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Randomized Controlled Trial
. 2026 Feb;35(2):480-486.
doi: 10.1007/s00586-025-09608-z. Epub 2026 Jan 5.

Evaluation of cartoon visuals versus traditional nursing instruction for patients after degenerative disc herniation surgery: A randomized controlled trial

Po-Fen Hsieh  1 , Chun-Jung Lin  2 , Cheng-You Lu  3 , Kuan-Yu Lin  4
Affiliations
Randomized Controlled Trial

Evaluation of cartoon visuals versus traditional nursing instruction for patients after degenerative disc herniation surgery: A randomized controlled trial

Po-Fen Hsieh et al. Eur Spine J. 2026 Feb.

Abstract

Purpose: This study aimed to incorporate cartoon visuals into nursing instructions for degenerative disc herniation surgery and test whether cartoon visuals in preoperative nursing instructions can help improve patients ' knowledge, satisfaction, and anxiety during hospitalization.

Methodology: The experimental study was conducted from January to June 2024 and involved 84 patients undergoing surgery for degenerative disc herniation. Participants were randomly assigned by computer into two groups, and preoperative and postoperative tests were conducted to understand the patients' anxiety, self-care knowledge, and satisfaction: the "traditional group" received standard paper-based nursing instructions, while the "experimental group" received cartoon visual nursing instructions.

Results: The study results were statistically significant differences in self-care knowledge (P = .02) and satisfaction (p < .001) among the experimental and traditional groups. There were no statistical differences in situational and trait anxiety, but the experimental group scores decreased. Another unexpected finding was a statistically significant difference (P = .02) in the experimental group, where the number of days of hospital stay was lower than that in the traditional group.

Conclusion: This study showed patients could improve their self-knowledge, reduce situational anxiety, increase satisfaction through cartoon visuals, and reduce the number of hospitalized days. Therefore, the engaging content of cartoon visuals can relieve patients' nervousness about surgery, increase their trust and cooperation, and further improve the effect of doctor-patient communication.

Keywords: Anxiety; Cartoon visuals nursing guidance; Degenerative disc herniation; Self-care knowledge.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. The authors have no personal, financial, or institutional interest in any materials or devices described in this article.

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