This randomized comparative trial evaluated whether an animated educational video, added to standard verbal counselling, differs from a content-matched written information leaflet, also added to standard verbal counselling, in improving procedural knowledge and reducing preoperative anxiety among adult kidney transplant candidates and prospective living donors. Participants were assessed immediately before and immediately after the assigned intervention. Secondary outcomes included participant satisfaction, preferred information modality, and the understandability and actionability of the educational materials.
Adult kidney transplant candidates undergoing preoperative evaluation and their prospective living donors were randomly allocated 1:1 to a video group or a written group. Both groups received standardized verbal counselling, unchanged across arms; the video group additionally viewed a \~2.5-minute animated video, and the written group additionally read a content-matched, illustrated A4 leaflet covering the same kidney transplant surgical pathway (laparoscopic live donor nephrectomy, bench surgery, and recipient stages). Procedural knowledge was measured with a seven-item investigator-developed questionnaire and preoperative anxiety with the validated Turkish Amsterdam Preoperative Anxiety and Information Scale (APAIS), administered immediately before and after the intervention. After the post-test, participants were cross-over exposed to the other format and indicated their preferred modality for future education. The understandability and actionability of both materials were independently rated using the Patient Education Materials Assessment Tool (PEMAT-A/V and PEMAT-P).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
130
Approximately 2.5-minute animation depicting the kidney transplant surgical pathway
Illustrated A4 leaflet with content identical to the video.
Ankara Bilkent City Hospital
Ankara, Turkey (Türkiye)
Change in procedural knowledge
Procedural knowledge was measured with a 7-item investigator-developed multiple-choice Kidney Transplant Surgical Process Knowledge Questionnaire, scored as the number of incorrect responses. Scores range from a minimum of 0 to a maximum of 7. Higher scores indicate worse knowledge (more incorrect answers); a decrease from pre- to post-test indicates a better outcome.
Time frame: Day 1 (immediately before and immediately after the intervention, same study visit)
Change in preoperative anxiety with the Amsterdam Preoperative Anxiety and Information Scale (APAIS) score
Preoperative anxiety and information need were measured with the Amsterdam Preoperative Anxiety and Information Scale (APAIS), total score. Scores range from a minimum of 6 to a maximum of 30. Higher scores indicate a worse outcome (greater anxiety and information need); a decrease from pre- to post-test indicates a better outcome.
Time frame: Day 1 (immediately before and immediately after the intervention, same study visit)
Post-intervention knowledge score (between groups)
Number of incorrect responses on the 7-item Kidney Transplant Surgical Process Knowledge Questionnaire after the intervention, compared between groups. Scores range from a minimum of 0 to a maximum of 7. Higher scores indicate worse knowledge (a worse outcome).
Time frame: Day 1 (immediately after the intervention, same study visit)
Post-intervention Amsterdam Preoperative Anxiety and Information Scale (APAIS) score (between groups)
Total Amsterdam Preoperative Anxiety and Information Scale (APAIS) score after the intervention, compared between groups. Scores range from a minimum of 6 to a maximum of 30. Higher scores indicate a worse outcome (greater anxiety and information need).
Time frame: Day 1 (immediately after the intervention, same study visit)
Participant satisfaction
Participant satisfaction was measured with a 5-item investigator-developed Satisfaction and Perceived Benefit Questionnaire, each item rated on a 5-point Likert scale, summed to a total score. Scores range from a minimum of 5 to a maximum of 25. Higher scores indicate a better outcome (greater satisfaction and perceived benefit).
Time frame: Day 1 (immediately after the intervention, same study visit)
Preferred information modality
Preferred information modality for future preoperative education, reported by participants after cross-over exposure to both formats immediately after the questionairre. This is a categorical outcome (video only / written only / both / no preference), not a scored scale; therefore minimum and maximum values are not applicable.
Time frame: Day 1 (immediately after interventions and cross-over exposure to both formats, same study visit)
Understandability of the educational materials, assessed with the Patient Education Materials Assessment Tool (PEMAT) score
Understandability of the educational materials, assessed with the Patient Education Materials Assessment Tool (PEMAT): the PEMAT for Audiovisual materials (PEMAT-A/V) for the animated video and the PEMAT for Printable materials (PEMAT-P) for the written leaflet. The understandability score is expressed as a percentage, ranging from a minimum of 0% to a maximum of 100%. Higher percentages indicate a better outcome (greater understandability).
Time frame: Baseline (educational materials assessed prior to participant enrollment)
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