Visual Resources for Postoperative Care to Overcome Language and Cultural Barriers

Card, Elizabeth B.; Zimmerman, Carrie E.; Kalmar, Christopher L.; Trueblood, Eo; Low, David W.; Ramı́rez, Juan M.; Friedland, Leonard R.; Schwartz, Alan Jay; Jackson, Oksana A.

doi:10.1097/prs.0000000000008561

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…Such illustrated instruction sheets could be shared across separate foreign surgical groups as a way to standardize postoperative care communication, and we created an online open-source visual resource repository to facilitate sharing of resources, posting our resources as the first contribution. 36 As mentioned earlier, foreign surgical missions are widely known to be less sustainable solutions for healthcare gaps compared to local teams. Local indigenous and nonindigenous surgeons and care teams could also benefit from illustrated instructions given that there are 22 Mayan languages spoken in Guatemala leading to language and cultural barriers within the country.…”

Section: Discussionmentioning

confidence: 99%

“…Culturally appropriate illustrated instructions for postoperative CL/P repair and ear tube placement were developed for caregivers of patients receiving any CL/P surgery with or without ear tube placement (Appendices A and B). 36 The instructions were written in English by cleft surgeons (DWL, OAJ) and an otolaryngologist (LRJ) and translated into Spanish by certified medical translators. The drawings were illustrated by medical illustrators (EBC, ET) and shown to Guatemalan nurses, doctors, and patient caregivers to check the understandability and cultural relevance of the illustrations.…”

Section: Methodsmentioning

confidence: 99%

“…Our initial experience revealed a need to improve the knowledge of postoperative care. 36 Thus, we sought to use carefully designed illustrated instructions as an intervention to improve communication surrounding postoperative care between our mainly indigenous patient population and non-indigenous and foreign medical teams. A demonstration of improved understanding and retention of care instructions would support the need for illustrated and culturally appropriate patient education materials in the context of foreign surgical missions.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Illustrated Postoperative Instructions on Knowledge and Retention During a Cleft Lip and Palate Surgical Mission

Card

Morales

Ramı́rez

et al. 2022

The Cleft Palate Craniofacial Journal

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Objective To determine the impact of illustrated postoperative instructions on patient-caregiver knowledge and retention. Design Prospective study with all participants receiving an educational intervention. Setting Pediatric plastic surgical missions in Guatemala City, Guatemala, between 2019 and 2020. Participants A total of 63 majority-indigenous Guatemalan caregivers of patients receiving cleft lip and/or palate surgery. Intervention Illustrated culturally appropriate postoperative care instructions were iteratively developed and given to caregivers who were surveyed on illustration-based and text-based information at preoperative, postoperative, and four-week follow-up time points. Main Outcome Measure Postoperative care knowledge of illustration-based versus text-based information as determined by the ability to answer 11 illustration- and 8 text-based all-or-nothing questions, as well as retention of knowledge as determined by the same survey given at four weeks follow-up. Results Scores for illustration-based and text-based information both significantly increased after caregivers received the postoperative instructions (+13.30 ± 3.78 % SE, + 11.26 ± 4.81 % SE; P < .05). At follow-up, scores were unchanged for illustration-based (−3.42 ± 4.49 % SE, P > .05), but significantly lower for text-based information (−28.46 ± 6.09 % SE, P < .01). Retention of text-based information at follow-up correlated positively with education level and Spanish literacy, but not for illustration-based. Conclusions In the setting of language and cultural barriers on a surgical mission, understanding of illustration-based and text-based information both increased after verbal explanation of illustrated postoperative instructions. Illustration-based information was more likely to be retained by patient caregivers after four weeks than text-based information, the latter of which correlated with increased education and literacy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Illustrated Postoperative Instructions on Knowledge and Retention During a Cleft Lip and Palate Surgical Mission

Card

Morales

Ramı́rez

et al. 2022

The Cleft Palate Craniofacial Journal

Self Cite

View full text Add to dashboard Cite

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Crowdsourcing the Impact of Illustration in Cleft Surgery Education

Wu,

Card,

Sussman

et al. 2024

The Cleft Palate Craniofacial Journal

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Objective This study aimed to (1) assess layperson preferences for how surgical information is presented; (2) evaluate how the format of visual information relates to layperson comfort with undergoing surgery, perceptions of surgeon character traits, and beliefs about artistic skill impacting plastic surgery practice; and (3) identify sociodemographic characteristics associated with these outcomes. Design A survey was developed in which one of five standardized sets of information depicting a unilateral cleft lip repair was presented as (1) text alone, (2) quick sketches, (3) simple drawings, (4) detailed illustrations, or (5) photographs. Setting Online crowdsourcing platform. Participants Raters aged 18 years and older from the United States. Interventions None. Main Outcome Measure(s) After viewing the surgical information, participants answered three sets of Likert scale questions. Ratings were averaged to produce three composite scores assessing (1) comfort with undergoing surgery (2) perceptions of surgeon character traits, and (3) beliefs about plastic surgery and artistry. Results Four hundred seventy-nine participants were included. Surgeon character traits score was highest among participants who viewed detailed illustrations at 4.46 ± 0.59, followed by photographs at 4.43 ± 0.54, text alone at 4.28 ± 0.59, simple drawings at 4.17 ± 0.67, and quick sketches at 4.17 ± 0.71 ( p = 0.0014). Participants who viewed detailed illustrations rated surgical comfort score and plastic surgery and artistry score highest, although differences did not achieve statistical significance. Conclusions Viewing detailed cleft lip repair illustrations was significantly associated with positive perceptions of surgeon character traits. Our data help to contextualize methods of communication and education valued by the public when seeking cleft care.

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Visual Resources for Postoperative Care to Overcome Language and Cultural Barriers

Cited by 2 publications

References 3 publications

Impact of Illustrated Postoperative Instructions on Knowledge and Retention During a Cleft Lip and Palate Surgical Mission

Impact of Illustrated Postoperative Instructions on Knowledge and Retention During a Cleft Lip and Palate Surgical Mission

Crowdsourcing the Impact of Illustration in Cleft Surgery Education

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