Animated Video Versus Written Leaflet for Preoperative Kidney Transplant Education

Comparing the Effects of Animated Video and Written Information on Understanding, Knowledge Level, and Anxiety in Explaining Kidney Transplant Surgery to Patients

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.

Study Overview

• Status: Completed
• Conditions: Preoperative Anxiety; Patient Education; Kidney Transplantation (Status Post)
• Intervention / Treatment: Behavioral: Animated educational video; Behavioral: Written information leaflet

Detailed Description

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
• Enrollment (Actual): 130
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye), 06800
    • Ankara Bilkent City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age 18 to 75 years
• Kidney transplant candidate or prospective living donor undergoing preoperative evaluation
• Able to read and write Turkish
• Provided written informed consent

Exclusion Criteria:

• Previous exposure to the study's animated educational video
• Cognitive impairment or inability to communicate adequately for assessment
• Visual or hearing impairment preventing completion of questionnaires or viewing of the material
• Documented severe psychiatric disorder

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Video group; Standard verbal counselling plus an animated educational video.	Behavioral: Animated educational video; Approximately 2.5-minute animation depicting the kidney transplant surgical pathway
Active Comparator: Written group; Standard verbal counselling plus a content-matched written information leaflet.	Behavioral: Written information leaflet; Illustrated A4 leaflet with content identical to the video.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	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)

Secondary Outcome Measures

Outcome Measure	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)
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)

Collaborators and Investigators

• Sponsor: Ankara City Hospital Bilkent
• Investigators: Principal Investigator: Muhammed E Polat, Dr., Ankara Bilkent City Hospital ; Department of Urology ; Ankara ; Türkiye

Study record dates

Study Major Dates

• Study Start (Actual): January 2, 2026
• Primary Completion (Actual): May 15, 2026
• Study Completion (Actual): May 17, 2026

Study Registration Dates

• First Submitted: June 10, 2026
• First Submitted That Met QC Criteria: June 13, 2026
• First Posted (Actual): June 16, 2026

Study Record Updates

• Last Update Posted (Actual): June 16, 2026
• Last Update Submitted That Met QC Criteria: June 13, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: patient education; kidney transplantation; informed consent; preoperative anxiety; living donor; APAIS; animated video
• Other Study ID Numbers: TABED 2-25-1755

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The de-identified participant data are available from the corresponding author on reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No