Procedures and data collection
Researchers were trained in the procedures and data collection before conducting the research. During the study period, all methods were performed in accordance with the relevant guidelines and regulations. Patients were recruited from the hospitals’ urology outpatient department. Those who met the inclusion criteria were informed of the purpose of the study and invited to participate. After patients signed the informed consent form, pre-test data were collected. Because the participants were not familiar with how to complete an online questionnaire, paper questionnaires were used for each of the three instances of data collection. The pre-test questionnaire was completed in a private place when patients visited the outpatient department for follow-up.The principal investigator obtained an assignment code through a random-number generator and placed each code into an opaque envelope. After the pre-test, the researcher opened the envelopes and used the randomly obtained code to assign the patients to the MIG or the CG. For the MIG, the researcher confirmed that the instant messaging application was installed on the participants’ smartphones. An information program guidebook was provided to patients in the MIG and their cohabitants. The patients and their cohabitants confirmed that they could successfully link to the multimedia information courses, using the instant messaging application. They also confirmed that they could use the instant messaging application to make calls and send messages.The multimedia information courses were distributed to the patients and cohabitants via an instant messaging application; a text message was sent to their mobile phone to remind them to view the content each week. The intervenor confirmed that the patients and cohabitants watched the multimedia information courses and set an appointment with them for after-class consultation and reinforcement, once a week for 6 weeks, during which the intervenor called the patient for after-class consultation and reinforcement.Post-test 1 (Time 1) and Post-test 2 (Time 2) paper questionnaires were used and were completed at 8 and 12 weeks, respectively, after the pre-test for the two groups. The post-test questionnaire was completed when patients returned to the outpatient department for follow-up. With their consent, a few patients were sent paper questionnaires because the in-hospital questionnaire administration time did not match the schedule of the patients’ hospital visits.In this study, the multimedia-based information program and instant messaging application were implemented without any interaction or communication between the intervenor and the CG. Furthermore, aside from visiting the hospital outpatient clinic for necessary follow-up due to illness, participants spent the remainder of their time either at home or in the community. There were no specific interactions between the MIG and the CG during the brief outpatient waiting periods. Additionally, the outpatient medical staff remained unaware of which patients were part of this study and their respective groups. In consideration of research ethics, this study did not impose restrictions on the MIG and the CG regarding additional self-learning of self-care skills. However, the MIG was verbally informed that the learning materials and content should not be shared with other patients or individuals outside their families. Following the conclusion of the experiment, this study provided the developed multimedia information courses and information program guidebook to the CG for their own use and learning.