Implementing a Brachytherapy Program in a Radiation Oncology Department in Vietnam: A Mixed-Methods Pre-Post Assessment of Staff Apprehension and Readiness

Abstract

Introduction: To identify factors contributing to healthcare professionals’ apprehension about the introduction of a new brachytherapy service and to evaluate changes in staff confidence and readiness following a structured implementation and training program.

Methods: A pre–post implementation study was conducted among clinical and non-clinical staff involved in establishing a new brachytherapy service. Participants completed an anonymous questionnaire assessing perceived usefulness, readiness, and apprehension regarding brachytherapy implementation using 10-point numerical rating scales. Underlying concerns were explored through semi-structured interviews with open-ended questions, and qualitative responses were analyzed thematically. Following the development of standardized workflows, implementation of standard operating procedures (SOPs), and delivery of a comprehensive multidisciplinary training program, the same questionnaire and interviews were administered to the same participants. Quantitative scores and qualitative themes were compared before and after the intervention.

Results: Twenty-three multidisciplinary team members participated in both assessments. Before training, the mean apprehension score was 8/10, while the mean readiness score was 3/10. Five major domains of concern were identified: radiation safety; limited knowledge and experience; workflow complexity and coordination; risk of procedural incidents, particularly source-retention events; and patient discomfort. Radiation safety was the most frequently reported concern, particularly among radiation therapists and members of their management teams. Following tailored training, workflow standardization, SOP implementation, and supervised initiation of clinical procedures, the mean apprehension score decreased by 3.2 points, while the mean readiness score increased to 7/10. Post-training assessments indicated greater confidence in radiation safety, improved understanding of the clinical benefits of brachytherapy, and increased motivation across professional groups.

Conclusion: The introduction of a new brachytherapy service may be associated with substantial apprehension among healthcare professionals, particularly concerning radiation safety, technical complexity, and unfamiliar workflows. A structured implementation approach that incorporates early identification of staff concerns, clearly defined SOPs, standardized workflows, and tailored multidisciplinary training may improve staff readiness and facilitate the adoption of brachytherapy services.