Video Education to Reduce Anxiety and Depression Before Cystoscopy: A Study in First-Time Patients

NCT07101211 | Completed

• 1 other identifier: IRB0242IKCU
• Study Type: interventional
• Target: 180
• Locations: 1 country
• Sites: 1

Brief Summary

This study looks at whether watching a short educational video before a cystoscopy can help reduce feelings of anxiety, stress, and depression in patients having the procedure for the first time. Cystoscopy is a test that helps doctors see inside the bladder and urinary tract. It can cause worry or fear, especially for patients who have never had it before. In this study, 180 adult patients were divided into two groups. One group received standard written information about the procedure, and the other group received the same written information plus a short, easy-to-understand animation video that explains what will happen during cystoscopy. The video shows what patients might feel, what the procedure looks like, and what to expect afterward. The study measured how patients felt before and after the procedure to see if the video helped them feel calmer and more prepared. The goal is to find out if using videos before medical procedures can improve the patient experience and reduce stress and anxiety.

Conditions

Anxiety; Depression Anxiety Disorder; Stress, Psychological; Cystoscopy

Keywords

Video-based education; Cystoscopy; Anxiety; Psychological stress; Depression

Outcome Measures

Primary Outcomes (2)

• Change in Anxiety Levels Assessed by HADS-A Before and After Cystoscopy

  The Hospital Anxiety and Depression Scale - Anxiety Subscale (HADS-A) assesses anxiety symptoms in patients while minimizing the influence of physical illness. It includes 7 items scored from 0 to 3, with a total score range of 0-21. Scores are interpreted as: 0-7 normal, 8-10 borderline, 11-21 abnormal. It avoids somatic symptoms and is widely validated across medical settings. The Turkish version used in this study was validated by Aydemir (1997). Due to its brevity and focus on emotional symptoms, HADS-A is suitable for measuring procedural anxiety before and after interventions such as cystoscopy. Turkish Validation: Aydemir O. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry. 1997 Apr;8:280-7.

  Immediately before cystoscopy and within 30 minutes post-procedure

• Change in Anxiety Levels Assessed by STAI Form TX-I Before and After Cystoscopy

  The State-Trait Anxiety Inventory - State Form (STAI Form TX-I) is a 20-item self-report scale measuring temporary, situation-specific anxiety. Each item is rated on a 4-point Likert scale, with scores ranging from 20 to 80. Higher scores indicate more severe state anxiety. Some items are reverse scored. Typical interpretations: 20-37 (low), 38-44 (moderate), ≥45 (high anxiety). The Turkish version was validated by Öner \& LeCompte (1983). It is widely used in procedural settings to assess acute stress responses and emotional tension before and after interventions such as cystoscopy. Turkish Validation: Öner, Necla, William Ayhan LeCompte. Durumluk Surekli Kaygi Envanteri El Kitabi, Bogazici Universitesi Yayinlari, Istanbul, 1-26. (In Turkish). 1983.

  Immediately before cystoscopy and within 30 minutes post-procedure

Secondary Outcomes (2)

• Change in Depression Levels Assessed by HADS-D Before and After Cystoscopy

  Immediately before cystoscopy and within 30 minutes post-procedure

• Change in Depression Levels Assessed by Beck Depression Inventory (BDI) Before and After Cystoscopy

  Immediately before cystoscopy and within 30 minutes post-procedure

Other Outcomes (2)

• Effect of Patient Education Level on Change in Anxiety Levels Measured by the Hospital Anxiety and Depression Scale - Anxiety Subscale (HADS-A) Before and After Cystoscopy

  Immediately before cystoscopy and within 30 minutes post-procedure

• Effect of Patient Education Level on Change in State Anxiety Levels Measured by the State-Trait Anxiety Inventory - State Form (STAI TX-I) Before and After Cystoscopy

  Immediately before cystoscopy and within 30 minutes post-procedure

Study Arms (2)

Video-Based Education + Standard Written Information

EXPERIMENTAL

Participants in this arm received the standard written informed consent form for cystoscopy along with a Turkish-dubbed educational animation video explaining the cystoscopy procedure. The video was provided via a QR code to allow patients to watch it on their mobile devices while waiting for the procedure. The video covered the procedure steps, sensations to expect, and post-procedure care.

Behavioral: Video-Based Educational Animation; Other: Standard Written Informed Consent

Standard Written Information Only

ACTIVE COMPARATOR

Participants in this arm received only the standard written informed consent form describing the cystoscopy procedure. No video-based educational intervention was provided before the procedure.

Other: Standard Written Informed Consent

Interventions

Video-Based Educational Animation BEHAVIORAL

A short, Turkish-dubbed educational animation video explaining the cystoscopy procedure, including steps of the procedure, expected sensations, and post-procedure care. The video is viewed by patients via QR code on their mobile devices before the cystoscopy to enhance patient understanding and reduce anxiety, stress, and depression.

Video-Based Education + Standard Written Information

Standard Written Informed Consent OTHER

A standard written informed consent form describing the cystoscopy procedure, including the purpose, steps, possible sensations, and post-procedure care, provided to all participants before the procedure.

Standard Written Information Only; Video-Based Education + Standard Written Information

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 years or older
• Undergoing first-time cystoscopy
• Provided written informed consent

You may not qualify if:

• History of previous cystoscopy
• Active urinary tract infection
• Cognitive impairment
• Current use of psychotropic medications

Sponsors & Collaborators

• Enis Mert Yorulmaz: lead
• Izmir Katip Celebi University: collaborator

Study Sites (1)

Izmir Katip Celebi University Ataturk Training and Research Hospital

Izmir, 35360, Turkey (Türkiye)

Location

Related Publications (4)

• McClintock G, Wong E, Mancuso P, Lalak N, Gassner P, Haghighi K, Rathore P, McAulay L, Jeffery N. Music during flexible cystoscopy for pain and anxiety - a patient-blinded randomised control trial. BJU Int. 2021 Oct;128 Suppl 1:27-32. doi: 10.1111/bju.15527. Epub 2021 Jul 30.

  PMID: 34174137 RESULT

• Zhang ZS, Wang XL, Xu CL, Zhang C, Cao Z, Xu WD, Wei RC, Sun YH. Music reduces panic: an initial study of listening to preferred music improves male patient discomfort and anxiety during flexible cystoscopy. J Endourol. 2014 Jun;28(6):739-44. doi: 10.1089/end.2013.0705. Epub 2014 Mar 31.

  PMID: 24548148 RESULT

• Gauba A, Ramachandra MN, Saraogi M, Geraghty R, Hameed BMZ, Abumarzouk O, Somani BK. Music reduces patient-reported pain and anxiety and should be routinely offered during flexible cystoscopy: Outcomes of a systematic review. Arab J Urol. 2021 Mar 3;19(4):480-487. doi: 10.1080/2090598X.2021.1894814. eCollection 2021.

  PMID: 34881066 RESULT

• Kwon OS, Kwon B, Kim J, Kim BH. Effects of Heating Therapy on Pain, Anxiety, Physiologic Measures, and Satisfaction in Patients Undergoing Cystoscopy. Asian Nurs Res (Korean Soc Nurs Sci). 2022 May;16(2):73-79. doi: 10.1016/j.anr.2022.02.002. Epub 2022 Feb 20.

  PMID: 35196580 RESULT

Related Links

• Video animation of the cystoscopy procedure (prepared by EAU). This video was shown to the patients in the intervention group with Turkish dubbing.

MeSH Terms

Conditions

Anxiety Disorders; Stress, Psychological; Depression

Condition Hierarchy (Ancestors)

Mental Disorders; Behavioral Symptoms; Behavior

Study Officials

• Enis M Yorulmaz, Assist Prof

  Izmir Katip Celebi University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome assessors who evaluated anxiety, stress, and depression scores using the HADS-A, HADS-D, STAI-TX-I, and BDI were blinded to group allocation to reduce assessment bias. This blinding ensured that the assessors were unaware of whether participants had received video-based education or only written information before cystoscopy. The blinding was implemented according to SPIRIT guidelines for clinical trial design to maintain the integrity of outcome evaluations and reduce potential bias in analyzing the psychological effects of the intervention.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor of Urology

Model Details: Participants were randomly assigned in a parallel design to one of two groups: a control group receiving standard written information about cystoscopy, and an intervention group receiving the same written information plus an educational animation video prior to the procedure. Outcomes were assessed pre- and post-procedure in both groups to compare the effects of video-based education on anxiety, stress, and depression levels.

Study Record Dates

• First Submitted: June 29, 2025
• First Posted: August 3, 2025
• Study Start: May 15, 2025
• Primary Completion: June 14, 2025
• Study Completion: June 14, 2025
• Last Updated: August 3, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)