Commentary

Although many studies report the effectiveness of nursing interventions on patient attitudes and behaviours,^1,2 few attempt to capture the link between changes in patients’ attitudes and their wellbeing. The study by Yates et al examined the way in which an intervention affected several aspects of patients’ lives.

The intervention (which appears to be easily integrated into clinical practice) improved patients’ knowledge, reduced concerns about side effects, and increased their sense of control. Despite these improvements, no change in wellbeing was found. Perhaps, however, the duration of the intervention (only 2 sessions, each <1 h) was insufficient to have an enduring effect. The authors suggest other possible explanations for the lack of a significant effect on wellbeing, including lack of patient specific targeting of the intervention and the differential effects of medical or social circumstances on the effectiveness of the intervention. However, the data may support use of a different theoretical approach and an alternative focus for the intervention (eg, a multimodal approach). Education alone is often not adequate, but education plus problem solving, social support, or additional approaches might lead to greater success in effecting change in patient outcomes.

Practitioners in oncology will find this study useful when evaluating educational programmes. The integration and individualisation of the intervention are commendable. The results also emphasise the value of including variables that measure both knowledge and wellbeing when evaluating effectiveness. Healthcare and oncology researchers should pay attention to the study’s design and questions, and the effect of the intervention on knowledge, side effects, perceived control over pain, and willingness to tolerate pain. The authors have provided a model for an intervention study with an emphasis on clinical applicability.