[Effects of a structured language intervention based on predictive coding theory on patient experience and completion...

Objective: To evaluate the effects of a structured language intervention based on predictive coding theory (PCT) on the examination experience and completion status of patients undergoing conventional gastroscopy. Methods: A randomized controlled trial was conducted. The adult patients undergoing conventional gastroscopy at the First Medical Center of the Chinese PLA General Hospital between June and December 2025 were prospectively enrolled. The patients were randomly assigned to the intervention group and the control group using the random number table method. The control group received standard preoperative and intraoperative verbal guidance, whereas the intervention group received a PCT-based structured language intervention. The primary outcome was the discomfort score, assessed by the visual analogue scale (VAS) immediately after gastroscopy, while the secondary outcomes were endoscopic operation time, endoscopic operation termination rate, and the proportion of patients willing to undergo regular gastroscopy again. Independent samples t-test, Mann-Whitney U test or χ² test were used to compare the primary and secondary outcomes between the two groups. Results: A total of 150 patients were enrolled, including 83 males and 67 females, aged (49±3) years. The intervention group and control group each included 75 patients. Compared to the control group, the intervention group had a significantly lower VAS discomfort score [3 (3, 4) vs 6 (5, 7), P<0.001], shorter endoscopic operation duration [(9.7±0.9) vs (13.0±1.2) min, P<0.001], and a higher proportion of patients willing to repeat gastroscopy [92.0% (69/75) vs 68.0% (51/75), P<0.001]. There was no statistically significant difference in procedure termination rates between the two groups [1.3% (1/75) vs 4.0% (3/75), P=0.311]. Conclusion: The structured language intervention based on PCT can reduce patients' discomfort, shorten operation duration, and promote willingness for repeated gastroscopy.