Department of Surgery, University of Alabama at Birmingham (UAB) Heersink School of Medicine, 1808 7th Ave South, BDB 505, Birmingham, AL, 35233, USA.
UAB Department of Surgery, 1808 7th Ave South, Boshell Diabetes Building, Suite 202, Birmingham, AL, 35233, USA.
Surg Endosc. 2023 Aug;37(8):6519-6525. doi: 10.1007/s00464-023-10153-3. Epub 2023 Jun 5.
INTRODUCTION: Bariatric surgery is a successful treatment for obesity, but barriers to surgery exist, including low health literacy. National organizations recommend patient education materials (PEM) not exceed a sixth-grade reading level. Difficult to comprehend PEM can exacerbate barriers to bariatric surgery, especially in the Deep South where high obesity and low literacy rates exist. This study aimed to assess and compare the readability of webpages and electronic medical record (EMR) bariatric surgery PEM from one institution. METHODS: Readability of online bariatric surgery and standardized perioperative EMR PEM were analyzed and compared. Text readability was assessed by validated instruments: Flesch Reading Ease Formula (FRE), Flesch Kincaid Grade Level (FKGL), Gunning Fog (GF), Coleman-Liau Index (CL), Simple Measure of Gobbledygook (SMOG), Automated Readability Index (ARI), and Linsear Write Formula (LWF). Mean readability scores were calculated with standard deviations and compared using unpaired t-tests. RESULTS: 32 webpages and seven EMR education documents were analyzed. Webpages were overall "difficult to read" compared to "standard/average" readability EMR materials (mean FRE 50.5 ± 18.3 vs. 67.4 ± 4.2, p = 0.023). All webpages were at or above high school reading level: mean FKGL 11.8 ± 4.4, GF 14.0 ± 3.9, CL 9.5 ± 3.2, SMOG 11.0 ± 3.2, ARI 11.7 ± 5.1, and LWF 14.9 ± 6.6. Webpages with highest reading levels were nutrition information and lowest were patient testimonials. EMR materials were sixth to ninth grade reading level: FKGL 6.2 ± 0.8, GF 9.3 ± 1.4, CL 9.7 ± 0.9, SMOG 7.1 ± 0.8, ARI 6.1 ± 1.0, and LWF 5.9 ± 0.8. CONCLUSION: Surgeon curated bariatric surgery webpages have advanced reading levels above recommended thresholds compared to standardized PEM from an EMR. This readability gap may unintentionally contribute to barriers to surgery and affect postoperative outcomes. Streamlined efforts are needed to create materials that are easier to read and comply with recommendations.
简介:减重手术是肥胖症的有效治疗方法,但手术存在障碍,包括健康素养低。国家组织建议患者教育材料(PEM)不超过六年级阅读水平。难以理解的 PEM 会加剧减重手术的障碍,尤其是在肥胖率高和低识字率并存的美国南部腹地。本研究旨在评估和比较一家机构的网页和电子病历(EMR)减重手术 PEM 的可读性。 方法:分析并比较了在线减重手术和标准化围手术期 EMR PEM 的可读性。使用经过验证的工具评估文本可读性:弗莱什阅读舒适度公式(FRE)、弗莱什-金凯德年级水平(FKGL)、冈宁 Fog 指数(GF)、科尔曼-廖指数(CL)、简单测糊度公式(SMOG)、自动化可读性指数(ARI)和林赛写作公式(LWF)。使用未配对的 t 检验计算平均可读性得分及其标准差,并进行比较。 结果:分析了 32 个网页和 7 个 EMR 教育文件。与“标准/平均”可读性 EMR 材料相比,网页总体上“难以阅读”(平均 FRE 为 50.5±18.3 与 67.4±4.2,p=0.023)。所有网页的阅读水平均达到或高于高中水平:平均 FKGL 为 11.8±4.4、GF 为 14.0±3.9、CL 为 9.5±3.2、SMOG 为 11.0±3.2、ARI 为 11.7±5.1 和 LWF 为 14.9±6.6。阅读水平最高的是营养信息,最低的是患者 testimonials。EMR 材料为六年级至九年级阅读水平:FKGL 为 6.2±0.8、GF 为 9.3±1.4、CL 为 9.7±0.9、SMOG 为 7.1±0.8、ARI 为 6.1±1.0 和 LWF 为 5.9±0.8。 结论:与 EMR 中的标准化 PEM 相比,外科医生精心策划的减重手术网页的阅读水平高于推荐的门槛。这种可读性差距可能会无意中导致手术障碍,并影响术后结果。需要进行简化工作,以创建更易于阅读且符合建议的材料。
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