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The growing number of women with breast cancer and their unmet knowledge expectations of radiotherapy pose a challenge to develop effective electronic patient education. Development efforts should be focused on e-feedback on knowledge because of its positive effects. In this study, we evaluated how an e-feedback knowledge intervention (e-Re-Know) before first radiotherapy improves breast cancer patients' knowledge of radiotherapy and identified the associations with patients' characteristics. Women with breast cancer (n = 128) were randomized prior to the radiotherapy period either to the intervention group or control group. The outcome measured three months after the radiotherapy period was knowledge level of radiotherapy. The increase in knowledge level was higher in the intervention group after adjustment for baseline knowledge level, and a significantly higher increase in knowledge level was seen in one subdomain, side-effect self-care, compared to the control group. The results of this study indicate that the e-Re-Know can be used in patient education to support empowerment. Future research should target new applications of e-Re-Know available on the Internet for those interested in the subject.

This study describes knowledge tests in patient education through a systematic review of the Medline, Cinahl, PsycINFO, and ERIC databases with the guidance of the PRISMA Statement. Forty-nine knowledge tests were identified. The contents were health-problem related, focusing on biophysiological and functional knowledge. The mean number of items was 20, with true-false or multiple-choice scales. Most of the tests were purposely designed for the studies included in the review. The most frequently reported quality assessments of knowledge tests were content validity and internal consistency. The outcome measurements for patient-education needs were comprehensive, validating knowledge tests that cover multidimensional aspects of knowledge. Besides the measurement of the outcomes of patient education, knowledge tests could be used for several purposes in patient education: to guide the content of education as checklists, to monitor the learning process, and as educational tools. There is a need for more efficient content and health problem-specific knowledge-test assessments.