Readability of advance directive documents.

PURPOSE

To assess the readability of advance directive documents.

DESIGN

Descriptive.

SAMPLE

Convenience, 10 advance directive documents from various sources.

METHODS

Advance directive documents were electronically scanned in 1994 then evaluated using three readability formulas: Flesch-Kincaid Grade Level, Flesch Reading Score, and Gunning's Fog Index.

FINDINGS

The average readability (in school grade levels) of the 10 documents was 11.3 using the Flesch-Kincaid Grade Level and 18.2 using the Gunning's Fog Index.

CONCLUSIONS

All documents were above reading levels usually recommended for patients.

CLINICAL IMPLICATIONS

Patients must be able to read and understand advance directive documents before signing them. Refinement of the documents is recommended to support patient understanding and autonomy in end-of-life care.