Virtual reality patient education before radiation therapy: effects on knowledge and psychological outcomes

Radiation therapy (RT) is a critical aspect of cancer treatment; however, many patients experience anxiety before treatment due to unfamiliar procedures, equipment, and potential side effects. Effective patient education is important for strengthening patient understanding and psychological preparedness. This study evaluated the effectiveness of VR-based education compared with conventional nurse-led education in improving knowledge and psychological outcomes among patients undergoing first-time RT. A single-center quasi-experimental, non-randomized, two-group parallel study was conducted in a regional hospital in Taiwan. Patients receiving RT for the first time were assigned to either a VR education group or a conventional education group using a predetermined alternating allocation sequence. The final analysis included 43 patients in the VR group and 41 patients in the conventional education group. Knowledge was assessed at baseline and after computed tomography (CT) simulation, whereas psychological status was assessed at baseline, after CT simulation, and after the fifth RT session. Generalized estimating equations were used to examine group-by-time interaction effects. Knowledge scores improved in both groups, but the group-by-time interaction was not significant (β = −1.67, 95% CI − 11.04 to 7.71; p = 0.732). The VR group exhibited a greater reduction in anxiety at the first follow-up after CT simulation than the conventional education group (β = −1.61, 95% CI − 2.62 to − 0.62; p < 0.01); however, this effect was not sustained after treatment initiation ( p = 0.742). Depressive symptoms decreased over time in both groups, with no significant group-by-time interaction effects. Virtual reality education may have potential as an adjunct to conventional education for reducing short-term anticipatory anxiety before RT initiation, although it did not produce additional benefits for knowledge acquisition or depressive symptoms. Trial registration This study was retrospectively registered at ClinicalTrials.gov (NCT07598851) on May 11, 2026.