Colorectal cancers (CRC) are the third most common cancers worldwide, regardless of age and
gender, and the second among cancer deaths. In terms of the incidence of colorectal cancers
in Turkey, regardless of gender, it ranks third in all age groups (9.8% in men, 8.1% in
women) (Turkey Unified Database, 2017). According to the Global Cancer 2020 data published by
the International Agency for Research on Cancer (IARC), it is predicted that approximately
21,000 individuals will be diagnosed with colorectal cancer in 2020 and the estimated
age-standardized death rate will be 10.1 per 100,000 individuals. Colonoscopy, which is the
gold standard for early diagnosis of colorectal cancers, reduces cancer-related morbidity and
mortality rates (World Health Organization, 2022).
Colonoscopy is a lower gastrointestinal system endoscopy method that enables imaging of the
large intestine (colon) for the purposes of screening, diagnosis, treatment and monitoring of
colorectal and anal canal pathologies. In the colonoscopy procedure, adequate intestinal
preparation is necessary for a good visualization of the entire mucosa and for an accurate
evaluation. American Society for Gastrointestinal Endoscopy (ASGE), ideal bowel preparation
(BH); defined as the rapid clearance of all macroscopic and microscopic fecal load in the
colon without disturbing the patient's comfort and fluid-electrolyte balance.
Inadequate bowel cleansing rates ranging from 10% to 75% have been reported in studies. It is
stated that when the bowel preparation of the patients is insufficient, 45% less polyps are
detected, and the rate of incomplete and canceled procedures is 5%. In addition, gas
compression and explosion, which can be seen rarely as a result of gas insufflation during
colonoscopy due to insufficient bowel preparation, can cause perforation of the intestines
and undesirable events such as bleeding. As a result, inadequate bowel cleansing can cause
repetition or prolongation of the procedure, loss of labor, time and cost for patients and
healthcare personnel.
Before colonoscopy, nurses provide patients with written and oral bowel preparation standard
training set by the institution. However, many studies suggest that this training should be
supported by visual and auditory tools to increase its effectiveness. In interventional
studies aimed at increasing the effectiveness of colonoscopy bowel preparation, the use of
educational booklets, patient education with poster images, patient education with both
visual use and educational videos, telephone/short message, interactive social media and
patient education with the use of telephone applications methods were used.
As a result of the literature review, Mobile Application Based Bowel Preparation Training,
which is an innovative method, was planned in order to improve the quality of colonoscopy
bowel preparation. In this study, it was determined that the quality of bowel preparation and
compliance with the procedure will increase by applying Mobile Application-Based Bowel
Preparation Training together with the standard education method in patient education before
colonoscopy; anxiety is predicted to decrease.
Aim This study was planned as a prospective, single-blind randomized controlled study to
determine the effect of mobile application-based bowel preparation training on patients'
bowel preparation compliance, quality and anxiety level in patients scheduled for
colonoscopy. With the increase in the quality of bowel preparation, effective and accurate
evaluation of colon pathologies during colonoscopy and, as a result, early diagnosis of colon
cancer will be provided. With adequate bowel preparation, the risk of complications
(perforation, hemorrhage, etc.) that may occur during colonoscopy will be reduced, and labor,
time and cost loss due to repeated or prolonged colonoscopy will be prevented.
Material Method In this study, in order to determine the effect of mobile application-based
bowel preparation training on the quality of bowel preparation, compliance and anxiety level
of patients who are planned for colonoscopy; The calculation (d-value) method developed by
Cohen was used to calculate the effect size. To determine the effect size index d. The
findings of the study, which investigated the effect of mobile application on patient bowel
cleansing before colonoscopy, were used. In the calculation made using the findings of this
study, the effect size of the bowel cleansing efficiency between the two groups
(Experiment=7.70±1.1; Control=7.70±0.8; p=0.007) was determined to be d=0.48. In this
context, a sample group of 140 people, 70 people in each group, was determined with the help
of the G-power (version 3.1) package program, accompanied by the specified criteria, with
d=0.48, α=0.05 (error margin), 1-β=0.80 (power). Due to the loss of patients who left the
study during data collection, 10 individuals will be added to the experimental and control
groups, and the data collection process will be completed. The sample will consist of
patients who meet the inclusion criteria and agree to participate in the study, whose
colonoscopy procedure is planned.
