Feasibility and induced cognitive-emotional change of an emotional disclosure intervention adapted for home application

• Published in: Patient education and counseling 2007-05, Vol.66 (2), p.177-187
• Main Authors: van Middendorp, Henriët, Sorbi, Marjolijn J, van Doornen, Lorenz J.P, Bijlsma, Johannes W.J, Geenen, Rinie
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Analysis of Variance; Arthritis, Rheumatoid - prevention & control; Arthritis, Rheumatoid - psychology; Attitude to Health; Clinical Protocols; Cognition; Communication; Controlled clinical trial; Disclosure; Emotions; Feasibility study; Female; Health Knowledge, Attitudes, Practice; Home application; Home Care Services; Humans; Internal Medicine; Intervention; Male; Middle Aged; Negativism; Netherlands; Nursing; Patient Education as Topic - methods; Rheumatoid arthritis; Safety; Self Disclosure; Semantics; Time Management - methods; Time Management - psychology
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2006.11.009

Abstract Objective Emotional engagement, cognitive restructuring, and positive future directedness are considered core elements to induce change in emotional disclosure interventions. Our aim was to examine the induction of these elements and the feasibility of an emotional disclosure intervention adapted for home application. Methods The intervention emphasized expression of negative and positive emotions (session 1–4), search for meaning (session 3), and a positive future-oriented ending (session 4). A randomized clinical trial in patients with rheumatoid arthritis compared the adapted intervention ( n = 40) with a time management control condition ( n = 28). Feasibility was evaluated regarding adherence, compliance with instructions, perceived viability, and clinical safety. Induction of core elements was evaluated by analysis of change in immediate affective responses and by computerized text analysis of word use. Results Feasibility criteria were successfully met. The disclosure condition produced higher immediate negative affect and use of emotion, insight, and optimism words compared to control, and induced the elements of change within sessions as intended. Conclusion The adapted intervention is feasible for home application and induces change in variables that indicate emotional engagement, cognitive restructuring, and positive future directedness. Practice implications Empirical support of health benefits of this emotional disclosure intervention will extend its applicability in patient self-care.