Evaluating the Impact of a Structured Health Education Program on Caregiver Knowledge in Pediatric Oncology: A Pre–Post Intervention Study at a Tertiary Hospital in Central Vietnam

Abstract

Background: In lower-middle-income countries, home-based care provided by primary caregivers is critical to the survival and quality of life of children with cancer. Limited caregiver health literacy contributes to preventable complications, treatment abandonment, and poorer clinical outcomes.

Objective: To evaluate baseline knowledge among primary caregivers of children with cancer and determine the effectiveness of a structured nursing-led educational intervention at a tertiary referral hospital in Central Vietnam.

Methods: A prospective pre–post intervention study was conducted among 80 primary caregivers at the Pediatric Center, Hue Central Hospital (January–December 2025). The intervention combined individualized nursing counseling with the standardized Childhood Cancer Care Handbook, available in print and via QR code. Caregiver knowledge was assessed before and at least one month after the intervention using a structured questionnaire covering five domains: general cancer knowledge, side-effect management, infection prevention, home monitoring and warning signs, and cultural misconceptions.

Results: Most caregivers were mothers (66.3%), female (75.0%), and from rural areas (75.0%). Baseline knowledge was lowest for general cancer concepts (61.6 ± 26.5%) and cultural misconceptions (34.5 ± 39.9%), with poor recognition of eye changes (31.2%) and bone pain/limb swelling (51.2%) as warning signs. Following the intervention, significant improvements were observed in general cancer knowledge (90.1 ± 14.7%), side-effect management (96.4 ± 7.7%), infection prevention (99.8 ± 1.9%), and misconception rejection (54.1 ± 41.7%) (all p < 0.05). Home-monitoring knowledge remained high and showed no significant change (92.6 ± 15.2% vs. 95.1 ± 10.1%, p > 0.05). Although educational level influenced baseline knowledge (p < 0.05), these differences were no longer significant after the intervention.

Conclusions: A standardized, nursing-led educational program substantially improved caregiver health literacy and reduced knowledge disparities across educational backgrounds. Structured, culturally appropriate education should be integrated into pediatric oncology care to strengthen home-based management and reduce healthcare inequities in resource-limited settings.