gms | German Medical Science

Background: Up-to-date health care implies users’ autonomous decision-making on diagnostic and therapeutic measures (informed consent). Patients depend on comprehensible information material to be able to understand an intervention and its consequences. However, studies on literacy and health literacy imply that many patients have difficulties in reading and completing medical forms [1]. The internet is the most common source of information concerning health. Many patients rely on information taken from the internet without consulting other sources [2]. So, the readability of patient information in the internet is crucial.

Aim/Research Question: The issue of this investigation was to assess the readability of information material in obstetrics and to identify useful readability assessment tools.

Methods: Informed consent sheets on cesarean section, other obstetrical measures and anesthesia methods were assessed for readability using tools including the G-SMOG (German Simple Measurement of Gobbledygook), Flesch-Index, Amstad-Formula and LIX (Lesbarkeitsindex) [3]. In addition comparative material on the same topics, e.g. from the internet, was assessed. The assessments were carried out manually and by using online tools.

Results: 21 texts were included. Most texts in this investigation were found to be difficult or very difficult to read. Especially the included informed consent sheets were estimated clearly above the recommended readability level. The information booklet on cesarean section published by the Berlin Association of Midwives proved to be difficult to read too.

About a third of the investigated texts from the internet were estimated difficult or very difficult to read. Texts published by the IQWiG were found to be fairly readable. One can conclude that even scientific content can be presented in a readable fashion.

In some cases the results of the online tools differed substantially from those of the manual calculations. Overall, it can be said, that the assessment tools developed for the German language proved to be useful for a readability screening.

Limitations: The sample of this investigation was small and the content quality of the included texts was not assessed.

Relevance: Providing understandable information material is an interdisciplinary issue. Midwives as well as gynecologists have to ensure, that women sufficiently understand interventions like cesarean section or anesthesia methods. They have to be able to check existing material concerning readability.

Recommendations: Efforts need to be made to prepare readable and comprehensible information material, e. g. by using the “Hamburg Model of Comprehensiblity” or the rules of plain language. The “Hamburg Model of Comprehensibility” suggests simplicity, structuring, brevity/conciseness and stimulating add-ons as means to make a text more readable [4]. The rules of Plain language include the avoidance of difficult grammar like passive constructions and subjunctives. Furthermore typografy and layout can be useful to make a text more readable [5]. Indispensable basic informations can be complemented by informations of different readability adjusted to the patient’s needs.

Ethics and conflicts of interest: No vote on ethics was obtained. The research was financed by own resources. There are no conflicts of interest.

The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].