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Original Article
Effects of Interactive Pictorial Education on Community Dwelling Older Adult’s Self Efficacy and Knowledge for Safe Medication
Myonghwa Park
Journal of Korean Academy of Nursing 2011;41(6):795-804.
DOI: https://doi.org/10.4040/jkan.2011.41.6.795
Published online: December 12, 2011

Associate Professor, College of Nursing, Chungnam National University, Daejeon, Korea

Associate Professor, College of Nursing, Chungnam National University, Daejeon, Korea

Address reprint requests to : Park, Myonghwa College of Nursing, Chungnam National University, 55 Munhwa-ro, Jung-gu, Daejeon 301-747, Korea Tel: +82-42-580-8328 Fax: +82-42-580-8309 E-mail: mhpark@cnu.ac.kr
• Received: May 30, 2011   • Revised: June 7, 2011   • Accepted: December 19, 2011

Copyright © 2011 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to examine the effects of interactive pictorial education on community dwelling older Korean adults’ self-efficacy and knowledge for safe medication.
  • Methods
    A quasi-experimental, three-group pre- and post-intervention design was used in this study. The interactive pictorial education was designed to suit the learning patterns and psychomotor skills of older adults. The education content, dealing with safe medication, was delivered over three sessions. A total of 136 older adults from local senior centers were assigned to one of the three groups: a) interactive pictorial education plus information booklet (experimental); b) education only with information booklet (conventional); or c) no intervention (control).
  • Results
    Participants receiving interactive pictorial education had significantly higher self-efficacy (F=24.32, p<.001) and knowledge (F=24.26, p<.001) scores than the information booklet or control group at post intervention. Post-hoc analyses indicated that both the interactive pictorial and the information booklet groups had significantly higher self-efficacy and knowledge scores than the control group at the post-test point (p<.05). Furthermore, the interactive pictorial group had higher self-efficacy and knowledge scores than the information booklet group at the post-test point (p<.05).
  • Conclusion
    These results suggest that the interactive pictorial education is an innovative approach that provides a means for older adults to learn appropriate medication use to improve their own health. It empowers older adults with different literacy levels to enhance their self-efficacy and knowledge for the safe use of medication.
Figure 1.
Interactive pictorial map for education.
jkan-41-795f1.jpg
Figure 2.
Interactive pictorial cards for education.
jkan-41-795f2.jpg
Figure 3.
Changes in the scores of self-efficacy for three groups.
jkan-41-795f3.jpg
Figure 4.
Changes in the scores of knowledge for three groups.
jkan-41-795f4.jpg
Table 1.
Homogeneity Test for General Characteristics between the Experimental Group and Control Groups (N=136)
Characteristic Categories Interactive pictorial (n=45)
Information booklet (n=45)
Control (n=46)
χ² or F p
n (%) n (%) n (%)
Gender Male 21 (46.7) 22 (48.9) 22 (47.8) 10.50 .228
Female 24 (53.3) 23 (51.1) 24 (52.2)
Age (yr) 65-69 7 (15.6) 9 (20.0) 7 (15.6) 5.52 .523
70-74 12 (26.7) 14 (31.1) 11 (24.4)
75-79 10 (22.2) 10 (22.2) 13 (28.9)
≥80 16 (35.6) 12 (26.7) 14 (31.1)
M (SD) 76.0 (6.5) 74.6 (5.8) 76.8 (6.0) 76.0 (6.0)
Education None (illiterate) 4 (8.9) 5 (11.1) 5 (10.9) 6.91 .103
level None (literate) 6 (13.3) 6 (13.4) 7 (15.2)
Elementary 23 (51.1) 22 (48.9) 22 (47.8)
Middle school 10 (22.2) 11 (24.4) 10 (21.7)
≥High school 2 (4.4) 1 (2.2) 2 (4.4)
Marital status Married 20 (44.4) 20 (44.4) 19 (41.3) 1.90 .070
Bereavement 22 (48.9) 23 (51.2) 25 (54.3)
Divorced 3 (6.7) 2 (4.4) 2 (4.4)
Income Low 15 (33.3) 14 (31.1) 14 (30.4) 6.01 .786
Medium 17 (37.8) 20 (44.4) 20 (43.5)
High 13 (28.9) 11 (24.4) 12 (26.1)
Health Very good 5 (11.2) 7 (15.6) 5 (10.9) 2.05 .057
condition Good 12 (26.7) 9 (20.0) 13 (28.3)
Fair 20 (44.4) 21 (46.7) 19 (41.3)
Somewhat bad 6 (13.3) 6 (13.3) 8 (17.4)
Very bad 2 (4.4) 2 (4.4) 1 (2.1)
Number of 0 1 (2.2) 3 (6.7) 2 (4.3) 1.81 .454
medical 1 20 (44.4) 18 (40.0) 20 (43.6)
diagnosis 2 18 (40.0) 12 (26.7) 14 (30.4)
3 5 (11.1) 9 (20.0) 8 (17.4)
4 1 (2.3) 3 (6.6) 2 (4.3)
Number of 1-2 20 (44.4) 17 (37.8) 18 (39.1) 0.23 .891
medication 3-4 18 (40.0) 20 (44.4) 19 (41.3)
Over 5 7 (15.6) 8 (17.8) 9 (19.6)
Table 2.
Homogeneity Test for the Scores of Self-Efficacy and Knowledge between the Experimental Group and Control Groups (N=136)
Measurement Interactive pictorial (n=45)
Information booklet (n=45)
Control (n=46)
F p
Mean±SD Mean±SD Mean±SD
Self-efficacy 26.30±3.92 26.70±3.20 25.33±4.06 5.55 .406
Knowledge 8.36±1.88 8.11±2.09 8.03±1.81 2.60 .267
Table 3.
Result of Oneway ANOVA for Self Efficacy and Knowledge (N=134)
Source SS df Mean Square F p
Self Efficacy* 24.32 <.001
Between groups 734.01 2 367.01
Within groups 2,671.10 133 15.09
Total 3,405.11 135
Knowledge
Between groups 214.21 2 107.11 24.26 <.001
Within groups 781.45 133 4.42
Total 995.66 135

*post-hoc Tukey’s test: The interactive pictorial education plus information booklet group >education only with information booklet group >no intervention group;

post-hoc Tukey’s test: The interactive pictorial education plus information booklet group >education only with information booklet group >no intervention group.

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    Effects of Interactive Pictorial Education on Community Dwelling Older Adult’s Self Efficacy and Knowledge for Safe Medication
    Image Image Image Image
    Figure 1. Interactive pictorial map for education.
    Figure 2. Interactive pictorial cards for education.
    Figure 3. Changes in the scores of self-efficacy for three groups.
    Figure 4. Changes in the scores of knowledge for three groups.
    Effects of Interactive Pictorial Education on Community Dwelling Older Adult’s Self Efficacy and Knowledge for Safe Medication
    Characteristic Categories Interactive pictorial (n=45)
    Information booklet (n=45)
    Control (n=46)
    χ² or F p
    n (%) n (%) n (%)
    Gender Male 21 (46.7) 22 (48.9) 22 (47.8) 10.50 .228
    Female 24 (53.3) 23 (51.1) 24 (52.2)
    Age (yr) 65-69 7 (15.6) 9 (20.0) 7 (15.6) 5.52 .523
    70-74 12 (26.7) 14 (31.1) 11 (24.4)
    75-79 10 (22.2) 10 (22.2) 13 (28.9)
    ≥80 16 (35.6) 12 (26.7) 14 (31.1)
    M (SD) 76.0 (6.5) 74.6 (5.8) 76.8 (6.0) 76.0 (6.0)
    Education None (illiterate) 4 (8.9) 5 (11.1) 5 (10.9) 6.91 .103
    level None (literate) 6 (13.3) 6 (13.4) 7 (15.2)
    Elementary 23 (51.1) 22 (48.9) 22 (47.8)
    Middle school 10 (22.2) 11 (24.4) 10 (21.7)
    ≥High school 2 (4.4) 1 (2.2) 2 (4.4)
    Marital status Married 20 (44.4) 20 (44.4) 19 (41.3) 1.90 .070
    Bereavement 22 (48.9) 23 (51.2) 25 (54.3)
    Divorced 3 (6.7) 2 (4.4) 2 (4.4)
    Income Low 15 (33.3) 14 (31.1) 14 (30.4) 6.01 .786
    Medium 17 (37.8) 20 (44.4) 20 (43.5)
    High 13 (28.9) 11 (24.4) 12 (26.1)
    Health Very good 5 (11.2) 7 (15.6) 5 (10.9) 2.05 .057
    condition Good 12 (26.7) 9 (20.0) 13 (28.3)
    Fair 20 (44.4) 21 (46.7) 19 (41.3)
    Somewhat bad 6 (13.3) 6 (13.3) 8 (17.4)
    Very bad 2 (4.4) 2 (4.4) 1 (2.1)
    Number of 0 1 (2.2) 3 (6.7) 2 (4.3) 1.81 .454
    medical 1 20 (44.4) 18 (40.0) 20 (43.6)
    diagnosis 2 18 (40.0) 12 (26.7) 14 (30.4)
    3 5 (11.1) 9 (20.0) 8 (17.4)
    4 1 (2.3) 3 (6.6) 2 (4.3)
    Number of 1-2 20 (44.4) 17 (37.8) 18 (39.1) 0.23 .891
    medication 3-4 18 (40.0) 20 (44.4) 19 (41.3)
    Over 5 7 (15.6) 8 (17.8) 9 (19.6)
    Measurement Interactive pictorial (n=45)
    Information booklet (n=45)
    Control (n=46)
    F p
    Mean±SD Mean±SD Mean±SD
    Self-efficacy 26.30±3.92 26.70±3.20 25.33±4.06 5.55 .406
    Knowledge 8.36±1.88 8.11±2.09 8.03±1.81 2.60 .267
    Source SS df Mean Square F p
    Self Efficacy* 24.32 <.001
    Between groups 734.01 2 367.01
    Within groups 2,671.10 133 15.09
    Total 3,405.11 135
    Knowledge
    Between groups 214.21 2 107.11 24.26 <.001
    Within groups 781.45 133 4.42
    Total 995.66 135
    Table 1. Homogeneity Test for General Characteristics between the Experimental Group and Control Groups (N=136)

    Table 2. Homogeneity Test for the Scores of Self-Efficacy and Knowledge between the Experimental Group and Control Groups (N=136)

    Table 3. Result of Oneway ANOVA for Self Efficacy and Knowledge (N=134)

    post-hoc Tukey’s test: The interactive pictorial education plus information booklet group >education only with information booklet group >no intervention group;

    post-hoc Tukey’s test: The interactive pictorial education plus information booklet group >education only with information booklet group >no intervention group.


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