Experimental Therapeutics, BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Curr Oncol. 2023 Jan 19;30(2):1439-1449. doi: 10.3390/curroncol30020110.
Patient education materials (PEM)s were extracted from provincial cancer agencies to determine their organizational health literacy by evaluating the quality, actionability, and functional accessibility (e.g., readability and understandability) of their PEMs. PEMs from 10 provincial agencies were assessed for their grade reading level (GRL), using eight numerical and two graphical readability scales, and underwent a difficult word analysis. The agencies were assessed for PEM quality using two methods (JAMA benchmarks and DISCERN), while actionability and understandability were assessed using the Patient Education Materials Assessment Tool (PEMAT). Seven hundred and eighty-six PEMs were analyzed. The overall average GRL was 9.3 ± 2.1, which is above the recommended 7th GRL for health information. The difficult word analysis showed that 15.4% ± 5.1% of texts contained complex words, 35.8% ± 6.8% of texts contained long words, and 24.2% ± 6.6% of texts contained unfamiliar words. Additionally, there was high overlap between the most frequently identified difficult words in the PEMs and the most frequently misunderstood words by cancer patients identified in the literature. Regarding quality indicators, no agency displayed all four indicators according to the JAMA benchmarks and DISCERN scores ranged between 38 (poor) to 66 (excellent). PEMAT scores ranged between 68% to 88% for understandability and 57% to 88% for actionability. PEMs continue to be written at a level above the recommended GRL across all provinces, and there was overall high variability in the quality, understandability, and actionability of PEMs among provincial agencies. This represents an opportunity to optimize materials, thus ensuring understanding by a wider audience and improving health literacy among Canadian cancer patients.
从省级癌症机构中提取患者教育材料(PEM),通过评估其 PEM 的质量、可操作性和功能可及性(例如,可读性和可理解性)来确定其组织健康素养。使用八种数字和两种图形可读性量表评估来自 10 个省级机构的 PEM 的阅读水平等级(GRL),并进行了困难词汇分析。使用两种方法(JAMA 基准和 DISCERN)评估机构的 PEM 质量,同时使用患者教育材料评估工具(PEMAT)评估可操作性和可理解性。共分析了 786 份 PEM。总体平均 GRL 为 9.3±2.1,高于健康信息推荐的第 7 级 GRL。困难词汇分析显示,15.4%±5.1%的文本含有复杂词汇,35.8%±6.8%的文本含有长词汇,24.2%±6.6%的文本含有不常见词汇。此外,在 PEM 中最常识别的困难词汇与文献中癌症患者最常误解的词汇之间存在高度重叠。关于质量指标,根据 JAMA 基准和 DISCERN 评分,没有一个机构显示所有四个指标,得分范围在 38(差)到 66(优)之间。PEMAT 的可理解性得分范围在 68%到 88%之间,可操作性得分范围在 57%到 88%之间。所有省份的 PEM 继续以高于推荐 GRL 的水平编写,省级机构的 PEM 质量、可理解性和可操作性总体差异较大。这代表了优化材料的机会,从而确保更广泛的受众能够理解,并提高加拿大癌症患者的健康素养。