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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).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Video group | Experimental | Standard verbal counselling plus an animated educational video. |
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| Written group | Active Comparator | Standard verbal counselling plus a content-matched written information leaflet. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Animated educational video | Behavioral | Approximately 2.5-minute animation depicting the kidney transplant surgical pathway |
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| Measure | Description | Time Frame |
|---|---|---|
| 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. | 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. | Day 1 (immediately before and immediately after the intervention, same study visit) |
| Measure | Description | Time Frame |
|---|---|---|
| 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). | Day 1 (immediately after the intervention, same study visit) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Muhammed E Polat, Dr. | Ankara Bilkent City Hospital ; Department of Urology ; Ankara ; Türkiye | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Bilkent City Hospital | Ankara | 06800 | Turkey (Türkiye) |
The de-identified participant data are available from the corresponding author on reasonable request.
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| Written information leaflet | Behavioral | Illustrated A4 leaflet with content identical to the video. |
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| 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). | 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). | 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. | 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). | Baseline (educational materials assessed prior to participant enrollment) |