Jolly B T, Scott J L, Feied C F, Sanford S M
Georgetown/George Washington Emergency Medicine Residency Program, Washington, DC.
Ann Emerg Med. 1993 Mar;22(3):573-8. doi: 10.1016/s0196-0644(05)81944-4.
To determine the ability of emergency department patients to understand common written discharge instructions and the level of reading difficulty of standard discharge instructions.
The study was performed in two parts. In part 1, subjects were asked to read one set of standard written discharge instructions. Then, with the instructions to refer to, subjects were asked to answer five questions about the instructions. A subject's level of success was correlated with age, sex, and highest level of education. In part 2, 47 sets of standard written discharge instructions from six different EDs were computer analyzed using five commonly used readability formulas. Results were reported as grade levels.
The ED of a large inner-city university hospital.
The subjects for part 1 were 400 adult ED patients who presented on randomly selected days.
Part 1: A significant proportion of patients failed to answer correctly at least four of five questions. Patients educated beyond high school demonstrated higher levels of success than did those with less education. A trend was noted for younger subjects to perform better than older subjects. The answers to the three most frequently missed questions were contained within areas of difficult sentence structure or long paragraphs containing large amounts of information. Part 2: The average grade level required to understand instruction sheets ranged from 6.0 to 13.4. More difficult instruction sheets tended to contain numerous multi-syllabic words, long sentences, and difficult sentence structure.
A significant proportion of ED patients have a demonstrable inability to understand common written instructions. ED instruction sheets are written at a level of difficulty that is out of the readable range for many patients. Health care providers should strive to simplify written materials and to develop new methods for instructing those for whom current written materials have no meaning.
确定急诊科患者理解常见书面出院指导的能力以及标准出院指导的阅读难度水平。
该研究分两部分进行。在第一部分中，要求受试者阅读一组标准书面出院指导。然后，让受试者参照这些指导回答五个关于指导内容的问题。受试者的成功水平与年龄、性别和最高教育水平相关。在第二部分中，使用五种常用的可读性公式对来自六个不同急诊科的47套标准书面出院指导进行计算机分析。结果以年级水平报告。
一家大型市中心大学医院的急诊科。
第一部分的受试者是400名在随机选定日期就诊的成年急诊科患者。
第一部分：相当一部分患者未能正确回答五个问题中的至少四个。受过高中以上教育的患者比受教育程度较低的患者表现出更高的成功率。有一个趋势是年轻受试者比年长受试者表现更好。三个最常答错的问题的答案包含在句子结构复杂或包含大量信息的长段落中。第二部分：理解指导手册所需的平均年级水平在6.0至13.4之间。较难的指导手册往往包含大量多音节词、长句子和复杂的句子结构。
相当一部分急诊科患者明显无法理解常见的书面指导。急诊科指导手册的编写难度超出了许多患者的可读范围。医疗保健提供者应努力简化书面材料，并开发新的方法来指导那些对当前书面材料毫无理解的患者。
