Our study presents an innovative educational approach combining visual and auditory elements, targeting the specific needs of the geriatric population. Generally, before colonoscopy, participants are given a written instruction describing the standard bowel preparation with the use of laxatives and enemas. In our study, in addition to this written instruction, the investigators aimed to support the bowel preparation procedure with visual training by using an animated video. The use of animated video has the potential to present complex medical instructions in a simple and understandable format. This approach is especially designed for elderly participants who have limited literacy skills or have difficulty in following written instructions. In addition, it was aimed to reduce the anxiety of the participants before the colonoscopy procedure and to increase patient compliance.

Colonoscopy is a critical screening method for early detection and prevention of colorectal cancer. However, the success of the procedure largely depends on the quality of bowel preparation. Inadequate bowel preparation may lead to repeated procedures, increased costs, potentially delayed diagnoses and associated poor prognosis. This problem is more prominent especially in the geriatric population over 60 years of age. With the animated video, the investigators aim to improve bowel cleansing before colonoscopy by providing visual and auditory training to participants and/or their carers. This project will both contribute to the improvement of colonoscopy preparation protocols for the geriatric population and potentially provide a model that can be adapted to other age groups.

Animation training video was created collaboratively by Mersin University Faculty of Medicine Department of General Surgery and Mersin University Graphic Arts Department.

The Boston Bowel Preparation Scale (BBPS) is a scoring system designed to assess bowel cleansing during colonoscopy. It provides a standardised, reliable measure to improve the quality and outcomes of colonoscopy procedures. While there are many different scales to measure bowel preparation, the BBPS was selected for use in the study as it is considered to be the most comprehensively validated bowel preparation scale. The BBPS is a 10-point scale that assesses bowel readiness. It assesses three segments of the colon (right, transverse and left) with scores ranging from 0 to 3 for each segment, leading to a total score of 0 to 9.

Using this scale, the investigators tried to determine whether there would be a difference in terms of bowel preparation between participants who watched an animated video and participants who were given standard instructions.

Inclusion Criteria:

• 60 years of age or older
• Indication for colonoscopy
• Volunteering to participate in the study
• Preparing for colonoscopy for the first time
• No history of previous operations on the small intestine and colon
• No diagnosed bowel disease
• Language proficiency to watch the animation
• Full understanding of visual and auditory messages

Exclusion Criteria:

• Previous colonoscopy experience
• History of previous small bowel and colon surgery
• Diagnosis of inflammatory bowel disease
• Presence of toxic colon and/or megacolon
• The presence of a mass in the intestine that does not allow colonoscopy to pass
• Unwillingness to participate in the study
• Lack of language proficiency
• Lack of ability to understand visual and auditory messages