Objective: To explore the effects of family-participatory radiation protection transitional care on radiation protection compliance and anxiety levels in patients undergoing iodine-125 seed implantation. Methods: A single-center, two-arm parallel randomized controlled trial was conducted. Patients with solid tumors receiving iodine-125 seed implantation for the first time and their primary caregivers were consecutively screened and enrolled. A total of 90 eligible patients were randomly allocated in a 1:1 ratio to either the intervention group or control group using a random number table-generated allocation sequence, with 45 patients assigned to each group. The control group received routine ward-based verbal education and standard outpatient follow-up. In addition to routine care, the intervention group received a family-participatory radiation protection transitional care intervention, including family-involved structured education, structured post-discharge follow-up, and online reminder support. Radiation protection compliance, anxiety levels, and quality of life were assessed at T0 (admission/pre-intervention), T1 (day of discharge), T2 (1 month after discharge), T3 (3 months after discharge), and T4 (6 months after discharge). Results: At T0, no statistically significant differences were observed between the two groups in baseline outcome measures (P > 0.05). From T1 to T3, the intervention group demonstrated higher radiation protection compliance scores and a higher proportion of patients achieving good adherence to radiation protection practices compared with the control group, whereas anxiety scores were significantly lower (all P < 0.05). At T4, no statistically significant differences between-group differences were observed in radiation protection compliance or anxiety levels (P > 0.05). From T1 to T4, the intervention group showed significantly higher quality-of-life scores than the control group (P < 0.05). Conclusion: Family-participatory radiation protection transitional care combining structured education, family support, and reinforced follow-up improved radiation protection compliance, reduced anxiety levels, and enhanced quality of life among patients undergoing iodine-125 seed implantation. This intervention may provide a feasible approach for optimizing transitional care after permanent iodine-125 seed implantation.
References
[1]
He, S.Y., Kang, B.G. and Huang, J. (2023) Progress of 125I Seeds Implantation Technology in the Treatment of Malignant Tumors. Chinese Journal of Nuclear Medicine and Molecular Imaging, 43, 48-51. (In Chinese)
[2]
Chuang, H.D., Lin, Y.H., Lin, C.H., Lai, Y., Wu, C. and Hsu, S. (2024) Radiation Safety Assessment in Prostate Cancer Treatment: A Predictive Approach for I-125 Brachytherapy. Cancers, 16, Article 1790. https://doi.org/10.3390/cancers16101790
[3]
Novak, J., Ladbury, C., Abuali, T., Tam, A., Brower, J., Evans, B., et al. (2025) Patient Perceptions of Radiation Therapy Prior to Initial Consultation with a Radiation Oncologist. Advances in Radiation Oncology, 10, Article ID: 101676. https://doi.org/10.1016/j.adro.2024.101676
[4]
Cui, D., Wang, P., Kong, L., Wang, J., Tang, C. and Liang, J. (2025) Knowledge, Attitude, and Practice of Cancer Patients regarding Radiotherapy and Radiation Protection. Frontiers in Oncology, 15, Article 1432187. https://doi.org/10.3389/fonc.2025.1432187
[5]
Zarei, F., Dehghani, A., Ratansiri, A., Ghaffari, M., Raina, S., Halimi, A., et al. (2024) ChecKAP: A Checklist for Reporting a Knowledge, Attitude, and Practice (KAP) Study. Asian Pacific Journal of Cancer Prevention, 25, 2573-2577. https://doi.org/10.31557/apjcp.2024.25.7.2573
[6]
Expert Consensus Group on Overall Management of Particle Implantation Therapy Care, et al. (2024) Expert Consensus on Whole-Process Management of Nursing Care for Percutaneous Radioactive Particle Implantation. Journal of Practical Oncology, 39, 393-400. (In Chinese)
[7]
Oh, S., Choi, H., Oh, E.G. and Lee, J.Y. (2023) Effectiveness of Discharge Education Using Teach-Back Method on Readmission among Heart Failure Patients: A Systematic Review and Meta-Analysis. Patient Education and Counseling, 107, Article ID: 107559. https://doi.org/10.1016/j.pec.2022.11.001
[8]
Watts, P.I., McDermott, D.S., Alinier, G., Charnetski, M., Ludlow, J., Horsley, E., et al. (2021) Healthcare Simulation Standards of Best Practicetm Simulation Design. Clinical Simulation in Nursing, 58, 14-21. https://doi.org/10.1016/j.ecns.2021.08.009
[9]
Wang, Z., Deng, S., Lv, H., Fan, Y., Zhang, L. and Wang, F. (2023) Effect of WeChat-Based Continuous Care Intervention on the Somatic Function, Depression, Anxiety, Social Function and Cognitive Function for Cancer Patients: Meta-Analysis of 18 RCTs. Nursing Open, 10, 6045-6057. https://doi.org/10.1002/nop2.1916
[10]
Zhou, S.S. (2021) Investigation and Analysis of the Current Status of Radiation Protection Standard Implementation in Patients after 125I Seed Implantation. Master’s Thesis, Soo-Chow University.
[11]
Kertz, S., Bigda-Peyton, J. and Bjorgvinsson, T. (2012) Validity of the Generalized Anxiety Disorder-7 Scale in an Acute Psychiatric Sample. Clinical Psychology & Psychotherapy, 20, 456-464. https://doi.org/10.1002/cpp.1802
[12]
Tian, R., Wang, S., Ji, Z., Li, J., Zhang, J., Zhang, S., et al. (2025) Association between Emotional Distress and the Efficacy of Advanced Gastric Cancer Patients Undergoing Treatment with Immune Checkpoint Inhibitors: A Cohort Study and Propensity Score Matching Study. Frontiers in Oncology, 15, Article 1516643. https://doi.org/10.3389/fonc.2025.1516643
[13]
Wan, C.H., Chen, M.Q., Zhang, C.Z., et al. (2005) Introduction of the Chinese Version of EORTC QLQ-C30 Quality of Life Questionnaire for Cancer Patients. Journal of Practical Oncology, 20, 353-355. (In Chinese)
[14]
Chuang, H., Lin, Y., Lin, C., Feng, C., Chui, C., Wu, C., et al. (2025) Assessment of External Radiation Exposure Dose Rates and Protective Strategies Following I-125 Permanent Prostate Implantation Treatment. Radiation Physics and Chemistry, 236, Article ID: 112920. https://doi.org/10.1016/j.radphyschem.2025.112920
[15]
Liu, G., Zhang, H., Li, J., Pang, G., Ying, L. and Xu, Y. (2025) Evaluating the Effect of Patient Education Led by Medical Physicists on Anxiety and Depression Induced by Radiotherapy. Scientific Reports, 15, Article No. 40695. https://doi.org/10.1038/s41598-025-24244-9
[16]
Atwood, T.F., Brown, D.W., Murphy, J.D., Moore, K.L., Juang, T., Azuara, A., et al. (2023) Examining the Effect of Direct Patient Care for Medical Physicists: A Randomized Prospective Phase III Trial. International Journal of Radiation OncologyBiologyPhysics, 115, 224-232. https://doi.org/10.1016/j.ijrobp.2022.05.014
[17]
Lim, K.H. (2024) Effects of Integrated Music-Video Therapy on Pain and Anxiety during High-Dose-Rate Brachytherapy. Pain Management Nursing, 25, e223-e229. https://doi.org/10.1016/j.pmn.2024.01.006
[18]
Choi, Y.Y., Hong, B., Rha, S.Y., Cho, S., Lee, H.S. and Lee, J. (2025) The Effect of Nurse-Led Enhanced Supportive Care as an Early Primary Palliative Care Approach for Patients with Advanced Cancer: A Randomized Controlled Trial. International Journal of Nursing Studies, 168, Article ID: 105102. https://doi.org/10.1016/j.ijnurstu.2025.105102
[19]
Liu, Y. and Guo, H. (2025) Impact of Personalized Nursing on the Quality of Life in Lung Cancer Patients. Frontiers in Oncology, 15, Article 1650066. https://doi.org/10.3389/fonc.2025.1650066
[20]
Mu？oz-Villaverde, S., Martínez-García, M., Serrano-Oviedo, L., Gómez-Romero, F.J., Sobrado-Sobrado, A.M., Cidoncha-Moreno, M.á., et al. (2024) Impact of Telenurse-Led Intervention in Clinical Trials on Health Literacy, Empowerment, and Health Outcomes in Patients with Solid Tumours: A Pilot Quasi-Experimental Study. BMC Nursing, 23, Article No. 86. https://doi.org/10.1186/s12912-023-01641-x
