Jindal Pranay, MacDermid Joy C
Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
Educ Health (Abingdon). 2017 Jan-Apr;30(1):84-88. doi: 10.4103/1357-6283.210517.
Written health information is commonly used by health-care professionals (HCPs) to inform and assess patients in clinical practice. With growing self-management of many health conditions and increased information seeking behavior among patients, there is a greater stress on HCPs and researchers to develop and implement readable and understandable health information. Readability formulas such as Flesch Reading Ease (FRE) and Flesch-Kincaid Reading Grade Level (FKRGL) are commonly used by researchers and HCPs to assess if health information is reading grade appropriate for patients.
In this article, we critically analyze the role and credibility of Flesch formula in assessing the reading level of written health information.
FRE and FKRGL assign a grade level by measuring semantic and syntactic difficulty. They serve as a simple tool that provides some information about the potential literacy difficulty of written health information. However, health information documents often involve complex medical words and may incorporate pictures and tables to improve the legibility. In their assessments, FRE and FKRGL do not take into account (1) document factors (layout, pictures and charts, color, font, spacing, legibility, and grammar), (2) person factors (education level, comprehension, health literacy, motivation, prior knowledge, information needs, anxiety levels), and (3) style of writing (cultural sensitivity, comprehensiveness, and appropriateness), and thus, inadequately assess reading level. New readability measures incorporate pictures and use complex algorithms to assess reading level but are only moderately used in health-care research and not in clinical practice. Future research needs to develop generic and disease-specific readability measures to evaluate comprehension of a written document based on individuals' literacy levels, cultural background, and knowledge of disease.
在临床实践中，医疗保健专业人员（HCPs）通常使用书面健康信息来告知和评估患者。随着许多健康状况的自我管理不断增加以及患者信息寻求行为的增多，HCPs和研究人员在开发和实施易读易懂的健康信息方面面临更大压力。研究人员和HCPs通常使用诸如弗莱什易读性（FRE）和弗莱什 - 金凯德阅读年级水平（FKRGL）等易读性公式来评估健康信息的阅读年级水平是否适合患者。
在本文中，我们批判性地分析了弗莱什公式在评估书面健康信息阅读水平方面的作用和可信度。
FRE和FKRGL通过测量语义和句法难度来确定年级水平。它们是一种简单的工具，可提供有关书面健康信息潜在识字难度的一些信息。然而，健康信息文件通常包含复杂的医学词汇，并且可能包含图片和表格以提高易读性。在评估中，FRE和FKRGL没有考虑到：（1）文件因素（布局、图片和图表、颜色、字体、间距、易读性和语法）；（2）个人因素（教育水平、理解能力、健康素养、动机、先验知识、信息需求、焦虑水平）；以及（3）写作风格（文化敏感性、全面性和适当性），因此不能充分评估阅读水平。新的易读性测量方法纳入了图片并使用复杂算法来评估阅读水平，但在医疗保健研究中仅得到适度使用，在临床实践中则未被使用。未来的研究需要开发通用的和针对特定疾病的易读性测量方法，以根据个人的识字水平、文化背景和疾病知识来评估书面文件的理解情况。
