Written information delivery to improve patient understanding and anxiety at Flexible cystoscopy

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Background and rationale: Patients undergoing procedures such as flexible cystoscopy are usually given information regarding the findings from the procedure, and further treatment plans. This may be done verbally (as is usual at Austin Health) or in writing (as is done in some centres). We hypothesise that the provision of written information will aid patient understanding and retention, and thereby reduce anxiety. Methodology: Patients undergoing flexible cystoscopy will be invited to participate, with the main exclusion being those with language, psychological or cognitive barriers to participation. Patients will be given a plain (English) language statement, and will sign the study consent form, and complete the pre-procedure questionnaire. They will then have their flexible cystoscopy as is usual practice. The findings from the cystoscopy as well as the plan of management will be communicated to them either verbally only or on a standardized written template in addition, according to a random allocation. At the conclusion of the procedure, the patient will be invited to complete the post-procedure questionnaire. Data collection and analysis: The questionnaires and limited clinical and demographic data will be collected in blinded fashion by members of the research team other than the proceduralists (p). Data from the medical record to be collected in de-identified fashion includes age, sex, diagnosis (ie bladder cancer, other pathology or normal), prior cystoscopies (& number) and need for further intervention (after cystoscopy). Endpoints: The patient’s understanding of the findings at cystoscopy and the subsequent plan will be coded as follows: *Good: patient’s response matches documentation from proceduralist *Fair: patient’s response is close to documentation from proceduralist, but with minor errors / discrepancies *Poor: No response or response completely erroneous The patients’ self-assessed impression of being well informed and worried will be scored on a standard 5-point scale. The above measures will be compared between the two groups receiving verbal vs written information, with assessment of associations with other variables (i.e. age, sex, diagnosis, prior cystoscopies and need for subsequent procedures) Significance: On the basis of this study, we will determine the preferred method for communicating with patients after flexible cystoscopy. The findings may have relevance for patient communication after day-case surgical procedures in general.