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Ten older adults were recruited to participate in focus group. Focus groups of older adults evaluated the education components in a formative manner during development of the instrument. The interface design was based on the learning styles of older adults (Houts et al., 2006). The interactive pictorial education was designed as a pictorial guide map, with pictorial cards for users. The following guidelines were used to develop the interactive pictorial education, as previously presented by (Sjourner & Wogalter, 1998) Collaborate with the target population and gain insight into their knowledge, beliefs, attitudes and expectations Use familiar ob- jects and symbols design simple, realistic pictures, with a limited content Use the whole body image, as isolated organs may cause confusion Use multiple-stage pictures with caution Use abstract symbols, symbols depicting motion and symbols conveying perspec- tive with caution Use background space appropriately If used, colors should be as realistic as possible Use the appropriate size and magni- fications And pre-test new pictograms in the target population. 80 and discrimination indices were all over.

Both difficulty and discrimination indices were used to select the most content-valid set of 15 items, which were then revised to improve clarity. The content validity was assessed and the items were pilot tested on the same individuals enrolled for the pilot study of the self-efficacy instrument. Total scores could range from 0 to 15 with a higher score indicating a greater knowledge of safe medication. The total number of correct answers was used in the analysis (i.e., correct =1, incorrect or don’t know= 0). Each question was formulated based on ex- amples of actual self-medication behaviors and tested both the knowledge and the application levels of Bloom’s taxonomy of the cognitive domain (Bloom, 1956). Fifteen questions, with possible ‘yes/no’ answers, were developed by the researcher based on the outline of the education contents and on previously developed instruments (Han, Moon, Park, & Park, 2000 Lee & Park, 2010). 890 for the original study (Risser et al., 2007) and.

The instrument was pilot tested on 30 volunteers recruited from senior centers which were not involved in the present study.

Higher scores indicated higher levels of self-efficacy for safe medication. Patients were asked to indicate their level of confidence in taking medications correctly, under a number of different circumstances (i.e., 1= not confident, 2 = somewhat confident, and 3 = very confident).

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The second is assessing the self- efficacy for taking medications under uncertain or changing circumstances, such as when the patient is unsure about how to take the medications or changes are made to the therapeutic regimen. The 13-item self-efficacy measure consists of two dimensions first is assessing the self- efficacy for taking medicines under difficult circumstances, such as when patients are busy, away from home, or have multiple medications to take. and the back translated English versions were assessed by an English native speaker and the Korean versions of the instrument were revised and re-translated when there were semantic differences between the two versions.

Pictorial map