Literacy in patients with a chronic disease: systemic lupus erythematosus and the reading level of patient education materials.
OBJECTIVE
(1) To assess literacy in a sample of patients with systemic lupus erythematosus (SLE); (2) to evaluate the reading level of patient education materials specific to SLE; and (3) to compare patient literacy levels to the readability of materials written for patients with SLE.


METHODS
Rapid Estimate of Adult Literacy in Medicine, a reading recognition test, was given to 94 patients with SLE. Socioeconomic status was assessed using Nam-Powers. Patient education materials frequently used with these patients were assessed for readability grade level.


RESULTS
The patients with SLE were reading on an average 7th-8th grade level; their average educational level (last grade completed in school) was 11.9. The average socioeconomic status (SES) according to the Nam-Powers assessment was 43, indicating high school completed, no college, an income range of $5000-$10,000, and occupations such as household workers and laborers. Multiple linear regression revealed that race and education correlated with reading (p < 0.001), but age, sex, and SES did not. The readability of surveyed SLE patient education materials ranged from 7th-15th grade level. Eighty-nine percent were written at a 9th grade level or above and were therefore inappropriate for about half the patients surveyed.


CONCLUSIONS
Reading skills below high school level existed for 48% of patients surveyed, yet only 11% of SLE patient education materials were written below a 9th grade level. Current SLE patient education materials are written on too high a level for many patients. Identifying patients with low literacy may help provide more appropriate patient education and better medical care.
Hearth-Holmes
M
M
Center of Excellence for Arthritis and Rheumatology, Department of Medicine, LSU Medical Center, Shreveport, Louisiana 71130-3932, USA.
Murphy
P W
PW
Davis
T C
TC
Nandy
I
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Elder
C G
CG
Broadwell
L H
LH
Wolf
R E
RE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004522:Educational Status; D005260:Female; D006801:Humans; D007258:Informed Consent; D016014:Linear Models; D008180:Lupus Erythematosus, Systemic / Q000523:psychology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic; D011932:Reading