Hadden Kristie, Prince Latrina Y, Barnes C Lowry
Center for Health Literacy (Drs Hadden and Prince) and Department of Orthopaedic Surgery (Dr Barnes), University of Arkansas for Medical Sciences, Little Rock.
Qual Manag Health Care. 2018 Apr/Jun;27(2):98-103. doi: 10.1097/QMH.0000000000000165.
In response to an assessment of organizational health literacy practices at a major academic health center, this case study evaluated the health literacy demands of patient-reported outcome measures commonly used in orthopedic surgery practices to identify areas for improvement.
A mixed-methods approach was used to analyze the readability and patient feedback of orthopedic patient-reported outcome materials. Qualitative results were derived from focus group notes, observations, recordings, and consensus documents. Results were combined to formulate recommendations for quality improvement.
Readability results indicated that narrative portions of sample patient outcome tools were written within or below the recommended eighth-grade reading level (= 5.9). However, document literacy results were higher than the recommended reading level (= 9.8). Focus group results revealed that participants had consensus on 8 of 12 plain language best practices, including use of bullet lists and jargon or technical words in both instruments.
Although the typical readability of both instruments was not exceedingly high, appropriate readability formula and assessment methods gave a more comprehensive assessment of true readability. In addition, participant feedback revealed the need to reduce jargon and improve formatting to lessen the health literacy demands on patients. As clinicians turn more toward patient-reported measures to assess health care quality, it is important to consider the health literacy demands that are inherent in the instruments they are given in our health systems.
为回应一家大型学术医疗中心对组织健康素养实践的评估，本案例研究评估了骨科手术实践中常用的患者报告结局测量工具的健康素养要求，以确定改进领域。
采用混合方法分析骨科患者报告结局材料的可读性和患者反馈。定性结果来自焦点小组笔记、观察、录音和共识文件。综合结果以制定质量改进建议。
可读性结果表明，样本患者结局工具的叙述部分是按照或低于推荐的八年级阅读水平（=5.9）编写的。然而，文档素养结果高于推荐阅读水平（=9.8）。焦点小组结果显示，参与者对12条简明语言最佳实践中的8条达成了共识，包括在两种工具中使用项目符号列表以及术语或技术词汇。
尽管两种工具的典型可读性都不是非常高，但适当的可读性公式和评估方法对真正的可读性进行了更全面的评估。此外，参与者的反馈表明需要减少术语并改进格式，以降低对患者的健康素养要求。随着临床医生越来越多地转向患者报告的测量方法来评估医疗质量，重要的是要考虑我们医疗系统中提供给他们的工具所固有的健康素养要求。
