Ghahremani Jacob S, Ogi Jenna E, Kody Michael T, Navarro Ronald A
Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
University of Southern California, Los Angeles, CA, USA.
J Shoulder Elbow Surg. 2024 Oct;33(10):2220-2229. doi: 10.1016/j.jse.2024.02.028. Epub 2024 Apr 4.
Online patient education materials (OPEMs) exist to inform patient medical decisions, yet the average adult in the United States reads at an eighth-grade level and 50% of Medicaid patients read at or below a fifth-grade level. To appropriately meet US health literacy needs, the American Medical Association and National Institutes of Health recommend that patient education materials not exceed a sixth-grade level. The purpose of this study was to assess and compare the readability of English and Spanish online patient education materials pertaining to shoulder instability surgery.
Google searches of the terms "shoulder instability surgery" and "cirugía de inestabilidad de hombro'' were conducted to include 25 eligible online patient education materials OPEMs per language. English OPEM readability was calculated using Flesch-Kincaid Grade Level, Flesch Reading Ease, Flesch Reading Ease Grade Level, Gunning-Fog Index, Coleman-Liau Index, and Simple Measure of Gobbledygook. Spanish OPEM readability was assessed using Fernandez-Huerta Index (FHI) (the Spanish equivalent of Flesch Reading Ease), FHI Grade Level, Gutiérrez de Polini's Fórmula de comprensibilidad, and INFLESZ.
Readability index analysis revealed that the mean Flesch Reading Ease of English online patient education materials was significantly lower than the mean FHI of Spanish online patient education materials. English materials were also found to be written at a significantly higher grade level than Spanish materials.
Shoulder instability surgery online patient education materials in both English and Spanish are written at higher reading levels than recommended by the American Medical Association and National Institutes of Health, though Spanish online patient education materials were more readable on average.
在线患者教育材料（OPEMs）旨在为患者的医疗决策提供信息，但美国成年人的平均阅读水平为八年级，50%的医疗补助患者阅读水平在五年级及以下。为了适当满足美国的健康素养需求，美国医学协会和美国国立卫生研究院建议患者教育材料的阅读水平不应超过六年级。本研究的目的是评估和比较与肩部不稳定手术相关的英文和西班牙文在线患者教育材料的可读性。
通过谷歌搜索“肩部不稳定手术”和“cirugía de inestabilidad de hombro”这两个术语，每种语言各纳入25份符合条件的在线患者教育材料OPEMs。英文OPEM的可读性使用弗莱施-金凯德年级水平、弗莱施阅读简易度、弗莱施阅读简易度年级水平、冈宁-福格指数、科尔曼-廖指数和简单费解度测量法进行计算。西班牙文OPEM的可读性使用费尔南德斯-韦尔塔指数（FHI）（西班牙语中相当于弗莱施阅读简易度的指标）、FHI年级水平、古铁雷斯·德·波利尼的可理解性公式和INFLESZ进行评估。
可读性指数分析显示，英文在线患者教育材料的平均弗莱施阅读简易度显著低于西班牙文在线患者教育材料的平均FHI。还发现英文材料的写作年级水平显著高于西班牙文材料。
英文和西班牙文的肩部不稳定手术在线患者教育材料所针对的阅读水平高于美国医学协会和美国国立卫生研究院的建议水平，不过西班牙文在线患者教育材料的平均可读性更强。
