Development and validation of a cost-effective virtual reality educational tool to reduce anxiety and improve set-up accuracy in radiotherapy patients

Purpose This study proposes a cost-effective method for educating radiotherapy patients through an immersive virtual reality (VR) system. Methods The VR educational tool comprises VR glasses, a handheld controller, the scientific knowledge of radiotherapy, radiotherapy demonstration, and an audio introduction. To verify its efficacy, 120 radiotherapy patients with tumors were prospectively enrolled and divided into the control group or VR intervention group. After the first treatment, set-up errors, including three translation errors and three rotation errors, were recorded in six directions. In addition, participants were required to complete a questionnaire before radiotherapy to assess anxiety and understanding degrees. The questionnaire was scored using a five-point Likert Scale. Finally, Spearman's rank correlation test was used to evaluate set-up errors and questionnaire scores. Results The set-up errors are significantly reduced in AP, SI, total translation, Roll and total rotation in the intervention group compared with the control group (p < 0.05). The scores are higher in the intervention group than in the control group in question 1 (2.1 +/- 0.58 vs. 3.3 +/- 0.55), question 2 (1.3 +/- 0.44 vs. 2.5 +/- 0.65), question 4 (2.2 +/- 0.65 vs. 3.2 +/- 0.82), question 5 (1.8 +/- 0.59 vs. 3.1 +/- 0.79), and all subscales (5.5 +/- 1.2 vs. 8.9 +/- 1.3 and 6.4 +/- 1.3 vs. 9.2 +/- 1.5). The scores of high, moderate, and low correlation are 47 (74%), 15 (23%), and 2 (3%) for the control group and 44 (69%), 17 (26%), and 3 (5%) for the intervention group, respectively. Conclusion The VR educational tool can significantly improve comprehension and reduce anxiety. There is a strong correlation between set-up errors and questionnaire scores. The VR educational tool may help reduce set-up errors for radiotherapy patients.