Delp C, Jones J
Michigan State University, College of Human Medicine, Grand Rapids, USA.
Acad Emerg Med. 1996 Mar;3(3):264-70. doi: 10.1111/j.1553-2712.1996.tb03431.x.
To evaluate the effect of cartoon illustrations on patient comprehension of and compliance with ED release instructions.
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.
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.
Cartoon illustrations are an effective strategy for conveying information and may improve patient compliance with ED release instructions.
评估卡通插图对患者理解和遵守急诊室出院指导的影响。
对一家社区教学医院急诊室在为期三个月的研究期间因伤口需要缝合而前来就诊的连续患者进行一项前瞻性、随机对照研究。在急诊室出院时，患者被随机分配接受有无卡通插图的伤口护理指导。三天后，通过电话对患者进行随访。一名不知情的调查员询问了一系列旨在测试患者对伤口护理指导的回忆、理解和遵守情况的问题。
共通过电话成功联系到234名患者；105名（45%）患者收到了带有卡通插图的急诊室出院指导，129名（55%）患者没有收到。两组在年龄、性别、教育程度或对急诊室就诊的满意度方面没有显著差异。收到卡通指导的患者更有可能阅读指导（98%对79%，p< .001），更有可能正确回答所有伤口护理问题（46%对6%，p< .001），并且在日常伤口护理方面更依从（77%对54%，p< .01）。对那些高中以下学历患者（n = 57）的亚组分析表明，两个治疗组在对急诊室出院指导的理解和遵守方面的差异更大。
卡通插图是传达信息的有效策略，可能会提高患者对急诊室出院指导的依从性。
