肩关镜手术中的健康素养：对在线患者教育材料的可理解性和可读性的定量评估。
Health Literacy in Shoulder Arthroscopy: A Quantitative Assessment of the Understandability and Readability of Online Patient Education Material.
机构信息
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Center for Sports Medicine and Orthopaedics, Chattanooga, Tennessee, USA.
出版信息
Iowa Orthop J. 2024;44(1):151-158.
BACKGROUND
The National Institutes of Health (NIH) and American Medical Association (AMA) recommend that online health information be written at a maximum 6th grade reading level. The aim was to evaluate online resources regarding shoulder arthroscopy utilizing measures of readability, understandability, and actionability, using syntax reading grade level and the Patient Education Materials Assessment Tool (PEMAT-P).
METHODS
An online Google™ search utilizing "shoulder arthroscopy" was performed. From the top 50 results, websites directed at educating patients were included. News and scientific articles, audiovisual materials, industry websites, and unrelated materials were excluded. Readability was calculated using objective algorithms: Flesch-Kincaid Grade-Level (FKGL), Simple Measure of Gobbledygook (SMOG) grade, Coleman-Liau Index (CLI), and Gunning-Fog Index (GFI). The PEMAT-P was used to assess understandability and actionability, with a 70% score threshold. Scores were compared across academic institutions, private practices, and commercial health publishers. The correlation between search rank and readability, understandability, and actionability was calculated.
RESULTS
Two independent searches yielded 53 websites, with 44 (83.02%) meeting inclusion criteria. No mean readability score performed below a 10th grade reading level. Only one website scored at or below 6th grade reading level. Mean understandability and actionability scores were 63.02%±12.09 and 29.77%±20.63, neither of which met the PEMAT threshold. Twelve (27.27%) websites met the understandability threshold, while none met the actionability threshold. Institution categories scored similarly in understandability (61.71%, 62.68%, 63.67%) among academic, private practice, and commercial health publishers respectively (p=0.9536). No readability or PEMAT score correlated with search rank.
CONCLUSION
Online shoulder arthroscopy patient education materials score poorly in readability, understandability, and actionability. One website scored at the NIH and AMA recommended reading level, and 27.27% of websites scored above the 70% PEMAT score for understandability. None met the actionability threshold. Future efforts should improve online resources to optimize patient education and facilitate informed decision-making. .
背景
美国国立卫生研究院（NIH）和美国医学协会（AMA）建议，在线健康信息的撰写应达到最高 6 年级阅读水平。其目的是利用可读性、可理解性和可操作性评估在线肩部关节镜资源，使用句法阅读年级水平和患者教育材料评估工具（PEMAT-P）。
方法
利用“肩部关节镜”进行了在线谷歌搜索。从前 50 个结果中，选择了针对教育患者的网站。排除新闻和科学文章、视听材料、行业网站和不相关的材料。使用客观算法计算可读性：弗莱什-金凯德等级（FKGL）、简单的胡言乱语测量（SMOG）等级、科尔曼-廖指数（CLI）和冈宁-福格指数（GFI）。使用 PEMAT-P 评估可理解性和可操作性，以 70%的分数为阈值。比较了学术机构、私人诊所和商业健康出版商的分数。计算了搜索排名与可读性、可理解性和可操作性之间的相关性。
结果
两次独立搜索产生了 53 个网站，其中 44 个（83.02%）符合纳入标准。没有一个平均可读性得分低于 10 年级阅读水平。只有一个网站的得分达到或低于 6 年级阅读水平。平均可理解性和可操作性得分分别为 63.02%±12.09%和 29.77%±20.63%，均未达到 PEMAT 阈值。12 个（27.27%）网站达到了可理解性阈值，而没有一个达到可操作性阈值。学术、私人诊所和商业健康出版商的机构类别在可理解性方面的得分分别为 61.71%、62.68%和 63.67%（p=0.9536），相似。没有可读性或 PEMAT 评分与搜索排名相关。
结论
在线肩部关节镜患者教育材料在可读性、可理解性和可操作性方面得分较差。一个网站的得分达到 NIH 和 AMA 推荐的阅读水平，27.27%的网站的可理解性得分超过 PEMAT 的 70%阈值。没有一个符合可操作性阈值。未来的工作应努力改善在线资源，以优化患者教育并促进知情决策。
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