Comics put patients in the picture for informed consent


Explaining cardiac surgery with the addition of comic book style pictures helps patients understand the process better and makes them less anxious, researchers have found.

While informed consent procedures should theoretically help patients make independent decisions about treatments, researchers found that patients facing cardiac catherisation often failed to grasp what the procedure entailed and its risks and benefits when they relied on reading standard consent forms.

The complex nature of the information involved means that patients often feel overwhelmed rather than well informed, said researchers from Charité – Universitätsmedizin Berlin.

The team therefore put together a 15-page comic-style booklet using a pictorial story format to explain the cardiac catheterisation and stent insertion processes.

Illustrator; Sophia Martineck

They then evaluated the comics in 121 patients due to undergo cardiac catheterisation who either went through the standard informed consent procedure, or the same process but with the addition of the comic-style information

Patients rated the comic-style booklet as more useful than standard consent forms in terms of comprehension and anxiety around the surgery, as well as satisfaction around the consenting process. Patients also rated the comic book highly for informing them on procedural details, risks and postoperative advice.

The patients in the comic-style information group also reported feeling less anxious after their informed consent procedure with 72% feeling satisfied with the instructions compared to 41% in the ‘non-visual” consent form group.

The results vindicated the notion that ‘a picture is worth more than a thousand words’,  said cardiologist and study researcher Dr Anna Brand.

“A comic-style presentation enables the simultaneous visual and textual processing of complex information. This has been shown to enhance comprehension in different learner types,” she said.

“The comic-based approach also enables readers to process the information presented at their own speed.”

She said future research would test whether similar positive effects can be achieved in patients undergoing other medical procedures.

The findings are published in Annals of Internal Medicine.

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