American Journal of Educational Research
ISSN (Print): 2327-6126 ISSN (Online): 2327-6150 Website: Editor-in-chief: Ratko Pavlović
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American Journal of Educational Research. 2016, 4(5), 371-377
DOI: 10.12691/education-4-5-2
Open AccessArticle

Developing Pictographs for Increasing Adherence in Patients with Diabetes Mellitus

Marziyeh Hasani1, Narges Khanjani2, Mohammad Reza Mahmoodi3, Mohammad Mehdi Fadakar4, , Abedin Iranpour4 and Mohammad Hossein Gozashti5

1Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

2Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran

3Cardiovascular Research Center, Institute of Neuropharmacology & Department of Nutrition, School of Health, Kerman University of Medical Sciences, Kerman, Iran

4Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

5Endocrine and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, Kerman University of Medical Sciences, Kerman, Iran

Pub. Date: April 08, 2016

Cite this paper:
Marziyeh Hasani, Narges Khanjani, Mohammad Reza Mahmoodi, Mohammad Mehdi Fadakar, Abedin Iranpour and Mohammad Hossein Gozashti. Developing Pictographs for Increasing Adherence in Patients with Diabetes Mellitus. American Journal of Educational Research. 2016; 4(5):371-377. doi: 10.12691/education-4-5-2


Introduction: The compliance of low literate and illiterate patients might be improved and disease complications prevented by using pictographs. This study was carried out using qualitative methods to design pictographs for increasing adherence in low literate and illiterate patients with diabetes mellitus. Material and methods: An action research was carried out after facing compliance problems in illiterate diabetic patients. A professional graphic designer designed pictographs under the supervision of health education, endocrinology and nutrition specialists, in two cycles and after conducting interviews with 23 low literate and illiterate patients. The data was analyzed by qualitative methods. Results: After a long and durable process and 23 interviews [with 16 illiterate and 7 low literacy persons[ and 2 cycles, 10 pictographs for correct medicine consumption, 8 for foot care, 4 for diet, 113 for food substitutes and 1 for physical exercises were created, which were acceptable and understandable for most patients. Conclusion: Pictographs might be helpful for increasing adherence in illiterate or low literate patients who have problems with written instructions. In the present study we designed some pictographs to help these patients. It is necessary to carry out studies to prove the efficacy of these pictographs in improving patient adherence through quantitative methods.

pictographs low literate illiterate diabetes mellitus adherence

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