Comparison of Conventional Anesthesia Nurse Education and an Artificial Intelligence Chatbot (ChatGPT) Intervention on Preoperative Anxiety: A Randomized Controlled Trial

Purpose: This study aimed to evaluate the effects of an artificial intelligence (AI) chatbot (ChatGPT-3.5, OpenAI) on preoperative anxiety reduction and patient satisfaction in adult patients undergoing surgery under general anesthesia. Design: The study used a single-blind, randomized controlled trial design. Methods: In this study, 100 adult patients were enrolled and divided into two groups: 50 in the control group, in which patients received standard preoperative information from anesthesia nurses, and 50 in the intervention group, in which patients interacted with ChatGPT. The primary outcome, preoperative anxiety reduction, was measured using the Japanese State-Trait Anxiety Inventory (STAI) self-report questionnaire. The secondary endpoints included participant satisfaction (Q1), comprehension of the treatment process (Q2), and the perception of the AI chatbot's responses as more relevant than those of the nurses (Q3). Findings: Of the 85 participants who completed the study, the STAI scores in the control group remained stable, whereas those in the intervention group decreased. The mixed-effects model showed significant effects of time and group-time interaction on the STAI scores; however, no main group effect was observed. The secondary endpoints revealed mixed results; some patients found that the chatbot's responses were more relevant, whereas others were dissatisfied or experienced difficulties. Conclusions: The ChatGPT intervention significantly reduced preoperative anxiety compared with the control group; however, no overall difference in the STAI scores was observed. The mixed secondary endpoint results highlight the need for refining chatbot algorithms and knowledge bases to improve performance and satisfaction. AI chatbots should complement, rather than replace, human health care providers. Seamless integration and effective communication among AI chatbots, patients, and health care providers are essential for optimizing patient outcomes. (c) 2024 Published by Elsevier Inc. on behalf of American Society of PeriAnesthesia Nurses.