The Effectiveness of Bowel Preparation in Colonoscopy Patients Using Artificial Intelligence-assisted Nursing Education

Evian Lin140 enrolled

Overview

Background: Colonoscopy is a critical diagnostic and screening tool for colorectal cancer, and its effectiveness largely depends on bowel preparation quality. Traditionally, bowel preparation education has been provided by nurses using written materials and verbal instructions. However, clinical workload pressures and staffing shortages frequently result in inadequate patient comprehension and poor adherence, negatively impacting bowel cleanliness, polyp or adenoma detection rates, examination quality, and overall medical efficiency. Recent advancements in artificial intelligence (AI) suggest potential improvements in patient education and adherence through AI-based interventions. Nevertheless, systematic studies assessing the effectiveness of AI smartphone applications (APPs) specifically tailored for bowel preparation education within local cultural and clinical contexts remain limited. Objective: This study aims to evaluate the effectiveness of an AI-integrated smartphone application designed for bowel preparation education before colonoscopy, focusing on patient cognition regarding bowel preparation, satisfaction with nursing education, and bowel cleanliness outcomes. Methods: A randomized controlled trial was conducted in the gastroenterology ward of a regional hospital in southern Taiwan. A total of 140 hospitalized patients scheduled for colonoscopy were enrolled and randomly assigned to either the experimental group (n=70) or the control group (n=70). The experimental group received multimodal education through an AI-based smartphone application, featuring visual and textual information, educational videos, and interactive chatbot dialogues. In contrast, the control group received conventional written and verbal nursing instructions. Demographic data were collected prior to colonoscopy. Post-examination evaluations included bowel cleanliness assessment (using the Aronchick Scale), nursing education satisfaction, and bowel preparation cognition questionnaires administered before and after the intervention. The overall effectiveness of the APP-based intervention was analyzed. Keywords: Artificial Intelligence, Bowel Preparation, Colonoscopy, Smartphone Application

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Interventions

The effectiveness of bowel preparation in colonoscopy patients using artificial intelligence-assistDEVICE

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rountine care

Eligibility

Sex: ALLMin age: 20 Years

Medical Language ↔ Plain English

Inclusion Criteria: Hospitalized patients scheduled for colonoscopy who are aged 20 years or older. Able to read and write. Conscious and able to communicate in Mandarin Chinese. Own a smartphone and have basic skills in using the LINE application. Exclusion Criteria: Patients undergoing hemodialysis or peritoneal dialysis. Unable to read or write. Patients receiving an enema during the bowel preparation process. Patients unable to take oral bowel preparation agents. Patients unable to consume a large volume of fluids. Individuals who do not meet the inclusion criteria. Patients scheduled for colonoscopy on the day before or the same day as the procedure without prior scheduling. Patients with intestinal stricture, bowel obstruction, or obstruction caused by an intestinal tumor. Patients with moderate or severe active gastrointestinal bleeding (\>100 mL/day). 有一點特別注意

Outcomes

Primary Outcomes

Bowel Preparation Quality Assessed Using the Aronchick Scale

Bowel preparation quality will be assessed by the endoscopist using the Aronchick Scale at the time of colonoscopy. The scale classifies bowel preparation into five categories: Excellent, Good, Fair, Poor, and Inadequate. The outcome will be reported as the proportion of participants with adequate bowel preparation, defined as an Aronchick rating of Excellent or Good. Fair, Poor, and Inadequate will be classified as inadequate bowel preparation.

Time frame: At the time of colonoscopy, following completion of bowel preparation

Secondary Outcomes

Bowel Preparation Knowledge

Bowel preparation knowledge will be assessed using a 10-item true-or-false questionnaire covering the purpose of colonoscopy, low-residue diet, clear-liquid diet, and fluid intake requirements. Each correct response will receive 10 points and each incorrect response will receive 0 points, resulting in a total score ranging from 0 to 100. Higher scores indicate greater knowledge of bowel preparation.

Time frame: At baseline before the educational intervention and immediately after completion of the educational intervention

Satisfaction With Nursing Education

Satisfaction with nursing education will be assessed using a 10-item questionnaire comprising five dimensions: communication quality and interaction, clarity and completeness of information, psychological and emotional support and sense of security, assistance with bowel preparation, and overall satisfaction and willingness to reuse. Each item is rated on a 5-point Likert scale from 1 (very dissatisfied) to 5 (very satisfied). Mean scores will be calculated for each dimension, ranging from 1 to 5, with higher scores indicating greater satisfaction with nursing education.

Time frame: Immediately after completion of the nursing education intervention