Comparing the effects of pictorial and Teach-Back education methods on self-efficacy and quality of life in patients with leukemia: a randomized controlled trial

Leukemia patients often experience reduced self-efficacy and impaired quality of life. Effective education can help improve these outcomes. This study aimed to compare the effects of the Teach-Back and pictorial education methods on self-efficacy and quality of life among patients with leukemia. This three-arm randomized controlled trial was conducted on 90 Leukemia patients at the Oncology Clinic of Shahid Beheshti Hospital, Hamadan, Iran, during 2023 and 2024. Participants were randomly assigned to one of three groups: Teach-Back education, pictorial education, and control. Both intervention groups received eight weekly sessions of 45 to 60 min, providing similar educational content regarding disease nature, symptom management, and coping skills. Data were collected using the Sherer General Self-Efficacy Scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) at baseline, one month, and two months post-intervention. Post-intervention, both educational methods significantly enhanced self-efficacy, overall quality of life, and multiple subdomains compared to the control group (P < 0.001). Nevertheless, the Teach-Back method appeared to be more effective than pictorial education and routine care across most domains and symptoms, including fatigue, pain, nausea/vomiting, dyspnea, sleep disturbances, constipation, diarrhea, and appetite loss. Between-group effect sizes were moderate and statistically significant for self-efficacy (η² = 0.494) and quality of life (η² = 0.522). These improvements were sustained at the two-month follow-up. Based on the findings of this study, it is recommended that the Teach-Back method be implemented by healthcare providers, particularly nurses, within care programs for patients with leukemia. IRCT20211227053551N3; Registration Date: 2022-11-26.