Pre-testing of pictograms used in medicines dispensed in missions of humanitarian relief

Authors: de Silva, S., Ryan, K., Becket, G. and Vaillancourt, R.

Journal: New Zealand Medical Journal

Volume: 116

Pages: 2-3

ISSN: 1175-8716


The Canadian Forces send Disaster Assistance and Response Team (DART) personnel on missions of humanitarian relief. A majority of people to whom healthcare services are provided during these missions do not speak English, Spanish or French. This presents a serious communication problem for healthcare workers who attempt to give directions for medication.

A project was developed to adapt the United States Pharmacopoeia pictograms for this purpose. The aim of this study was to ascertain non-English-speaking people’s understanding of sixteen pictograms and to test the cultural appropriateness of the images used. Interviews were conducted via an interpreter with Kurdish, Khmer and Korean participants, who could neither read nor speak English, Spanish or French. Individual interviews were conducted to determine how the individual understood the pictograms, while focus-group interviews consisting of six to eight participants were conducted to determine the community perception and cultural relevance of these pictures. The demographic data and response to each pictogram were recorded in terms of a ‘Degree of Success Scale’ (a = no misunderstandings; b = timing errors; c = route of administration errors; d = quantity errors; e = auxiliary directions errors; f = other problems) for each participant.

Some pictograms were well understood while others caused confusion. Some pictures were not understood because the picture was not clear, the picture was culturally irrelevant (the concept of alcohol was misunderstood by over 75% of Khmer and Kurdish participants, but well understood by the Korean participants), or the picture was misinterpreted (over 87% of Kurdish interpreted the ‘take with food’ symbol as ‘crush the tablet’). The pictograms that were not well understood would have to be redesigned. These pictures will eventually be evaluated in the field and used

Source: Manual

Preferred by: Kath Ryan

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