Theory-based education improves nurses' competence in managing cancer pain in older cancer patients with cognitive...

Older cancer patients with cognitive decline are vulnerable to pain under-assessment and undertreatment because communicative and behavioural changes obscure symptom presentation, and existing observational tools capture only part of this prevalent pain burden. Consequently, this study aimed to develop and evaluate a structured nursing practice approach to enhance pain relief in older cancer patients with cognitive decline.

The approach was implemented as part of an educational programme targeting 52 nurses in two hospitals in Japan. Quantitative data were collected before and after the intervention using a 48-item measurement tool to assess the perceived difficulty of pain-management tasks and an 11-point ordinal scale to assess self-rated confidence in managing cancer-related pain. Linear mixed-effects models and cumulative link mixed models were applied to examine the effects of the intervention.

After the intervention, nurses reported that pain-management tasks were significantly less difficult and that their confidence in managing cancer-related pain had increased. The adjusted analyses also showed that their years of experience in cancer care were positively associated with both outcomes. The results suggest enhanced clinical competence and readiness to manage cancer-related pain in older patients with cognitive impairment.

A structured educational programme grounded in existing theoretical frameworks improved nurses' perceived competence in managing cancer-related pain in older adults with cognitive decline. These findings support the integration of such interventions into nursing education to promote consistent high-quality care for the vulnerable patient populations.