Communicating Information to Patients: The Use of Cartoon Illustrations to Improve Comprehension of Instructions
Article first published online: 29 SEP 2008
© 1996 Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 3, Issue 3, pages 264–270, March 1996
How to Cite
Delp, C. and Jones, J. (1996), Communicating Information to Patients: The Use of Cartoon Illustrations to Improve Comprehension of Instructions. Academic Emergency Medicine, 3: 264–270. doi: 10.1111/j.1553-2712.1996.tb03431.x
- Issue published online: 29 SEP 2008
- Article first published online: 29 SEP 2008
- Received: March 16, 1995; revision received: August 31, 1995 accepted: September 5, 1995; updated: September 25, 1995
- patient instructions;
- patient follow-up;
- discharge instructions;
Objective: To evaluate the effect of cartoon illustrations on patient comprehension of and compliance with ED release instructions.
Methods: A prospective, randomized, controlled study of consecutive patients who presented to the ED of a community teaching hospital with lacerations necessitating wound repair during a three-month study period. At ED release, the patients were randomly assigned to receive wound care instructions with or without cartoon illustrations. Three days later, the patients were followed up by telephone. A blinded investigator asked a series of questions designed to test the patient's recall of, understanding of, and compliance with wound care instructions.
Results: A total of 234 patients were successfully contacted by telephone; 105 (45%) had been given ED release instructions with cartoons, 129 (55%), without cartoons. There was no significant difference in age, gender, level of education, or satisfaction with the ED visit between the two groups. The patients given cartoon instructions were more likely to have read the instructions (98% vs 79%, p < 0. 001), were more likely to answer all wound care questions correctly (46% vs 6%, p < 0. 001), and were more compliant with daily wound care (77% vs 54%, p < 0. 01). Subset analysis of those patients who had less than a high school education (n = 57) demonstrated even larger differences between the two treatment groups in terms of comprehension of and compliance with ED release instructions.
Conclusion: Cartoon illustrations are an effective strategy for conveying information and may improve patient compliance with ED release instructions.