Effectiveness of a Nurse-Led Patient Education for Oncology Patients to Promote Self-Management in Pain Therapy - An Exploratory Before-After Study.

Purpose
Pain reduction and the associated reduction in activities of daily living (ADL) should be achieved through targeted pain management and the promotion of patient self-management. We investigated whether a short, structured nursing patient education to promote self-management of pain therapy reduces pain-related limitations in ADL in patients with cancer.
Design
Exploratory before-after study.
Methods
Brief Pain Inventory total scores were compared between a control group and an intervention group receiving patient education. These scores reflect functional capacity in ADL and serve as a validated measure for assessing daily functioning, thereby enabling comparisons of limitations. Data were collected at baseline and follow-up (after four to eight weeks). Controlgroup data were used to adjust for caregiver-related effects. For this exploratory study, an a priori sample size of at least 30 patients per group was determined. Changes in pain scores were analyzed using multivariable linear regression, accounting for patient satisfaction with pain control and attitude toward pain management.
Results
A total of 31 controls and 31 exposed patients were assessed. Baseline characteristics were similar except for differences in satisfaction with pain control and attitude toward pain management. The education intervention significantly reduced painrelated ADL limitations compared to controls (-3.56 points; 95% CI: -7.11 to -0.01; p=0.049). Female patients showed greater benefits, though not statistically significant (p=0.293).
Conclusions
The patient education intervention was effective in enhancing pain self-management and overcoming limitations in ADL. While the results indicate only marginal statistical significance, it is important to consider that the control group received a conversation addressing patient questions. In typical clinical practice such specific communication between nursing staff and patients about pain management is uncommon. Therefore, the observed effect may underestimate the true impact in real-world settings.
Clinical Implications
Nurses should be encouraged to offer structured pain self-management instruction - such as the nurse-led patient education evaluated in this study - to improve daily living of oncology patients. The results should be confirmed in further controlled clinical trials.