Nurse-Led Education Before ERCP: Effects on Patient Knowledge and Anxiety (ERCP-EDU)

September 1, 2026 updated by: Beril DEMIR, Gazi University

Effect of Structured Nurse-Led Preprocedural Education on Knowledge Level and State Anxiety in Patients Undergoing Endoscopic Retrograde Cholangiopancreatography: A Randomized Controlled Trial

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure frequently accompanied by preprocedural anxiety, which has been associated with altered physiological parameters, reduced procedural tolerance, higher sedation requirements and lower patient satisfaction. Nurses are in a position to deliver structured preprocedural information and thereby strengthen patients' sense of control.

This randomized controlled trial will evaluate whether a structured, nurse-led, one-to-one educational intervention delivered before ERCP reduces state anxiety and improves procedure-related knowledge compared with routine institutional information. Sixty adult patients scheduled for ERCP will be randomly allocated to the intervention or control group. State anxiety will be assessed with the Spielberger State-Trait Anxiety Inventory (state subscale) and procedure-related knowledge with a 17-item multiple-choice questionnaire, both at baseline and immediately before the procedure.

Study Overview

Detailed Description

Setting. The study will be conducted in the Endoscopy Unit of the Department of Gastroenterology, Gazi University Faculty of Medicine.

Participants and allocation. Adults aged 18 years or older scheduled for elective ERCP who are able to read and understand Turkish and who provide written informed consent will be enrolled. Participants will be randomly allocated in a 1:1 ratio to the intervention or control group using a computer-generated randomization sequence with sequentially numbered, opaque, sealed envelopes for allocation concealment.

Control group. Patients will receive the routine information ordinarily provided in the unit before ERCP, consisting of the standard verbal explanation given during the informed consent process.

Intervention group. In addition to routine information, patients will receive a structured, one-to-one educational session delivered by a trained nurse. The session lasts approximately 30 to 45 minutes and comprises a standardized slide presentation and a printed colour brochure covering the purpose of ERCP, the sequence of events on the procedure day, sedation, expected sensations, duration, the recovery period, postprocedural instructions and warning symptoms.

Assessments. A structured interview form will record demographic and clinical characteristics. The state subscale of the Spielberger State-Trait Anxiety Inventory and a 17-item multiple-choice knowledge questionnaire will be administered at baseline (before allocation) and immediately before the procedure, after the intervention has been delivered and before any sedative agent is given. A further state anxiety assessment will be performed two hours after the end of the procedure.

Blinding. Because of the nature of the intervention, participants and the nurse delivering the education cannot be blinded. The investigator performing data entry and statistical analysis will be blinded to group allocation.

Statistical analysis. Data will be analysed with SPSS version 26.0. Distribution will be assessed using the Kolmogorov-Smirnov test. Between-group comparisons of continuous variables will use the independent samples t test or the Mann-Whitney U test as appropriate, and within-group comparisons will use the paired t test or the Wilcoxon signed rank test. Categorical variables will be compared using the chi-square test or Fisher exact test. Analysis of covariance will be used to compare postintervention scores with adjustment for baseline values. A two-sided p value below 0.05 will be considered statistically significant.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Aged 18 years or older
  • Scheduled to undergo elective ERCP
  • Able to read and understand Turkish
  • Willing to participate and able to provide written informed consent

Exclusion Criteria:

  • Current use of anxiolytic medication
  • Known cognitive impairment or any condition preventing reliable completion of the questionnaires
  • Need for emergency or urgent endoscopy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Structured nurse-led education
Participants receive routine institutional information plus a structured one-to-one educational session delivered by a trained nurse (standardized slide presentation and printed colour brochure), lasting approximately 30 to 45 minutes, before the procedure.
A standardized 30 to 45 minute one-to-one educational session delivered by a trained nurse using a slide presentation and a printed colour brochure, covering the purpose of ERCP, the sequence of events on the procedure day, sedation, expected sensations, procedure duration, the recovery period, postprocedural instructions and warning symptoms.
Active Comparator: Routine information
Participants receive the routine information ordinarily provided in the endoscopy unit before ERCP, consisting of the standard verbal explanation given during the informed consent process.
Standard verbal explanation about the procedure provided in the endoscopy unit as part of the usual informed consent process.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
State anxiety immediately before the procedure, measured by the Spielberger State-Trait Anxiety Inventory (state subscale, STAI-S)
Time Frame: Immediately before the procedure (within 30 minutes prior to sedation) on the day of ERCP
The state subscale of the Spielberger State-Trait Anxiety Inventory comprises 20 items scored on a four-point scale, yielding a total score between 20 and 80, with higher scores indicating greater anxiety. The assessment is performed after delivery of the allocated intervention and before administration of any sedative agent.
Immediately before the procedure (within 30 minutes prior to sedation) on the day of ERCP

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Procedure-related knowledge level immediately before the procedure
Time Frame: Immediately before the procedure on the day of ERCP
Knowledge about ERCP is assessed with a 17-item multiple-choice questionnaire developed by the investigators, with one point awarded for each correct answer, producing a total score between 0 and 17, where higher scores indicate greater knowledge.
Immediately before the procedure on the day of ERCP

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 30, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

March 1, 2027

Study Registration Dates

First Submitted

September 1, 2026

First Submitted That Met QC Criteria

September 1, 2026

First Posted (Actual)

September 4, 2026

Study Record Updates

Last Update Posted (Actual)

September 4, 2026

Last Update Submitted That Met QC Criteria

September 1, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared publicly. De-identified data may be made available from the principal investigator upon 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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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