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Effects of an expressive writing program for women with high-risk first pregnancies: a quasi-experimental study
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Jae-Mi Kwon, Hye-Jin Kim
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Received March 26, 2026 Accepted September 28, 2026 Published online October 12, 2026
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DOI: https://doi.org/10.4040/jkan.26045
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 Abstract
 ePub
- Purpose
This study aimed to develop an expressive writing program for hospitalized women with high-risk first pregnancies and evaluate its effects.
Methods
A nonequivalent control group pretest–posttest design was used. Hospitalized women with high-risk first pregnancies in the experimental group (n=24) participated in four expressive writing sessions over four days, whereas those in the control group (n=24) received standard nursing care. From May to November 2024, data on stress, state anxiety, depression, and maternal–fetal attachment were collected using structured questionnaires. Two-way repeated-measures analysis of variance was used to assess the effects of time, group, and their interaction on each outcome.
Results
For stress, the main effects of time (F=1.13, p=.327) and group (F=2.38, p=.130) were not significant; the time×group interaction (F=1.43, p=.244) was also not significant. For state anxiety, the main effects of time (F=9.41, p<.001) and group (F=5.03, p=.030) were significant, as was the time×group interaction (F=3.21, p=.045). For depression, the time×group interaction was also significant (F=3.13, p=.049).
Conclusion
This study confirmed the effectiveness of an expressive writing program in reducing state anxiety and depression among women with high-risk pregnancies. The findings may inform the development of nursing interventions to address emotional needs in this population, and future use of the program is anticipated.
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