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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2011

Open Access 01-12-2011 | Study protocol

The WRITTEN-HEART study (expressive writing for heart healing): rationale and design of a randomized controlled clinical trial of expressive writing in coronary patients referred to residential cardiac rehabilitation

Authors: Gian Mauro Manzoni, Gianluca Castelnuovo, Enrico Molinari

Published in: Health and Quality of Life Outcomes | Issue 1/2011

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Abstract

Background

Coronary heart disease (CHD) is typically associated with many cardiovascular risk factors (e.g., elevated blood pressure), low health-related quality of life, depression, anxiety and psychological stress. Expressive writing (EW) has shown beneficial effects on such variables in both people from the community and in patients with a variety of chronic illnesses. However, no study to date has evaluated the physical and psychological effects of the expressive writing procedure on coronary patients referred to cardiac rehabilitation (CR).

Methods

The clinical effectiveness of a 2-week disease-related expressive writing procedure (writing about one's deepest thoughts and feelings regarding the experience with heart disease) compared with the standard writing task (writing about one's deepest thoughts and feelings about the most traumatic or negative event experienced in the life), a neutral writing condition (writing about the facts regarding heart disease and its treatment) and an empty control condition will be evaluated in a randomized controlled clinical trial (RCT) with repeated follow-up measurements at 3, 6 and 12 months after discharge from CR. The primary outcome is health-related quality of life (SF-12). Secondary outcome measures are depression (BDI-II), anxiety (BAI) and post-traumatic growth (PTGI). Furthermore, the study will explore the moderating effects of coping styles, type D personality, perceived emotional support and participants' evaluative ratings of the writing interventions on the main experimental effects in order to identify sub-groups of patients showing different results.

Discussion

The WRITTEN-HEART study aims to explore and expand the frontiers of the expressive writing research enterprise by investigating the feasibility, safety and clinical efficacy of brief and cost-effective expressive writing interventions in patients with CHD referred to CR.

Trial registration

ClinicalTrials.gov NCT01253486
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Metadata
Title
The WRITTEN-HEART study (expressive writing for heart healing): rationale and design of a randomized controlled clinical trial of expressive writing in coronary patients referred to residential cardiac rehabilitation
Authors
Gian Mauro Manzoni
Gianluca Castelnuovo
Enrico Molinari
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2011
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-9-51

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