Berthenet Marion, Vaillancourt Régis, Pouliot Annie
a Pharmacy Department , Children's Hospital of Eastern Ontario , Ottawa , Ontario , Canada.
J Health Commun. 2016;21 Suppl 1:27-33. doi: 10.1080/10810730.2015.1133737.
Poor health literacy has been recognized as a limiting factor in the elderly's ability to comprehend written or verbal medication information and also to successfully adhere to medical regimens. The objective of this study was to validate a set of pictograms depicting medication instructions for use among the elderly to support health literacy. Elderly outpatients were recruited in 3 community pharmacies in Canada. One-on-one structured interviews were conducted to assess comprehension of 76 pictograms from the International Pharmaceutical Federation. Comprehension was assessed using transparency testing and pictogram translucency, or the degree to which the pictogram represents the intended message. A total of 135 participants were enrolled in this study, and 76 pictograms were assessed. A total of 50 pictograms achieved more than 67% comprehension. Pictograms depicting precautions and warnings against certain side effects were generally not well understood. Gender, age, and education level all had a significant impact on the interpretation scores of certain individual pictograms. When all pictograms were included, younger males had a significantly higher comprehension score than older females, and participants with a higher level of education provided significantly higher translucency scores. Even when pictograms reached the comprehension threshold set by the International Organization for Standardization in the general populations, only 50 of these pictograms achieved more than 67% comprehension among the elderly, confirming that validation in this subpopulation should be conducted prior to using specific pictograms. Accompanying pictograms with education about these pictograms and important counseling points remains extremely important.
健康素养低下已被认为是老年人理解书面或口头用药信息以及成功遵守医疗方案能力的限制因素。本研究的目的是验证一组用于老年人的描绘用药说明的象形图，以提高健康素养。在加拿大的3家社区药房招募了老年门诊患者。进行一对一的结构化访谈，以评估对国际制药联合会的76个象形图的理解。使用透明度测试和象形图半透明度来评估理解程度，即象形图代表预期信息的程度。本研究共纳入135名参与者，并评估了76个象形图。共有50个象形图的理解率超过67%。描绘针对某些副作用的预防措施和警告的象形图通常理解不佳。性别、年龄和教育水平对某些单个象形图的解读分数均有显著影响。当纳入所有象形图时，年轻男性的理解分数显著高于老年女性，教育水平较高的参与者提供的半透明度分数显著更高。即使象形图在一般人群中达到了国际标准化组织设定的理解阈值，但在老年人中只有50个象形图的理解率超过67%，这证实了在使用特定象形图之前应在该亚人群中进行验证。为象形图配以关于这些象形图和重要咨询要点的教育仍然极为重要。
