The readability of online laryngectomy patient information: how do Australia and New Zealand compare?

Abstract

Aim: The decision for a patient to undergo a laryngectomy is an extremely important one. The aim of our research was to review the readability of international laryngectomy patient information and compare this with Australian and New Zealand resources.

Methods: Online searches were undertaken using the terms "laryngectomy", "laryngectomy patient information", "voice box removal" and "voice box removal patient information". Twenty-nine articles were included for review. The primary outcomes measures were the Flesch-Kincaid Grade Level, the Flesch Reading Ease Score, the Gunning Fog Index, the Coleman-Liau Index, the SMOG Index, the Automated Readability Index and the Linsear Write Formula.

Results: Overall, we found that laryngectomy patient information from Australian and New Zealand sources was more difficult for patients to understand compared with international sources. The average Flesch-Kincaid Grade Level (equivalent to the United States grade level of education) for Australian and New Zealand websites was 10.41, compared with 9.09 for international websites. For reference, guidelines suggest that articles aimed at the public should have a grade level of 8. Similarly, the average Flesch Reading Ease Score was 55.8 and 58.23 for Australian/New Zealand and international resources respectively-which correlate to "fairly hard" to read, rather than the "easy" or "very easy" categories that are recommended for the general population.

Conclusion: For the resources analysed, Australian and New Zealand laryngectomy patient information was less readable than information distributed by international organisations, and is at a high risk of being too complicated for patients to read and understand. Consideration should be given to distributing patient information accessible to patients with lower literacy levels.