Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Granada, Spain.
Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Granada, Spain.
Res Social Adm Pharm. 2024 Jan;20(1):54-62. doi: 10.1016/j.sapharm.2023.09.001. Epub 2023 Sep 9.
Patient understanding of health information is crucial for successful pharmaceutical care. Pharmaceutical pictograms enable communication of medication instructions to patients who may not share a common language or are illiterate. However, cultural factors can impact the accurate interpretation of these visual aids.
This study aimed to assess and compare the comprehensibility of two sets of pictograms from different cultural backgrounds among sub-Saharan migrants recently arrived in Europe.
In June 2022, a cross-sectional survey was conducted at the Migrant Temporary Stay Center in Melilla, Spain. Participants were randomly assigned to interpret 10 pictograms from either the U.S. Pharmacopeia or South African counterparts, with a minimum of 50 participants per group. Following the International Organization for Standardization's testing comprehensibility criterion, pictograms achieving a 66.7% correct interpretation rate were considered acceptable. Health literacy was measured using a culturally validated sub-Saharan version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Data analysis included Fisher's exact test or chi-square test (for qualitative variables) and the Mann-Whitney test (for quantitative variables).
A total of 106 participants were included (51 in the U.S. pharmacopeia group and 55 in the South African group). None of the assessed pictograms met the comprehensibility criterion, and both groups exhibited high nonresponse rates. The South African pictograms were better understood than the American ones for all intended messages, with a statistically significant difference in overall comprehension (p = 0.002). Additionally, the participants' country of birth was a statistically significant factor for comprehension (p = 0.019).
Our findings indicate that evaluated pharmaceutical pictograms cannot be validly used in newly arrived sub-Saharan immigrants in Europe. However, the significantly better comprehension of South African pictograms compared to North American ones highlights the importance of cultural alignment between pictograms and their prospective users for effective comprehensibility.
患者对健康信息的理解对于成功的药物治疗至关重要。药品象形图可将药物使用说明传达给可能语言不通或不识字的患者。然而，文化因素可能会影响这些视觉辅助工具的准确解读。
本研究旨在评估和比较最近抵达欧洲的撒哈拉以南非洲移民中来自不同文化背景的两组象形图的可理解性。
2022 年 6 月，在西班牙梅利利亚的移民临时停留中心进行了一项横断面调查。参与者被随机分配解释来自美国药典或南非的 10 个象形图，每组至少有 50 名参与者。根据国际标准化组织的测试可理解性标准，象形图的正确解释率达到 66.7%被认为是可接受的。健康素养使用经过文化验证的撒哈拉以南非洲版欧洲健康素养调查问卷（HLS-EU-Q16）进行测量。数据分析包括 Fisher 精确检验或卡方检验（用于定性变量）和 Mann-Whitney 检验（用于定量变量）。
共纳入 106 名参与者（美国药典组 51 名，南非组 55 名）。评估的象形图均未达到可理解性标准，两组均表现出高不响应率。南非象形图在所有预期信息上比美国象形图更容易理解，整体理解程度存在统计学显著差异（p=0.002）。此外，参与者的出生地是理解的统计学显著因素（p=0.019）。
我们的研究结果表明，评估的药品象形图不能在欧洲新抵达的撒哈拉以南非洲移民中有效使用。然而，与北美象形图相比，南非象形图的理解程度明显更好，这突出了象形图与其潜在用户之间的文化一致性对于有效理解的重要性。
