Radiation Therapy Patient Education: A Scoping Review to Identify Future Directions for Scholarship.

Abstract

Patient education is demonstrated to reduce patient anxiety, facilitate shared decision-making, and improve treatment outcomes. This scoping review characterizes the state of radiation therapy patient education (RPE) scholarship to identify research trends and knowledge gaps to guide future patient education research efforts. A scoping review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review guidelines. PubMed and a modified snowball method with Google Scholar were used to identify publications describing RPE. English language articles published after January 1, 1990, that primarily focused on patient education in radiation oncology were included. Descriptive statistics were used to characterize the types of RPE scholarship. A total of 1128 publications were identified, with 236 meeting the inclusion criteria. The most common education topic was "general overview of treatment" (46.2%), followed by "treatment logistics" (20.3%) and "toxicity management" (14%). 45.6% of included articles were primarily problem identification or needs assessment, 48.7% were implementation focused, and 3.8% included components of both. Of 115 interventional studies, 51.3% were experimental and 48.7% were observational, with 52 case series (45.2%) and 46 randomized trials (40.0%) as the most prevalent study designs. Educational formats were verbal (40.9%), print (33.9%), video (21.7%), electronic education (11.3%), audio (10.4%), and virtual reality (8.7%). The modified Kirkpatrick level of evaluation was "reaction" (44.3%), "results" (26.9%), "learning" (22.6%), and "change in behavior" (14.7%). A total of 63 out of the 115 (54.8%) intervention studies required staff support: nurses (58.7%), physicians (31.7%), radiation therapists (20.6%), and others (23.8%). A total of 46 out of the 115 (40%) interventional studies detailed educational material that the health care professional actively explained or used with the patient. This study identifies opportunities to further develop, implement, and evaluate RPE scholarship. The results suggest future studies should focus on interventional (6-step phases 3-6) studies and evaluating the extent to which they improve patient knowledge, reduce anxiety, or change behavior.