Reading-Level Scores of Patient Education Materials and the Effect of Teaching Special Vocabulary

Abstract

The recent trend toward early hospital discharge, with the subsequent increase in the home care patient population, has made the need for effective patient education more apparent. A major resource for patient education is printed patient education material (PEM). Ease of comprehension is one measure of the adequacy of this material. Assessment of the reading level of the text may be important in determining comprehensibility. A grade-level score, or index, of 6.5-8.5 is believed to be comprehensible by the majority of adult Americans. We hypothesized that the reading-grade level of PEM commonly used for COPD patients would exceed the reading level ability of the average American citizen but that vocabulary training would reduce the reading-grade-level score significantly—making the PEM easier to read. Methods and Materials: Our study applied the SMOG Index and Standal's procedure to PEM for COPD patients, gleaned from voluntary agencies, corporate sources, and three major teaching hospitals in the Kansas City area. Results: Analysis of 10 randomly selected representative PEM revealed a mean SMOG Index score of 11.8 (±0.7), ie, grade level = 11.8, for the material analyzed. Adjusting the application of the formula on the assumption that patient educators would define and teach technical vocabulary terms (Standal's procedure) resulted in a decrease in the SMOG Index to grade level 9.9 (±0.7). Conclusions: We conclude that the SMOG Index can be a useful tool in determining the appropriateness of printed PEM and that defining terms may significantly decrease the required reading ability. Even so, the reading-grade level of much PEM may be beyond the ability of the majority of our patients. Further research should include a broader-based sample, and patient educators should perfect other methods of patient instruction.