Assessment of pictographs developed through a participatory design process using an online survey tool.


Journal Article

Inpatient discharge instructions are a mandatory requirement of the Centers for Medicare and Medicaid Services and Joint Commission on Accreditation of Healthcare Organizations. The instructions include all the information relevant to post-discharge patient care. Prior studies show that patients often cannot fully understand or remember all the instructions. To address this issue, we have previously conducted a pilot study in which pictographs were created through a participatory design process to facilitate the comprehension and recall of discharge instructions.The main objective of this study was to verify the individual effectiveness of pictographs created through a participatory design process.In this study, we included 20 pictographs developed by our group and 20 pictographs developed by the Robert Wood Johnson Foundation as a reference baseline for pictographic recognition. To assess whether the participants could recognize the meaning of the pictographs, we designed an asymmetrical pictograph-text label-linking test. Data collection lasted for 7 days after the email invitation. A total of 44 people accessed the survey site. We excluded 7 participants who completed less than 50% of the survey. A total of 719 answers from 37 participants were analyzed.The analysis showed that the participants recognized the pictographs developed in-house significantly better than those included in the study as a baseline (P< .001). This trend was true regardless of the participant's gender, age, and education level. The results also revealed that there is a large variance in the quality of the pictographs developed using the same design process-the recognition rate ranged from below 50% to above 90%.This study confirmed that the majority of the pictographs developed in a participatory design process involving a small number of nurses and consumers were recognizable by a larger number of consumers. The variance in recognition rates suggests that pictographs should be assessed individually before being evaluated within the context of an application.

Full Text

Cited Authors

  • Kim, H; Nakamura, C; Zeng-Treitler, Q

Published Date

  • February 24, 2009

Published In

Volume / Issue

  • 11 / 1

Start / End Page

  • e5 -

PubMed ID

  • 19275981

Pubmed Central ID

  • 19275981

Electronic International Standard Serial Number (EISSN)

  • 1438-8871

International Standard Serial Number (ISSN)

  • 1439-4456

Digital Object Identifier (DOI)

  • 10.2196/jmir.1129


  • eng