One of the key role of the Health and Safety Executive (HSE) is promotion of high quality information for patients, their care-givers, families and the general public (Protheroe et al 2015). Dissemination of quality and informative literature to patients and member soft e general public helps them to understand their health needs. Pines (2015) adds that this informational too helps the patients and the rest of the target audience to make correct decisions pertaining their health as well as their families. One methodology of achieving this goal is through health education (Mateti et al 2015, 623) and it is one of the major constituents of health promotion. Jafari and Peyman (2018) defines health education as assisting people to improve and manage their health and that of others; influencing people to make rightful health-related decisions and support healthful practices, distributing information and advancing comprehension of health circumstances and issues leading to bad health just to mention a number. One of the most common channels of health information dissemination to patients is Patient information leaflet (PIL) and can be defined as printed information intended to cause awareness to the target audience about safe use of medicine or certain identified medical condition. This piece of work attempts to appraise a PIL associated to HSE, 2016 campaign on postnatal depression awareness campaign as well as patient support guide for creating awareness to mothers, Families and Friends. This piece of works endeavours to conduct a critical appraisal of this leaflet basing overall size of the material, design, colour, textual layout and the language used.
Several qualities should be taken into account when generating content for and designing a patient information leaflet (Schmitz et al 2017). Details such as the target audience and the size of the leaflet should also be considered. An ideal information leaflet should be able to quickly capture the attention of the target audience through appealing headlines, appropriate colours and attractive graphics (Sørensen et al 2015, 1052). The information should be short and precise, poignant and should provoke an action. Herber et al (2014) suggests the AIDA model for creating a leaflet which stands for; Attention, Interest, Desire and Action.
The size of the leaflet is ordinary medium size that befits the ideal characteristic size of any patient information leaflet. This is done so to present an overall impression of a small, simple and portable document that is still informative at the same time (Hassol et al 2014). Research shows that most patients and the general public for that matter are in some kind of apparent impatience and thus tent to have no time carrying a huge document to read. In fact they may end up not even picking or reading it (Hamnes et al 2016).
The leaflet’s design is simple and does not have any illustrations for any action. The front cover has been designed with dark blue background and stormy cloud that depicts depression or disturbance. The designer could have however, made the heading font bolder if not bigger. The absence of illustration for actions has been seen as a major undoing for this this PIL. A picture is worth a thousand statements (Sustersic et al 2017, 533). In the remedial section, the designers could have included illustrations for actions like rest, eat well and have fun. One may not remember the wording of “have fun” but would certainly remember an image of a balloon same is the case with the contacts section where numbers are just thrown there and one may not be able to tell whether they are fax or telephone contacts. A simple picture of a telephone before the contacts would have done better.
It is imperative that the colour scheme of a print media appeals to a wide range of ages (Van Den Bosch et al 2016, 698). The background of the leaflet is white which gives good contrast with the black texts thus creating good visibility as well as readability. It is also plausibly neutral and does not attract one gender more than the other. The subheadings are white which contrasts well with green and blue heading backgrounds and thus adds a striking effect. Generally, the leaflet is not very colourful. This is acceptable to some extent given that the target audience are adults. However, the non-appearance of a single bright colour like orange, red or even yellow makes it loose some degree of reader attention as one may get bored as she progresses downwards. This is further substantiated by the fact that the number one target audience for the leaflet are women, whom Greenhalgh (2015) finds to be obsessed with bright colours. Furthermore, dull colours and the entire scheme may appear cool but one may not want to imagine the output in case the only available printer is a monochrome.
All the textual content of the leaflet has been designed in a simple manner that allows easy reading and gains some acceptable level of readers’ attention. The texts have been well spaced and compressed into a few lines to avoid swamping the reader with unnecessary details. Bullets are used to highlight data and present it in readable chunks (Webster et al 2018). However, bullets and numbers have not been adequately used especially at ‘signs and symptoms’ section. One would expect a quick point overview of the signs and symptoms in bullet format before going into specific detail and explanation as was done at the types of postnatal depressions. This exhibits some lack of consistency in textual content design and organisation.
The use of direct language in the leaflet (e.g. You may find it hard to sleep, You may feel inadequate) is praiseworthy as it directly addresses the audience and effectively retains their attention. It also makes the reader resonate well with the real-life experience (de Bont et al 2015). Rhetorical questions such as “What is it?” and “What causes it?” have also been used for related purpose.
Designing an effective patient health education material is a painstaking task considering the numerous aspects one has to bear in mind (Clarke et al 2016). These include the overall size of the material, design, colour, textual layout and the language used (WHO 2018). Considering all the aspect named and discussed herein this paper, the HSE 2016 patient information leaflet on postnatal depression is a well above average publication. The use of appropriate language, and simple graphical and textual design make this PIL a standard document. However, some aspect such as font effect on the title, illustrations and use of bright colours would have made it much better were not given a lot of consideration. The material however, meets its objectives and is deemed suitable for a large number of its audience.
References
Clarke, Martina A., Joi L. Moore, Linsey M. Steege, Richelle J. Koopman, Jeffery L. Belden, Shannon M. Canfield, Susan E. Meadows, Susan G. Elliott, and Min Soon Kim. “Health information needs, sources, and barriers of primary care patients to achieve patient-centered care: A literature review.” Health informatics journal 22, no. 4 (2016): 992-1016.
De Bont, E.G., Alink, M., Falkenberg, F.C., Dinant, G.J. and Cals, J.W., 2015. Patient information leaflets to reduce antibiotic use and consultation rates in general practice: a systematic review. BMJ open, 5(6), p.e007612.
Greenhalgh, T., 2015. Health literacy: towards system level solutions. BMJ: British Medical Journal (Online), 350.
Hamnes, B., van Eijk-Hustings, Y. and Primdahl, J., 2016. Readability of patient information and consent documents in rheumatological studies. BMC medical ethics, 17(1), p.42.
Hassol, A., Goodman, L., Younkin, J., Honicker, M., Chaundy, K. and Walker, J.M., 2014. Survey of state health information exchanges regarding inclusion of continuity of care documents for long-term post-acute care (LTPAC) patient assessment. Perspectives in health information management, 11(Fall).
Herber, O.R., Gies, V., Schwappach, D., Thürmann, P. and Wilm, S., 2014. Patient information leaflets: informing or frightening? A focus group study exploring patients’ emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices. BMC family practice, 15(1), p.163.
Jafari, A. and Peyman, N., 2018. Application of theories/models of health education and promotion in Health Literacy research: a systematic review. Journal of Health Literacy, 3(2), pp.124-136.
Mateti, U.V., Nagappa, A.N., Attur, R.P., Bairy, M., Nagaraju, S.P., Mallayasamy, S., Vilakkathala, R., Guddattu, V. and Balkrishnan, R., 2015. Preparation, validation and user-testing of pictogram-based patient information leaflets for hemodialysis patients. Saudi Pharmaceutical Journal, 23(6), pp.621-625.
Pines, A., 2015. Patient information leaflets: friend or foe?
Protheroe, J., Estacio, E.V. and Saidy-Khan, S., 2015. Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness. Br J Gen Pract, 65(632), pp.e192-e197.
Schmitz, J., Kamping, S., Wiegratz, J., Müller, M., Stork, J., Colloca, L., Flor, H. and Klinger, R., 2017. Impact of patient information leaflets on pain medication intake behavior: a pilot study. Pain reports, 2(6).
Sørensen, K., Pelikan, J.M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiters, E. and Falcon, M., 2015. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). European journal of public health, 25(6), pp.1053-1058.
Sustersic, M., Gauchet, A., Foote, A. and Bosson, J.L., 2017. How best to use and evaluate Patient Information Leaflets given during a consultation: a systematic review of literature reviews. Health Expectations, 20(4), pp.531-542.
Van Den Bosch, S., Koudstaal, M., Versnel, S., Maal, T., Xi, T., Nelen, W., Bergé, S. and Faber, M., 2016. Patients and professionals have different views on online patient information about cleft lip and palate (CL/P). International journal of oral and maxillofacial surgery, 45(6), pp.692-699.
Webster, R.K., Weinman, J. and Rubin, G.J., 2018. Positively framed risk information in patient information leaflets reduces side effect reporting: A double-blind randomized controlled trial. Annals of Behavioral Medicine.
World Health Organization (WHO), 2018. Health literacy. The solid facts.
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