JMIR Publications

ABSTRACT

Background:

Deficiencies in post-operative communication and telemedicine contributes anxiety after Voluntary Medical Male Circumcision (VMMC). Narrative approaches and large language models hold promise in addressing these issues.

Objective:

We aim to evaluate the effectiveness of narrative-enhanced communication by assessing anxiety scores and to introduce a novel AI-assisted follow-up tool to assess its value.

Methods:

This trial was conducted from July 1, 2023, to April 29, 2024.Patients aged ≥15 years who underwent VMMC were recruited. Participants were randomly assigned to standardized risk tool (SRT) or narrative enhanced tool (NET) group. In addition to the regular postoperative communication, NET group received an extra narrative video. AI-assisted consulting (AAC) was introduced to facilitate follow-ups. The main outcome assessed changes in anxiety levels, sleep quality, quality of life, and pain. Secondary outcomes included analgesic usage, follow-up satisfaction, and efficiency of healthcare workers.

Results:

A total of 671 participants were eligible for the study and 388 participants (mean±SD age, 26.21±3.69 years vs. mean±SD age, 26.41±3.56 years) completed a 30-day follow-up. The NET group had lower 7-item Generalized Anxiety Disorder (GAD-7) scores (7.06±2.73 vs. 9.95±3.50, P < 0.05) and more regular use of analgesics (59.17% vs. 89.02%, P < 0.05). SRT, inability to recall opioid risk level, hematoma, swelling, and pain were independent risk factors for the GAD-7 scores. The time healthcare workers spend on follow-ups has significantly decreased by using AAC (2.34±1.95 min vs. 7.85±2.65 min, P < 0.05).

Conclusions:

The study demonstrates that narrative is effective in reducing anxiety, improving quality of life, and improving pain management post-VMMC. The integration of AI into clinical follow-up protocols has the potential to enhance healthcare worker efficiency without compromising patient satisfaction. Clinical Trial: ChiCTR230076099