Evaluation of an educational program for nurses on the care coordination of pleural mesothelioma patients: A pilot randomized controlled trial

Our plain-English summary of Evaluation of an educational program for nurses on the care coordination of pleural mesothelioma patients: A pilot randomized controlled trial, by Y. Nagamatsu, W. Ono, Y. Sakyo, et al (Japan Journal of Nursing Science, 2026).

The study

• Authors: Y. Nagamatsu, W. Ono, Y. Sakyo, E. Barroga, K. Hosokawa, M. Ito, S. Matsuura, T. Fukujin, Y. Maehara, M. Ito, H. Mitsunaga, S. Nakajima, N. Fujimoto, K. Okabe
• Journal: Japan Journal of Nursing Science
• Published: 2026;23(1):e70043
• Type of article: Randomized trial
• Read it: PubMed · Publisher · Free full text

Abstract

Objective: This study aimed to evaluate the effects of the care coordination of pleural mesothelioma program (CCOM program), an educational program that we developed for nurses to improve their knowledge, attitude, and confidence on the care coordination of pleural mesothelioma (PM) patients.

Methods: In this randomized controlled study relative to the CCOM program, we measured the self-reported total scores of knowledge, attitude, and confidence of nurses before (pre-test) and after (post-test) the CCOM program. The CCOM program consisted of a care guide and nine study videos featuring various aspects of PM (2 h 15 min) and a face-to-face workshop (3 h 30 min). Sixty participants were randomly assigned to the intervention group (n = 30; with program) and control group (n = 30; without program). Fifty-eight participants completed the study (intervention group, 28; control group, 30). The total scores of knowledge, attitude, and confidence at pre-test and post-test were compared using one-way repeated measures analysis of variance (ANOVA).

Results: At pre-test, the groups showed no significant differences in age, experience of taking care of PM patients, and working department, except for the years of experience as a nurse. The CCOM program improved the knowledge, attitude, and confidence in the intervention group, whereas the control group showed stability in the scores. Repeated measures ANOVA showed significantly greater beneficial changes in the intervention group on main measurement scores.

Conclusions: The CCOM program was effective in improving the knowledge, attitude, and confidence of nurses on the care coordination of PM patients.

© 2026 The Author(s). Japan Journal of Nursing Science published by John Wiley & Sons Australia, Ltd on behalf of Japan Academy of Nursing Science.

In plain English

This pilot randomized controlled trial in Japan tested the CCOM program, which the authors developed to teach nurses care coordination for pleural mesothelioma patients. Invitations went to 24 hospitals with an asbestos disease center; 60 nurses agreed and were randomly assigned to the program or to no education. The program combined nine 15-minute videos and a care guide with a three-and-a-half-hour face-to-face workshop. Fifty-eight nurses were evaluated: 28 program, 30 control. Nurses completed questionnaires, including a knowledge test and self-ratings of attitude and confidence. Mean knowledge scores (0 to 8) rose from 3.7 to 7.3 in the program group versus 3.5 to 3.8 in controls. Attitude scores (10 to 50) rose from 32.6 to 40.0, versus 31.4 to 31.9. Confidence scores (10 to 50) rose from 23.4 to 40.3, versus 20.8 to 24.3. The between-group differences in change were statistically significant, adjusted for the control group's longer nursing experience. The authors concluded that the program significantly improved nurses' knowledge, attitude, and confidence. They noted that scores were measured only twice and the questionnaires had limited validity testing.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Open-label pilot randomized controlled trial with a pre-test and post-test design and two parallel groups at a 1:1 ratio
• Who was studied: Licensed nurses in Japan who understood Japanese. Invitation forms were sent to 24 hospitals with an asbestos disease center. 60 nurses agreed to participate and were randomized (30 per group). 58 were evaluated (28 intervention, 30 control). The study ran from November to December 2023.
• Exposure: The intervention was the CCOM educational program. It had a preparation stage (nine 15-minute videos, 2 h 15 min in total, plus a care guide handout) and a 3 h 30 min face-to-face workshop. The control group received no education.
• Main results:
  • Knowledge was measured with eight items scored right or wrong (range 0 to 8). Mean knowledge score: intervention group 3.7 (SD 1.6) at baseline and 7.3 (SD 0.9) at post-test; control group 3.5 (SD 1.4) and 3.8 (SD 1.6).
  • Knowledge: significant group-by-time interaction (p less than .001, eta squared 0.51)
  • Mean attitude score (5-point Likert items, range 10 to 50): intervention group 32.6 (SD 4.2) at baseline and 40.0 (SD 5.9) at post-test; control group 31.4 (SD 5.6) and 31.9 (SD 6.0). Group-by-time interaction p less than .001, eta squared 0.32.
  • Mean confidence score (5-point Likert items, range 10 to 50): intervention group 23.4 (SD 7.9) at baseline and 40.3 (SD 5.9) at post-test; control group 20.8 (SD 8.2) and 24.3 (SD 8.0). Group-by-time interaction p less than .001, eta squared 0.43.
  • The control group had significantly longer nursing experience than the intervention group (p = .003). This was adjusted for as a covariate.
  • Participants rated the program as appropriate in its implementation (96.3%) and its duration (93.3%), and as useful in caring for PM patients and their families (96.7%).
• The authors' conclusion: The authors concluded that the educational program significantly improved knowledge, attitude, and confidence in the intervention group compared with the control group, which received no program.
• Limitations the authors state:
  • Effects were measured only at two points, pre-test and post-test, with no follow-up to check whether they lasted.
  • The program did not include communication skills for caring for dying PM patients and their families.
  • The outcome questionnaires had been tested only for internal consistency and content validity. Concurrent validity was not assessed.
  • The program's true effectiveness must be judged by nurses' future care coordination practice and by the care satisfaction of patients and families, which were not measured.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

Related studies

• Impact of a nursing education program about caring for patients in Japan with malignant pleural mesothelioma on nurses' knowledge, difficulties and attitude: a randomized control trial — Y. Nagamatsu, Y. Natori, et al. (2014)
• Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients? — C.L. Paul, A.W. Boyes, et al. (2016)
• Beta-carotene supplementation and cancer risk: a systematic review and metaanalysis of randomized controlled trials — N. Druesne-Pecollo, P. Latino-Martel, et al. (2010)
• Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions: a randomized, controlled trial — M. Metintas, G. Ak, et al. (2010)
• Exploring efficacy and safety of oral Pirfenidone for progressive, non-IPF lung fibrosis (RELIEF) - a randomized, double-blind, placebo-controlled, parallel group, multi-center, phase II trial — J. Behr, P. Neuser, et al. (2017)
• Effectiveness of postal smoking cessation advice: a randomized controlled trial in young men with reduced FEV1 and asbestos exposure — S. Humerfelt, G.E. Eide, et al. (1998)

Browse return to medical research.