Cesarean Delivery Affecting Newborn, Health Literacy, Postpartum, Randomized Controlled Trial
Conditions
Brief summary
Post-cesarean delivery discharge instructions are not currently at an appropriate health literacy level. Enhancing discharge instructions with a visual aid did not improve scores on comprehension quizzes, either immediately or two-weeks post-discharge. However, participants preferred to have access to visual images with discharge instructions.
Detailed description
Objective: To evaluate the effect of a visual aid on improving comprehension of hospital discharge instructions for cesarean wound care. Methods: A randomized control trial with a 1:1 allocation ratio and an intention to treat analysis was performed at an urban, tertiary care center from June-November 2017. Fifty English-speaking patients ages 18-50 who had undergone a cesarean delivery were randomized to receive either standard or enhanced discharge instructions regarding post-cesarean incision care. Enhanced instructions included a visual aid not present in the standard instructions. Participants completed a comprehension quiz prior to hospital discharge and again 2 weeks after discharge as well as the REALM literacy assessment prior to discharge.
Interventions
OTHERVisual Aid
The visual aid was a one-sheet diagram with illustrations of important features of post-cesarean wound care.
Standard discharge instructions WITHOUT supplement of visual aid.
Sponsors
Rebecca Lawrence, BS
Sarah Cohen, MD
Rebecca Newbrander, MD
Jason K. Baxter, MD
Thomas Jefferson University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* Able to consent * Identified as English speaking * Had a cesarean delivery during the index hospitalization for delivery of their living newborn
Exclusion criteria
* Non-English speaking * Declined to participate * Required a translator for communication * Intellectual disability (as self-identified or as determined by healthcare provider) * Currently incarcerated
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comprehension Score Two Weeks Post-Discharge | Two weeks | Total score on 11-point quiz (Discharge Instructions Comprehension Quiz) administered via phone two weeks post-discharge, score range 1-11 with one point assigned for each correct answer (no subtractions for incorrect answers); higher scores are favorable indicating answers consistent with higher comprehension |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Immediate Comprehension | 15 minutes | Total score on 11-point quiz (Discharge Instructions Comprehension Quiz) administered immediately after discharge instructions reviewed, score range 1-11 with one point assigned for each correct answer (no subtractions for incorrect answers), higher scores are favorable indicating answers consistent with higher comprehension |
Countries
United States
Outcome results
None listed