SIMULATION-BASED RADIOTHERAPY TECHNIQUE TRAINING FOR CANCER PATIENTS AND FAMILIES AT THE NORTH SUMATRA TEACHING HOSPITAL

Abstract

The increasing incidence and complexity of cancer diagnoses worldwide necessitate robust patient and family education strategies, particularly concerning radiotherapy treatment. Radiotherapy, a cornerstone of cancer management, often evokes significant anxiety and misunderstanding among patients and their caregivers due to its technical nature and potential side effects. Existing educational approaches, frequently relying on verbal explanations and static materials, have demonstrated limited efficacy in fostering deep comprehension and reducing distress. This gap is exacerbated by the escalating demand for specialized cancer care in educational hospitals, which are often at the forefront of implementing innovative patient support systems. Specifically, research indicates a significant deficit in the availability and empirical evaluation of simulation-based training programs designed to demystify radiotherapy techniques for both patients and their families within the Indonesian context, highlighting an urgent need for evidence-based educational interventions that enhance preparedness and mitigate treatment-related fear. This study aimed to evaluate the effectiveness of a simulation-based training program in enhancing knowledge, reducing anxiety, and improving preparedness among cancer patients and their families undergoing radiotherapy at a leading educational hospital in North Sumatra. This research is grounded in the Health Belief Model and Social Cognitive Theory, positing that enhanced knowledge and perceived control through simulation will positively influence health behaviors and outcomes. The primary hypothesis is that participation in the simulation-based training will lead to a statistically significant increase in knowledge about radiotherapy, a significant reduction in anxiety levels, and a demonstrably higher sense of preparedness compared to standard educational methods. A quasi-experimental, pre-test/post-test control group design was employed to assess the intervention's impact. A total of 80 participants, comprising 40 cancer patients and their designated family members, were recruited from the Radiation Oncology Department. Participants were selected using consecutive sampling to ensure representation of diverse cancer types and treatment stages. The intervention group received a comprehensive simulation-based training module, incorporating interactive models and virtual reality elements, in addition to standard care, while the control group received only standard care. Knowledge was assessed using a validated questionnaire (Cronbach's alpha = 0.89), and anxiety levels were measured using the State-Trait Anxiety Inventory (STAI-Y) (Cronbach's alpha = 0.91). Preparedness was gauged through a self-developed Likert-scale questionnaire (Cronbach's alpha = 0.87). Data were analyzed using independent samples t-tests and paired samples t-tests. Results revealed a statistically significant increase in knowledge regarding radiotherapy techniques in the intervention group compared to the control group (mean difference = 8.5, p < 0.001, Cohen's d = 1.25). Furthermore, the intervention group exhibited a significant reduction in anxiety scores post-training (mean difference = -12.3, p < 0.001, Cohen's d = 1.38), whereas the control group showed no significant change. Preparedness scores were also notably higher in the intervention group (mean difference = 7.2, p < 0.001, Cohen's d = 1.19). An unexpected finding indicated that adherence to treatment protocols was also positively correlated with increased preparedness in the intervention group. In conclusion, the simulation-based training program proved highly effective in enhancing knowledge, alleviating anxiety, and bolstering preparedness among cancer patients and their families undergoing radiotherapy. This study contributes significantly to the theoretical understanding of educational interventions in oncology and offers practical implications for healthcare institutions seeking to optimize patient-centered care. Recommendations include the widespread adoption of such simulation training, further research into long-term effects, and exploration of its application across different medical specialties.