Write to heal: the impact of an expressive writing intervention on stress in first-year nursing students

First-year nursing students often face high stress and challenges in adjusting to academic and social demands, which can negatively affect their psychological well-being and academic performance. Expressive writing, a brief therapeutic approach encouraging reflection on personal thoughts and emotions, has shown promise in reducing stress and enhancing college adjustment.

To evaluate the effectiveness of an expressive writing intervention in reducing stress and improving college adjustment among first-year nursing students in a multicultural higher education setting.

A quasi-experimental, controlled pre-test-post-test design was conducted at the College of Nursing, Ras Al Khaimah Medical and Health Sciences University, UAE, during the 2023-2024 academic year. Sixty first-year nursing students were recruited via purposive sampling and assigned to an intervention group (n = 30) or control group (n = 30). The intervention group participated in four consecutive daily 15-minute expressive writing sessions addressing academic stress, exams, expectations, and college life. Stress and college adjustment were assessed at baseline, immediately post-intervention, and at one- and three-month follow-ups using a modified Student Stress Inventory and adjustment to college scale. The control group received no intervention.

Both groups were comparable at baseline (overall stress: intervention 92.1 ± 13.7 vs. control 91.5 ± 12.9, p > 0.05). Post-intervention, the intervention group showed significant reductions in overall stress at immediate (100.96 ± 17.31 vs. 137.46 ± 7.11), one-month (90.06 ± 15.93 vs. 144.96 ± 7.57), and three-month follow-ups (82.70 ± 20.22 vs. 143.06 ± 8.64; all p < 0.001) compared to the control group. College adjustment scores significantly improved in the intervention group at immediate (2.93 ± 0.52 vs. 1.90 ± 0.71), one-month (3.03 ± 0.61 vs. 1.56 ± 0.67), and three-month assessments (3.16 ± 0.53 vs. 1.83 ± 0.69; all p < 0.001).

Expressive writing is a simple, low-cost strategy that can meaningfully reduce stress and help first-year nursing students adjust to college life. Beyond measurable outcomes, it offers students a safe space to reflect on personal challenges, promoting self-awareness, emotional resilience, and a more positive academic experience. Incorporating expressive writing into orientation programs or student wellness initiatives may empower students to navigate stress more effectively while fostering a supportive educational environment.

Not applicable.