Photo stories appear to be a good way to prepare patients for a doctor’s appointment. These are the findings of doctoral research by Ruth Koops van ’t Jagt. Particularly the elderly and people who find it difficult to communicate with a GP stand to benefit. People may be more likely to notice leaflets that use photo stories, and such stories may help people approach doctor’s appointments differently. Ruth Koops van ’t Jagt will be awarded a PhD by the University of Groningen on 12 July.
We’ve all seen them: leaflets in a rack or on the table in the doctor’s waiting room. Important information but people who really need them do not read or understand them properly. What’s more, a visit to the doctor is often hard enough as it is. Delicate topics, nerves, a lot of information from the doctor, unfamiliar terms… Patients often leave a doctor’s appointment with more questions. ‘Did I explain everything?’ ‘What did the doctor say about that again?’ PhD student Ruth Koops van ’t Jagt believes that health communication could be improved and that photo stories are a promising tool.
The elderly and people with what is termed limited health literacy experience problems communicating with their doctor. One in three of the Dutch population has limited health literacy, says Koops van ’t Jagt. ‘A large group of people often have difficulty understanding information in leaflets and talking to health-care providers. I researched how we can make leaflets that really will help them.’
Koops van ’t Jagt’s research focused on how GPs can use photo stories. These are stories with photos and captions about topics that are relevant to a doctor’s appointment. Koops van ’t Jagt developed seven short photo stories, each of which covered one topic in one page. These included comprehensible language, bringing someone along with you to your appointment, taking medication and acting on the doctor’s advice. She looked at which topics would be best for photo stories and researched whether people noticed the stories in waiting rooms and whether the target group appreciated them. ‘Elderly people said they preferred this form of communication to a traditional leaflet. People in waiting rooms also said that they noticed the photo stories more often than they did leaflets.’
Koops van ’t Jagt developed the photo stories together with elderly people themselves. One method she used was role playing with a retired GP. ‘That was really useful. They came up with the topics and problems. And the people in the photo stories aren’t “heroes” who do everything right, but people who, like the elderly, have doubts, uncertainties and questions. However, the stories show exactly what you can say to your doctor, and elderly people seem to need this. That explains the title of the doctoral thesis, “Show don’t tell.”’
‘Leaflets to disappear from GP waiting room’ was the headline on Dutch teletekst on 14 June. A headline saying ‘Leaflets to disappear from theatre foyer’ would never have made it so far. This demonstrates the societal importance of good health communication, and leaflets were one form of this for decades. Were, because the Dutch College of General Practitioners claims that the number of patients and people in waiting rooms who use these leaflets is decreasing, and that a website would be better. Koops van ’t Jagt: ‘I think that the present leaflets must change in some way, but I don’t think a website is the best solution either. The people that this is about, the people you want to reach, often have limited digital skills too. A vulnerable group is then doubly disadvantaged.’
Interactive electronic versions of the photo stories were also developed. These can be found on oefenen.nl, for instance, a website where people can learn various skills. ‘Some organizations already use the photo stories. They unintentionally also prove good at helping people learn Dutch,’ says Koops van ‘t Jagt.
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