Vargas Christina R, Ricci Joseph A, Lee Michelle, Tobias Adam M, Medalie Daniel A, Lee Bernard T
Department of Plastic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
J Surg Res. 2017 Sep;217:198-206. doi: 10.1016/j.jss.2017.05.026. Epub 2017 May 11.
The transgender population is disproportionally affected by health disparities related to access to care. In many communities, transgender specialists are geographically distant and locally available medical professionals may be unfamiliar with unique needs of transgender patients. As a result, use of Internet resources for information about gender affirming surgery is particularly important. This study simulates a patient search for online educational material about gender affirming surgery and evaluates the accessibility, readability, and quality of the information.
An Internet search for the term "transgender surgery" was performed, and the first 10 relevant hits were identified. Readability was assessed using 10 established tests: Coleman-Liau, Flesch-Kincaid, FORCAST, Fry, Gunning Fog, New Dale-Chall, New Fog Count, Raygor Estimate, Simple Measure of Gobbledygook, and Flesch Reading Ease. Quality was assessed using Journal of the American Medical Association criteria and the DISCERN instrument.
Review of 69 results was required to identify 10 sites with relevant patient information. There were 97 articles collected; overall mean reading level was 14.7. Individual Web site reading levels ranged from 12.0 to 17.5. All articles and Web sites exceeded the recommended sixth grade level. Quality ranged from 0 to 4 (Journal of the American Medical Association) and 35 to 79 (DISCERN) across Web sites.
Web sites with relevant patient information about gender affirming surgery were difficult to identify from search results. The content of these sites universally exceeded the recommended reading level. A wide range of Web site quality was noted, and this may further complicate successful navigation. Barriers in access to appropriately written patient information on the Internet may contribute to disparities in referral, involvement, satisfaction, and outcomes.
跨性别群体在获得医疗服务方面面临的健康差异问题尤为严重。在许多社区，跨性别专家在地理位置上较为分散，而当地的医疗专业人员可能不熟悉跨性别患者的特殊需求。因此，利用互联网资源获取性别肯定手术的信息尤为重要。本研究模拟患者搜索有关性别肯定手术的在线教育材料，并评估信息的可及性、可读性和质量。
在互联网上搜索“跨性别手术”一词，并确定前10个相关搜索结果。使用10种既定测试评估可读性：科尔曼-廖指数、弗莱什-金凯德指数、FORCAST、弗莱阅读法、冈宁迷雾指数、新戴尔-查尔指数、新迷雾指数、雷戈尔估计法、简单费解度测量法和弗莱什易读性指数。使用美国医学会标准和DISCERN工具评估质量。
需要查看69个结果才能确定10个包含相关患者信息的网站。共收集到97篇文章；总体平均阅读水平为14.7。各个网站的阅读水平在12.0至17.5之间。所有文章和网站均超过了推荐的六年级阅读水平。各网站的质量在0至4（美国医学会标准）和35至79（DISCERN工具）之间。
从搜索结果中很难找到包含有关性别肯定手术相关患者信息的网站。这些网站的内容普遍超过了推荐的阅读水平。网站质量参差不齐，这可能会使成功浏览信息变得更加复杂。在互联网上获取编写恰当的患者信息存在障碍，这可能会导致转诊、参与度、满意度和治疗结果方面的差异。
