{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T06:06:07Z","timestamp":1780380367898,"version":"3.54.1"},"reference-count":45,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the impact of illustrated postoperative instructions on patient-caregiver knowledge and retention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective study with all participants receiving an educational intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Pediatric plastic surgical missions in Guatemala City, Guatemala, between 2019 and 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 63 majority-indigenous Guatemalan caregivers of patients receiving cleft lip and\/or palate surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Illustrated culturally appropriate postoperative care instructions were iteratively developed and given to caregivers who were surveyed on illustration-based and text-based information at preoperative, postoperative, and four-week follow-up time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>Postoperative care knowledge of illustration-based versus text-based information as determined by the ability to answer 11 illustration- and 8 text-based all-or-nothing questions, as well as retention of knowledge as determined by the same survey given at four weeks follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Scores for illustration-based and text-based information both significantly increased after caregivers received the postoperative instructions (+13.30\u2009\u00b1\u20093.78 % SE,\u2009+\u200911.26\u2009\u00b1\u20094.81 % SE;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). At follow-up, scores were unchanged for illustration-based (\u22123.42\u2009\u00b1\u20094.49 % SE,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05), but significantly lower for text-based information (\u221228.46\u2009\u00b1\u20096.09 % SE,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01). Retention of text-based information at follow-up correlated positively with education level and Spanish literacy, but not for illustration-based.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the setting of language and cultural barriers on a surgical mission, understanding of illustration-based and text-based information both increased after verbal explanation of illustrated postoperative instructions. Illustration-based information was more likely to be retained by patient caregivers after four weeks than text-based information, the latter of which correlated with increased education and literacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656221100052","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T01:57:41Z","timestamp":1655431061000},"page":"1010-1020","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Illustrated Postoperative Instructions on Knowledge and Retention During a Cleft Lip and Palate Surgical Mission"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3612-6281","authenticated-orcid":false,"given":"Elizabeth B.","family":"Card","sequence":"first","affiliation":[{"name":"University of Pennsylvania Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie E.","family":"Morales","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan M.","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Partner for Surgery, Guatemala City, Guatemala, Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marce","family":"Billingslea","sequence":"additional","affiliation":[{"name":"Partner for Surgery, Guatemala City, Guatemala, Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Marroqu\u00edn","sequence":"additional","affiliation":[{"name":"Partner for Surgery, Guatemala City, Guatemala, Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eo","family":"Trueblood","sequence":"additional","affiliation":[{"name":"The Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luv R.","family":"Javia","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, The Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M.","family":"McCormack","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard R.","family":"Friedland","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Low","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan Jay","family":"Schwartz","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Scott","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8119-9442","authenticated-orcid":false,"given":"Oksana A.","family":"Jackson","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2019.06.008"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2012.00767.x"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2014.02.130137"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.894147"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530210031026"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1203475417715208"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2016.01.020"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(02)00239-2"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2012.712621"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2019.01.007"},{"issue":"10","key":"e_1_3_4_12_2","first-page":"219","article-title":"Patients\u2019 memory for medical information","volume":"96","author":"Kessels RPC","year":"2003","unstructured":"Kessels RPC. 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