Empowering breast cancer clients through AI chatbots: transforming knowledge and attitudes for enhanced nursing care

BACKGROUND: Breast cancer remains a leading cause of morbidity worldwide, necessitating innovative and accessible interventions that address both clinical and psychosocial needs. AI-powered chatbots are increasingly used in health education due to their 24/7 availability, personalization, and interactivity. However, empirical evidence on their effectiveness in enhancing knowledge, empowerment, and attitudes in oncology settings remains limited. AIM: This randomized controlled trial (RCT) evaluated the impact of an AI chatbot intervention on knowledge, empowerment, and attitudes toward AI among breast cancer patients. METHODS: A two-arm, pre-post RCT was conducted with 122 women diagnosed with breast cancer at Kafr El-Sheikh University Hospital. Participants were randomly assigned to an intervention group (n = 61) receiving structured AI chatbot-based education plus standard care, or a control group (n = 61) receiving standard care alone. Data were collected using validated questionnaires assessing breast cancer and AI knowledge, attitudes toward AI, and perceived empowerment. G*Power analysis determined sample adequacy for between-group comparisons. RESULTS: Post-intervention, the intervention group showed significantly higher knowledge (20.3 ± 2.1 vs. 17.9 ± 3.4, p <.001) and more positive attitudes (82.4 ± 7.2 vs. 72.6 ± 8.9, p <.001) compared to controls. Logistic regression indicated that knowledge gain and higher education predicted a positive AI attitude. Path analysis revealed both direct and mediated effects of knowledge on attitude via empowerment. Usage data and chatbot session logs supported high engagement. CONCLUSION: Integrating AI chatbots into oncology nursing care significantly enhances knowledge, empowerment, and AI acceptance. These findings support chatbot integration in patient-centered digital health strategies, particularly in oncology. CLINICAL TRIAL NUMBER: Not applicable. TRIAL REGISTRATION: NCT06943911 (retrospectively registered on 24/4/2025).