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Are end-of-life patient education materials readable?

Although established guidelines for developing low-literacy patient education materials are available, poorly designed material continue to be disseminated. We evaluated the readability and layout of English-language end-of-life patient education materials available on the Internet. Internet websites of five national palliative care organizations were searched to identify patient education materials for review. A convenience sample of 15 patient education materials per palliative care organization (n = 75) was downloaded and printed. The Simplified Measure of Gobbledygook (SMOG) was used to calculate the reading grade level (readability) of the text, while the layout features was assessed using criteria from the User-Friendliness Tool (UFT). The reading grade level of patient education materials ranged from 7th to 12th grade (mean ± SD = 11.1 ± 1.9). None of the patient education materials scored high on all UFT criteria. In particular, the greatest need was increasing the amount of white space and improving the way in which information was organized visually. Healthcare providers can only aid in the decision process, patients and their loved ones are ultimately responsible for making these choices. These decisions are important as choices need to be made about end-of-life care while patients are still cognitively able to do so. Well designed end-of-life patient education materials can offer a wealth of knowledge to assist and guide decision making. On the basis of these results, end-of-life patient education materials should be revised so that the average adult is able to understand the message presented, thereby enhancing his/her ability to make informed decisions.