UNIVERSITI TEKNOLOGI MARA

VISUAL LITERACY: IMPLEMENTING VISUALS IN COMMUNICATING

HEALTHCARE INFORMATION

NOR SYAMIMI BINTI SAMSUDIN2012359041

ED702

RESEARCH PROPOSAL

FACULTY OF EDUCATION

DECEMBER 2013

CONTENTS

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CHAPTER 1: INTRODUCTION.........................................................................................31.0 Introduction...............................................................................................................31.1 Problem Statement...................................................................................................51.2 Research Objectives.................................................................................................61.3 Research Questions.................................................................................................61.4 Significance of the Study..........................................................................................71.5 Limitation of the Study..............................................................................................81.6 Operational Definitions.............................................................................................8

1.6.1 Visual Literacy....................................................................................................81.6.2 Visuals................................................................................................................81.6.3 Communication...................................................................................................91.6.4 Healthcare information.......................................................................................9

1.7 Conclusion................................................................................................................9CHAPTER 2: LITERATURE REVIEW.............................................................................10

2.0 Introduction.............................................................................................................102.1 Visual Literacy.........................................................................................................102.2 Problem in understanding healthcare information..................................................12

2.2.1 Literacy.............................................................................................................122.2.2 Age...................................................................................................................132.2.3 Disability...........................................................................................................132.2.4 Language..........................................................................................................132.2.5 Culture..............................................................................................................142.2.6 Emotion............................................................................................................14

2.3 Communication through visuals..............................................................................142.4 Conceptual framework............................................................................................172.5 Conclusion..............................................................................................................18

CHAPTER 3: RESEARCH METHODOLOGY.................................................................193.0 Introduction.............................................................................................................193.1 Research Design....................................................................................................203.2 Population and Sampling........................................................................................203.3 Instrumentation.......................................................................................................21

3.3.1 Questionnaire...................................................................................................213.3.2 Unstructured interview......................................................................................213.3.3 Document analysis...........................................................................................22

3.4 Data Collection.......................................................................................................223.5 Data Analysis..........................................................................................................233.6 Conclusion..............................................................................................................24

The Bibliography..............................................................................................................25Appendices27

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CHAPTER 1

INTRODUCTION

1.0 Introduction

Art and science is the branch of knowledge but there was split between two

hemispheres of brain; left and right brain. According to Williams (1983), the left brain

more to analytical skills, language, mathematical concepts, medical experimental, logic

and science stream while right brain characteristic based on creativity, the ability to see

pattern, spatial awareness, visual and art stream. He stated that if both of the

hemisphere combined, there will be contributed toward effective instructional material in

educating people in future. In this study, the implementation of art into science or

medical areas in communicating healthcare information will be studied.

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Figure 1: The illustration by Mark Tatro, Rotate Graphic (www.rotategraphic.com)

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Health literacy is about communication and understanding. It affects how people

understand wellness and illness, participate in health promotion and prevention

activities, weigh decisions about treatment, take medications, and follow self-care

instructions. Health literacy is defined as the degree to which individuals have the

capacity to obtain, process, and understand basic health information and services

needed to make appropriate health decisions (Osborne,2005)

According to Andrus and Roth (2002), healthcare practitioner face problem in

recognizing when patients do not understand written words and challenging on how to

communicate through visuals or other visual media. In recent years, there has been an

increasing interest in implementing visuals in communicating healthcare information by

the doctor. The integration of art (visuals literacy) into science (health literacy) will be

facilitating people in understanding healthcare information in effectively and promoting

the best healthcare services.

However, not all health professionals have time, interest, or talent to draw, and the

information may be too complex to simply convey in visuals. They not artists or designer

to come out with graphically design of healthcare information. The is no reason to expect

that health professionals either know to draw pictures or feel confident doing so. Here,

the art practitioner can plays the roles as the facilitator or designer in creating handout

specific to a medical practice or facility. Collaborations between health professionals and

visual artist are often more effective than working alone (Osborne, 2005).

The good health and well-being require a clean and harmonious relationship

between doctor and patients. The integration of the visual into healthcare environments

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can play a important role in achieving these objective. Moreover, those who provide

healthcare now understand that communicating clearly with their patient is essential to

quality patient care and serve the quality of healthcare service.

1.1 Problem Statement

This research is based on several factors. Patients and their family members often

receive an overwhelming amount of health information. The content may be unfamiliar,

complicated, confusing or perhaps even frightening. The format can include numbering

data, dense text, unreadably small fonts and number presented as fractions or decimals

or percentages. Adding to these problems, patients and their families often receive

health information at times when they feel sick, distracted an are not at their learning

best (Osborne, 2006).

"...The doctor or healthcare administrator never laid a hand on me, he or she

never touched me, he or she was hardly listening and they were busy entering stuff into

the computer and they start to do assumption on the disease about the patient. The

doctor just say the biological terminology that I cannot understand and they will suggest

the medication and do's and dont's and they asked to come back for another 4

weeks..".

(The Fading Art of The Physical Exam by Richard Knox ,2012)

Based on the statement above that stated by Richard Knox in his research, he

believed that common patient complaint about on how the doctor treats them as the

patients. The important of healthcare story is as to recognize emergencies, essential

information, to follow the medical instruction and to know what to do when they occur.

So, every patient has the rights to access competent healthcare and treatment because

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this can truly be a matter of life and death. If the communication just on verbally not

attached with visual and adding with patient's emotion in that time, might be the

healthcare information end up with the wrong interpretation by the patients.

1.2 Research Objectives

The research objectives of this study are:

i. To identify why people have trouble in understanding healthcare information.

ii. To identify the design of visual that want to implement in communicating healthcare

information

iii. To produce the effective visuals literacy tools that can help interpret the healthcare

information.

1.3 Research Questions

The research questions for this study are:

i. Why people have trouble in understanding healthcare information?

ii. How the design of visual that want to implement in communicating healthcare

information?

iii. How to produce the effective visuals literacy tools that can help interpret the

healthcare information?

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1.4 Significance of the Study

The significance of this research is as to promoting on how visual can help in

interpreting the healthcare information. This study also contributing on how important art

by using visual as the simple approach in delivering healthcare information. It is

important to make a study, documentation and producing visual materials that related to

deliver the healthcare information as a references for the benefit to people.

According to Fitzgerald (1995), visual literacy are becoming the predominant

form of communication across a range of learning and teaching resources, delivered

across a range of medias and formats. He argued that the visual literacy is now crucial

for obtaining information, constructing knowledge and building successful educational

outcomes. These reasons seem to be relevant as the significance of this study as to

relate visual literacy in health literacy together. People needs to aware with the important

of the implementation of visual literacy in communicating healthcare information because

everyone in this world is involved with healthcare matter since we are early infancy to

older ages.

It is hoped that the findings from this study will provide insights to this issues may

help health professionals in implementing visuals in communicating to their patients

about the healthcare information and fully conveyed in effective ways. This study also as

the encouragement of visuals artists to involve in actively in society in contributing

something useful in healthcare aspects.

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1.5 Limitation of the Study

The main limitation of this research is the integration between science and art

together in one research. The researcher need to study about the medication area that

not very familiar and need to ask many expertise in this area for avoid to gain the wrong

data and misleading healthcare information. Moreover, the researcher also need to find

out the variety of resources from biological, medication and art to obtain the information.

The researcher should have to produce a visual material based on healthcare

information. The limitation also from the process of development in producing a visual

material based on healthcare story. The researcher should have to understand the

health information first and interpret all of the text in the visual art form. The duration for

producing final product is quite short and the important of final product’s quality is

needed.

1.6 Operational Definitions

1.6.1 Visual Literacy

According to Giorgis, Johnson, et.al, (1999), visual literacy refers to the ability

in constructing the meaning from visual images. In this research, visual literacy is

defined as an ability to understanding the meaning of visuals in healthcare

information.

1.6.2 Visuals

Visuals refers to a picture, a piece of film, or display used to illustrate or

accompany something, etc , used to make an article or a talk easier to understand

or more interesting (The Oxford Advanced Learners Dictionary, 7th Edition, 2005). In

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this research, visuals is defined as a tools or material to convey the meaning of

healthcare information in effectively.

1.6.3 Communication

Communication is defined as a process of transmitting ideas, informations,

attitudes by the use of symbols, words, pictures, figures from the source, for the

purpose of influencing with intent (Rappaport, 2002). In this study, communication

refer to the process of telling something about healthcare information and

participating people to understanding the contents.

1.6.4 Healthcare information

Healthcare information refers to the process of telling something about the

healthcare or medical information that involved the communication between the

doctor and the patient (American Medical Association Foundation, 2003). In this

study, healthcare information defined as the information about healthcare that will be

explained by the doctor to patients using the visuals as the medium of instruction.

1.7 Conclusion

This chapter has covered the background of this study, the statement of the

research problem, the research objectives, the research questions, the operational

definitions, the limitation of this study and the significance of this study. The literature

review of the topics related to this study will be discussed in the next chapter.

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CHAPTER 2

LITERATURE REVIEW

2.0 Introduction

In this chapter we will be focusing on the perspectives of other researchers, as

well as previous researches to be able to produce a more significant and concrete

research. The research that is being done is the contents of visual literacy and health

literacy. Other than that, this research will also explore the relationship between visuals

and healthcare information itself. Summarized in the following review of the literature are

the definition of visual literacy, the important of visual literacy, the problem in

understanding healthcare information and how visuals can help in communicating

healthcare information.

2.1 Visual Literacy

The term "visual literacy" originally coined by John Debes in 1968 and he believed

that it is the ability to see, comprehend, discriminate and interpret objects and symbols in

the environment, integrate them with other sensory experiences and use them to

creatively communicate with others or derive enjoyment (Debes, 1968). Later, according

to Cochran (1972) in Ausburn and Ausburn (1978), she examined 72 different definitions

of visual literacy and identified three themes in common; human abilities, teaching

strategies and the promotion of ideas based on the types of visual language in body

language, object language, sign and symbol language and abstract language.

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Visual literacy can be defined as the ability to interpret, use, appreciate and create

images and video using both conventional and 21st century media in ways that advance

thinking, decision, making, communication and learning. Visual literacy also refers to the

learned ability to interpret visual and messages accurately and to create such messages.

There have two major approaches; helping learners to decode, or "read", visuals

proficiently by practicing visual analysis skills and helping learners to encode, or "write",

visuals to express themselves and communicate with others (Smaldino, Lowther &

Russell, 2012).

According to Ausburn & Ausburn (1978), visual literacy includes the group of skills

which enable an individual to understand and use visuals for intentionally communicating

with others. The International Visual Literacy Association (IVLA) was founded to

investigate the potential value of visual literacy principle and to apply them to enhance

education and communication. There has been a steady development in the field since

that time, and visual aids have been integrated into classroom instruction, advertising,

business, and patient education regarding healthcare procedures

(http://www.uniteforsight.org/visual-literacy/module3#_ftnref1).

Visual literacy encourages an appreciation and comprehension of visual

communication. In healthcare matter, visual literacy allowed a healthcare professionals

to be able to interpret and communicate difficult terminologies and explain to their patient

about their condition. Two ways of communication achieved in successfully if the

healthcare professionals share the responsibilities and the patients understand the

contents about the healthcare information. The important of visual literacy contributes to

problem solving and critical thinking through exposure to interesting and varied images

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in communicating healthcare information materials.

2.2 Problem in understanding healthcare information

Patients and their family members often struggle to understand health information.

According to Thompson (2003), discussing health topics with patients orally presents

many challenges. He added that verbal instruction are often complex, delivered rapidly

and easily forgotten in stressful situations. In addition, language barriers present

comprehension problem.

Strunk (1979) stated that how people absorb some information is different from

others; auditory learners, kinesthetic learner and visual leaners.Besides of the learner

style, Osborne (2006) stated that people have trouble understanding health information

because of learning challenges. There are literacy aspect, age, disability, culture and

emotion of the patients. Instead, people might be also are in different learning

characteristic.

2.2.1 Literacy

Literacy has been consistently observed as critical to participation in healthcare

programs and to improve quality of live. According to Smaldino, Lowther and Russell

(2012), they claimed that literacy is defined as an individual's ability to read, write,

speak, compute and solve problem at levels of proficiency necessary to function on

the job and in society, to achieve one's goals and to develop one's knowledge and

potential. People with low literacy will have difficulty learning information from many

written patient medical materials, including medication labels. A lot of health

information is in written formats like brochures, fact sheet and websites. To

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understand these materials, people who struggle with literacy almost always have

trouble understanding health information because so much of it is communicated in

writing.

2.2.2 Age

Age also affect how people learn and understand health information. People of

all ages want to know what new diagnose or treatments will mean in their lives and

how to cope with their medical conditions on a day to day basis As people age,

many factor can interfere with health understanding. Older adult for example may

also be struggling with difficult emotions and anxiety in understanding the complex

of health information by doctor (Osborne, 2006).

2.2.3 Disability

When people have disabilities that interfere with seeing, hearing or

remembering, their receptive (taking in) and expressive (giving out) communication

skills are affected (Osborne, 2006). So, it can impact on a person's ability to

understand about the health information well and needs someone to be the

interpreter or family member to explain it back.

2.2.4 Language

Next, the problem based on the language. Here, in healthcare information its

refer to medical terminologies and words choice that used by the doctor. Patients

can easily overlook or understanding the exact meaning. In short, the fluent of

language need to involve with body language and visuals materials as to ensure the

misconception will be overcome.

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2.2.5 Culture

Culture provides a context or framework for people to understand concepts.

This problem arises when there have culturally diverse patient. In some cultures,

patients are not the ones to make health decisions. Despite cultural and linguistic

differences, healthcare information need to convey in ways all of the patients can

understand.

2.2.6 Emotion

In addition to all the other factors that affect health understanding, people's

emotions affect how they learn. It is more difficult to concentrate and comprehend

when feeling scared, sick or in pain (Osborne, 2006).

2.3 Communication through visuals

Research has shown that visual aids can increase a patient's understanding of their

medication regimen(s). Visuals accompanied by oral instructions have increased

patients' recall more than if they are given oral instructions alone (Houts et al., 2001). In

addition, they claimed that by using pictures and text, patients more understand and help

them in recalling information because the formation of the message is encoded in

multiple places in memory.

Visual materials help people remember information they hear. Schwarzberg (2005)

suggested that people remember 10% of what they read, 20% of what they hear, 30% of

what they see and 70% of what they see and hear. He believed that the use of visuals

can help teach about something that can not be easily seen (example, female internal

anatomy). Visuals can illustrate a specific point and demonstrate steps to follow to

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complete a task. In fact, visuals are an effective way to present real-life situations.

In order to do all of this, healthcare information must be simply, clearly and

correctly understood, even when the content is difficult or people have trouble in learning

and understanding information. Visuals can help in interpreting healthcare setting. They

not only are interesting and attractive to look at, but can reinforce the written or spoken

health message. Such example layout and design, pictograph and cartoons, pain scales

and visual tools, maps, genograms and other diagrams and form in interactive way.

(Osborne, 2006).

According to Delp and Jones (1996), the studies of the role of cartoons in

emergency room instructions, they founded that these illustrations are effective way to

convey information. This also agreed by Houts et al. (2001), they believed that the use of

pictographs (refer to simple line drawings that illustrate ideas or actions), shows that

pictographs can be aid of learning and communicating in healthcare information, even

for person who have lower or limited literacy skills.

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Figure 2: The example of layout for healthcare service.

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Figure 3: The example of pictograph and cartoons illustration in healthcare service.

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Figure 4: The example of pain scales illustration in healthcare service.

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Figure 5: The example of medical genograms symbols in healthcare service.

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Visuals not only are interesting and interactive to look at, but more toward the

efficient and effective of the content delivered based on the written and healthcare

information. Health information is not always linear, often it is too complex, but visuals

can help in interrelationships it.

2.4 Conceptual framework

Figure 1: Conceptual Framework

The study is focused from visual literacy among patient in the ways of understanding

about healthcare information. The doctor have shared responsibility on communicating

health information to patients (Osborne, 2006). There have major problem that involved

the patient in understanding health information based on literacy, age, disability,

language, culture and emotion. All patients have their right in gain the best explanation

about their healthcare, but the doctor need to use visuals approaches to communicate

the healthcare information. Visuals play an important roles in interpret healthcare

information so for the last step in this study, the researcher will be come out with visuals

materials based on healthcare information as the final product for this study.

Problem in understanding

health information

Visuals can help interpret the healthcare information

Produce the visual materials that can help

interpret the healthcare information

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2.5 Conclusion

Researches from previous studies have proved that visual literacy have its

contribution toward medical aspect (health literacy). So, the problem in understanding in

healthcare information will be overcome by visuals material and verbal communication

that combined together as to ensure there no misleading and difficulties occurs. More

research are encourage as to promoting visuals literacy in healthcare information in

future.

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CHAPTER 3

RESEARCH METHODOLOGY

3.0 Introduction

This chapter explains the research design of this study, the method of data

collection, the population as well as the sample of this study and the data analysis of the

data. The data that has been analyzed will then be presented in the next chapter.

Figure 3.1: Chart of Methodology

Visual literacy: Implementing Visuals in

Communicating Healthcare Information

Unstructured interviews

Questionnaire Document Analysis

FindingsData Analysis

Product(Visuals Material)

Conclusion & Recommendations

Instrumentation

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3.1 Research Design

This study will be carried out using quantitative approach as well as quantitative

approach as well as qualitative approach; mixed method research. Under the

quantitative approach, the researcher will be conducting a survey research as to identify

why people have trouble in understanding health information. "A cross-sectional survey

is one in which data are collected from selected individuals at a single point in time"

(Fraenkel, Wallen & Hyun, 2012).

Apart from that, according to Fraenkel, Wallen and Hyun (2012), unstructured

interview is an informal interview that is not aimed at obtaining answers to predetermined

questions but rather to obtain information about where the participants are coming from

and what they have experienced. There are the research designs that will be used to

gather the data is needed for this study.

3.2 Population and Sampling

The target population of this study was a public people. The researcher will be

using simple random sampling because all individuals in the selected population have an

equal and independent chance to be selected for the sample ((Fraenkel, Wallen & Hyun,

2012). Besides of using the public people as the sample for this study, six healthcare

practitioner or doctor from the hospital will be interviewed in order to gain their insights

and experienced in communicating healthcare information to their patients.

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3.3 Instrumentation

3.3.1 Questionnaire

The first instrument that will be used in this study is a questionnaire. This

questionnaire form was divided into 3 main parts. There are Part A: Respondent's

Background asked about the respondent's background based on the question

given.Then, Part B: Trouble in Understanding Healthcare Story. This study aims to

identify what are some of the main factors which contribute people having trouble in

understanding healthcare story. Part C: Design of the Visual that want to implement.

This part as to identify about the design and visual that want to implement in

communicating healthcare story. The questionnaire is included in the appendix

section.

3.3.2 Unstructured interview

The second instrument that will be used in this research is unstructured

interview. Interviews are one of the methods used to gain qualitative information.

The researcher used interviews method as to collect and gain the relevant the

information for this study. The purpose of interviewing the samples is to complement

and extend data from questionnaire as well as to find out where the samples are

coming from and their experiences. The interviews are questions designed to draw

out the subjects’ responses on a topic of interest. These respondents are free to

answer in their own word rather than have to choose from predetermined option, as

in a survey in questionnaire for example. The unstructured open-ended format

permits a greater flexibility and responsiveness to emerging issues for the

participants. The interview questions are included in the appendix section.

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3.3.3 Document analysis

This study also uses documents from others research and then a document

analysis are carried out. For the document analysis, the researcher would also get

the additional sources such as books, newspapers, the Internet and so on to

supplement the findings. All the data were analyzed to obtain the complete

information and facts.

Books are one of the important sources used to collect all the information for

this study. There are several books that the researcher has relied on to collect the

information. The researcher also made use of article from newspapers and journal to

collect the relevant information in order to complete this study. The Internet is also

one of the sources that the researcher has relied on to collect all the related

information for this study.Lots of web pages have been used to collect and gain the

relevant information for this study. Most of the information that gained in the Internet

is reliable and useful for the researcher.

3.4 Data Collection

Before the real data collection process for this study is carried out, the researcher

was sought from Malaysian Ministry of Health and Health Department of Selangor. After

obtaining approval, the researcher requested lists of health practitioner from the

Department of Health in Selangor. Then, the researcher sent a letter to health

practitioner where there would be respondents for the study and the dates that it would

take place. Further, the researcher asked cooperation from public people in the hospital

in distributing the questionnaires and collecting completed questionnaires from them.

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For the unstructured interview, six samples will be used as the interviewees. The

interview will be conducted at the clinic and the hospital and will be recorded.

3.5 Data Analysis

After the completed questionnaires have been collected, the resulting data will be

tabulated and entered into a spreadsheet. Then, the data will be summarized using

descriptive statistics. The types of descriptive statistics that will be used to measure the

value of data from the questionnaires. As for the data analysis for the unstructured

interview, the interview transcripts will be read and memos will be written. The data from

the interview transcripts will be coded and each code indicate a certain pattern and

meaning.

Besides that, the researcher also need to produce the visual material that can help

interpret healthcare information. There are several expenses involved with producing

visual material for healthcare.

Step 1: Planning the visual material by identify the resources needed, define the

target audience, goal and objectives, determine the concepts and messages,

identify the look and design.

Step 2: Writing the visual material by recognize the content, literacy demand,

graphics and interaction.

Step 3: Revising the visual material

Step 4: Formating the visual material

The next chapter will be discussed about the process involved in final product based

on visual materials in communicating healthcare information.

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3.6 Conclusion

This chapter has covered the research design, the sample population, the

instrument, the data collection and the data analysis. The next chapter will be discussing

on the findings of this study.

The Bibliography

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Andrus, M.R., & Roth, M.T. (2002). Health Literacy: A review. Pharmacotherapy, 22, 282-302.

Ausburn, L. & Ausburn, F. (1978). Visual Literacy: Background,, Theory and Practice. PLET, 15 (4), 291-297.

Debes, J. (1968). Some Foundations of Visual Literacy. Audio Visual Instruction, 13, 961-964.

Delp, C. & Jones, J. (1996). Communicating Information to Patients: The Use of Cartoon Illustration to Improve Comprehension of Instructions, Academic Emergency Medicine, 3:264-270.

Fitzgerald, M. (1995). NAA Leaders disagree over the value of cyberspace. International Federation of Newspaper Publishers Research Association, 128 (12), 48-49.

Frankel, J.R., Wallen, N.E., & Hyun, H.H. (2012). How to Design and Evaluate Research in Education. Eight Edition. New York: McGraw Hill International Edition.

Giorgis, C., Johnson, N.J., Bonomo, A. Colbert, C., & al, e. (1999). Visual Literacy. Reading Teacher, 53 (2), 146-153.

Houts, P.S., Witmer, J.T, Egeth, H.E., Loscalzo, M.J., & Zabora, J.R. (2001). Using pictographs to enhance recall of spoken medical illustrations. Patient Education and Counseling, 43, 231-242.

Osborne H. (2005). Health Literacy from A to Z: Practical Ways to Communicate Your Health Message. United States: Jones and Bartlett Publishers

Osborne H. (2006). Health Literacy: How Visuals Can Help Tell the Healthcare Story. Journal of Visual Communication in Medicine, Vol.29, No.1, pp 28-32.

Rappaport, T.S. (2002). Wireless Communication Principles and Practice. Second Edition. United States: Person Education

Richard Knox. (2012). The Fading Art of The Physical Exam. Unpublished doctoral dissertation, Emory University: United States

Schwartzberg J.G. (2005). Understanding Health Literacy: Implications for Medicine and Public Health. Chicago: AMA Press.

Smaldino, S.E., Lowther, D.L., & Russell, J.D. (2012). Instructional technology and media for learning (10th ed.). Upper Saddle River, NJ: Prentice Hall.

Strunk W.Jr (1979). The Elements of Style. New York: MacMilan.

Thompson T.L. (2003). Handbook of Health Communication. New Jersey: Lawrence Erlbaum Associates.

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Williams, L.V. (1983). A Guide to Right Brain/ Left Brain Education: Teaching with the Two Sided Mind. Englewood Cliffs, New Jersey: Prentice-Hall.

Health Literacy. Retrieved October 30,2013 fromhttp://www.healthypeople.gov

Visual Literacy. Retrieved November 29,2013 fromhttp://www.uniteforsight.org/visual-literacy/module3#_ftnref1

The Oxford Advanced Learners Dictionary, 7th Edition. (2005)

American Medical Association Foundation (2003)

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APPENDICES

Visual Literacy: Implementing Visuals in Communicating Healthcare Information

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Universiti Teknologi MARA, SHAH ALAM

This questionnaire form was divided into 3 main parts. There are:

Part A: Respondent's BackgroundThis part asked about the respondent's background based on the question given.Part B: Trouble in Understanding Healthcare StoryThis study aims to identify what are some of the main factors which contribute people having trouble in understanding healthcare story.Part C: Design of the Visual that want to implementThis study also want to identify about the design and visual that want to implement in communicating healthcare story.

The information collected will be kept confidential and will only be used by the researcher for analyzing this research only.

Thank you for your valuable time and cooperation.

PART A: RESPONDENT'S BACKGROUND

Part A: Respondent's BackgroundPlease answer all questions and tick (√) in the appropriate box.

1. Gender Male Female 2. Age

Below 18 years old19 - 29 years old30 - 39 years old40 - 49 years old50 - 59 years old60 years old and above

3. What is your ethnic group?MalayChineseIndianOthers:___________

4. How often you meet your doctor for healthcare service?Always Sometimes Never

5. Do you satisfied after hear the explanation about your healthcare information from your doctor?

Yes No

PART B: To identify why people have trouble when understanding healthcare story.

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For question, please indicate the extent to which you agree with these statements by using circle (o) or tick (√) the most appropriate answer.

(1- strongly disagree, 2- disagree, 3- agree, 4- strongly agree)

1. Literacya. I always understand health information in written formats 1 2 3 4b. I do not understand if all the health information using texts,

number and chart.1 2 3 4

c. I prefer the health information using more visual than texts 1 2 3 4

2. Verbal Communication / Languagea. I prefer my doctor explain about health information in slowly

and using simple term.1 2 3 4

b. I prefer when my doctor explain things in clear by using plain language.

1 2 3 4

c. I understand if my doctor explain using too many statistic 1 2 3 4

3. Agea. I prefer the approaches of explanation health information is

divided into age group.1 2 3 4

b. I always confuse and misleading about the healthcare information that the doctor explained to me

1 2 3 4

c. I need someone to help me to explain back the healthcare information after see the doctor.

1 2 3 4

4 Emotiona I feel very difficult to concentrate when the doctor

communicate about the healthcare information to me1 2 3 4

b I am not very sure about the healthcare information because i anxiety.

1 2 3 4

c I can control my emotion when hear the explanation from the doctor

1 2 3 4

6. What is your learning style?Visual learnerAuditory learnerKinesthetic learnerMixed leaner

PART C: To identify the design of visual that want to implement in communicating

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healthcare information.

For question, please indicate the extent to which you agree with these statements by using circle (o) or tick (√) the most appropriate answer.

1. Which is the best following show about medication images?

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35

A B

Reason of your answer:_____________________________________________________

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2. Which is the best following show about the body part (heart and brain)?

A B

Reason of your answer:_____________________________________________________

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3. Which is the best following show about "do not take this dairy product"?

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A BReason of your answer:_____________________________________________________

4. Based on the image below, I become more understand about the healthcare information.

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Yes No

Please give your reason if you say YES or NO.

__________________________________________________________________________________________________________________________________________________________________________________________________________________

5. Based on the pictograph (image) show below, I become more understand about the medication prescription.

Yes No

Please give your reason if you say YES or NO.

__________________________________________________________________________________________________________________________________________________________________________________________________________________

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Unstructured Interview

1. What is your opinion based on health literacy?

2. Do you agreed if the visuals material implement in communicating healthcare

information? Why?

3. Do you have any problem when communicating about healthcare information to your

patients?

4. If yes, what is your approach to overcome the problem?

5. What is your suggestion if visual literacy implementing in communicating healthcare

information?

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