Evidence map›Paper›PMID 41723472›Full record

ArticleBMC nursing2026

A randomized controlled trial comparing visual-based and traditional educational materials in radiotherapy patient education: implications for nursing practice.

Huei-Fan Yang, Ying-Hsiang Chou, Chia-Wen Yeh, Jing-Yang Huang, Hsueh-Ya Tsai, Ya-Fang Ke, Pei-Fang Tsai, Hsiu-Man Chan, Tsung-Hsien Lee, Yueh-Chun Lee

Registry-linked trialAbstract read
In one paragraph

Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06678204 (Enhancing Self-care Strategies in Radiation Therapy Patients Through Diverse Smart and Flipped Education Compared to Traditional Text Booklets), which is not on this map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06678204 nacompletednot on this map

Enhancing Self-care Strategies in Radiation Therapy Patients Through Diverse Smart and Flipped Education Compared to Traditional Text Booklets

TypeinterventionalSponsorChung Shan Medical UniversityRan2023 to 2024Enrolled200ConditionsRadiation Therapy, Head Neck Cancer, Breast Cancer InvasiveArmsOptimized illustrated pamphlets
3 · Its place in the literature

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Huei-Fan YangDepartment of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan.
Ying-Hsiang ChouDepartment of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan.
Chia-Wen YehDepartment of Mass Communication and Public Relations Office, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan.
Jing-Yang HuangInstitute of Medicine, Chung Shan Medical University, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan.
Hsueh-Ya TsaiDepartment of Nursing, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan.
Ya-Fang KeDepartment of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan.
Pei-Fang TsaiDepartment of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan.
Hsiu-Man ChanDepartment of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan.
Tsung-Hsien LeeInstitute of Medicine, Chung Shan Medical University, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan. jackth.lee@gmail.com.
Yueh-Chun LeeDepartment of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung, 40201, Taiwan. lee.yuehchun@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEffective patient education is a core component of supportive care delivered by radiotherapy teams. However, conventional text-based materials may not adequately address the needs of patients with limited health literacy or high anxiety. Visual-enhanced educational tools may help patients better understand treatment procedures, manage side effects, and engage in self-care, but evidence from randomized controlled trials in radiotherapy settings remains limited.

methodsWe conducted a single-center, prospective, parallel-group randomized controlled trial including 200 adults (100 breast cancer and 100 head and neck cancer) initiating radiotherapy at a medical center. Participants were randomly assigned 1:1 (stratified by cancer type) to receive either visual-based illustrated pamphlets (enhanced group) or traditional text-based pamphlets (control group) as part of a standardized education session delivered by certified oncology nurses. Anxiety was assessed using the Hamilton Rating Scale for Anxiety (HAMA), and self-care knowledge was measured using a structured questionnaire, both at baseline and at two weeks after radiotherapy initiation. Inter-group differences in changes over time were examined using independent t-tests and analysis of covariance, with effect sizes and 95% confidence intervals reported.

resultsBoth groups demonstrated reductions in anxiety and improvements in self-care knowledge over time; however, the visual-based group showed significantly greater benefits. Participants who received illustrated materials had a larger decrease in total HAMA scores compared with the control group (mean change - 3.39 ± 4.48 vs. -0.17 ± 3.11; p < 0.0001). Enhanced improvements were also observed across multiple anxiety-related domains. In addition, the visual-based group achieved higher post-intervention scores on key self-care knowledge items, particularly in areas such as treatment frequency, skin protection, dietary adjustment, and hydration, with consistently significant inter-group differences.

conclusionsVisual-based educational materials delivered by certified oncology nurses significantly reduced anxiety and enhanced self-care knowledge among patients initiating radiotherapy, compared with traditional text-only materials. Integrating illustrated educational tools into routine radiotherapy education may promote patient-centered care and improve health literacy. Future studies should evaluate long-term behavioral outcomes, broader implementation in diverse oncology settings, and resource/workflow impact.

trial registrationThis randomized controlled trial was retrospectively registered at ClinicalTrials.gov (NCT06678204) on 29 October 2024 and is reported in accordance with the CONSORT 2025 Statement.

Indexed as

AnxietyHealth literacyHolistic healthcareInnovative educational interventionsNursing educationPatientsRadiation therapySelf-careTaiwan

Identifiers

PMID41723472
PMCPMC12998282

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.