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Background and Aims Patients undergoing painless gastroscopy often experience anxiety due to unfamiliarity with the procedure, affecting cooperation and trust. The AIDET model (Acknowledge, Introduce, Duration, Explain, Thank) can reduce negative emotions and improve satisfaction through structured communication. This study examines AIDET’s impact on information need satisfaction and analyzes the dual mediation of anxiety and trust.Methods This study employed a randomized controlled trial design, enrolling 200 patients scheduled for painless gastroscopy. They were randomly assigned to an experimental group (receiving AIDET communication intervention) and a control group (receiving routine care). Data on information need satisfaction, anxiety levels (measured by the GAD-7 scale), and nursing trust (assessed via the Trust in Nurses Scale) were collected through validated questionnaires. A chain mediation model was used to analyze the dual path effects of anxiety and trust.Results Patients in the experimental group had significantly higher information need satisfaction (mean difference: 12.3 points, P < 0.001), lower anxiety levels (GAD-7 score: -4.7, P < 0.001), and greater nursing trust (Trust score: +15.6, P < 0.001) compared to the control group. Chain mediation analysis revealed that the AIDET communication model indirectly enhanced information need satisfaction by reducing anxiety and further promoted it by increasing nursing trust. Specifically, anxiety partially mediated the relationship between the AIDET communication model and information need satisfaction (partial mediation effect: = 0.32), while trust played a full mediating role (complete mediation effect = 0.48).Conclusions The AIDET communication model significantly improves information need satisfaction in patients undergoing painless gastroscopy by reducing anxiety and enhancing nursing trust. This study provides a new perspective for clinical nursing practice and recommends incorporating the AIDET communication model into routine care for painless gastroscopy to enhance patient experience and nursing quality.