Pictorial Versus Verbal Guidance for Home-Based Tracheostomy Care: A Randomized Controlled Trial

Tracheostomy care is essential for patient safety at home, yet standardized educational approaches are lacking, particularly in developing countries. To determine whether pictorial representations of standardized tracheostomy care reduce the incidence of tube-related complications at home compared with verbal counseling, and to evaluate their effect on caregiver understanding and ease of care. This was a randomized, controlled trial. It was conducted at a tertiary center in South India from August 2023 to July 2024. A total of 97 caregivers of tracheostomized patients were enrolled and randomized into the intervention group (n = 48) or the control group (n = 49). The intervention group received a pictorial pamphlet on details of the tracheostomy care at the time of discharge, while the control group received standard verbal education. The primary outcome was the incidence of tracheostomy-related complications at home over a 1-month follow-up period. Secondary outcomes included caregiver understanding of tracheostomy care and their ease of performing care, assessed using a clinician administered interview costume made for our study. In the pictorial education group, the incidence of tracheostomy-related complications at home was significantly lower compared to the verbal counseling group (25 vs 19; P <.001). Caregiver understanding scores were significantly higher in the pictorial group (mean score, 11 vs 6; P <.001). Additionally, ease of care was rated significantly higher by the caregivers in the intervention group. (9 vs 7; P <.001). Incorporating pictorial tools on tracheostomy care into discharge education may benefit tracheostomized patients and their caregivers by enhancing their comprehension, reducing their apprehension, and thus, improving the overall efficacy of care. Trial Registry: ctri.nic.in; Identifier: CTRI/2023/08/056331.