679 The effect of select linguistic parameters on patient comprehension of audio instructions for postoperative wound care

Many patients, especially those who are visually impaired or have low literacy, may find it difficult to correctly follow written instructions for wound care following dermatologic procedures. These patients may find it easier to follow step-by-step audio instructions. However, few studies have delineated how to optimize audio instructions linguistically to aid patient understanding. In this study, we examined whether word count, duration, and word choice of audio instruction affects patient comprehension. A computer narrated directions for a 13-step dressing-change to participants. In 2021, 56 participants followed the instructions to perform a dressing change on a fake incision. Patient confusion regarding a step was measured by the number of questions they asked following that step. The narrated steps ranged from 3 to 16 words in length and 2.41 to 8.58 seconds in duration. Univariate linear regression showed that the number of questions asked by participants was not associated with step length (p=0.370) or duration (p=0.997). The greatest number of questions followed a step that used the word “Telfa,” a brand-name of a dressing pad. In the presence of the objects they were asked to manipulate, our patients understood instructions of lengths between 3 and 16 words similarly and between approximately 2 to 9 seconds in duration similarly. Also, since the most questions were asked when a non-standard word was used, it may be prudent to use only standard English in patient care instructions. This pilot study is limited by a small sample size but provides potential parameters for narrated instructions for patient self-care and informs our ongoing efforts to clarify causes of confusion with the use of audio aids.