysis. Journal of Social Issues, 35, 120-155.

The Korean Journal of Health Psychology