title: Analysis of stroke patients' and carers' reading ability and the content and design of written materials: recommendations for improving written stroke information.
abstract: OBJECTIVE
  This study (a) evaluated the reading ability of patients following stroke and their carers and the reading level and content and design characteristics of the written information provided to them, (b) explored the influence of sociodemographic and clinical characteristics on patients' reading ability, and (c) described an education package that provides well-designed information tailored to patients' and carers' informational needs.
  
  
  METHODS
  Fifty-seven patients and 12 carers were interviewed about their informational needs in an acute stroke unit. Their reading ability was assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM). The written information provided to them in the acute stroke unit was analysed using the SMOG readability formula and the Suitability Assessment of Materials (SAM).
  
  
  RESULTS
  Thirteen (22.8%) patients and 5 (41.7%) carers had received written stroke information. The mean reading level of materials analysed was 11th grade while patients read at a mean of 7-8th grade. Most materials (89%) scored as only adequate in content and design. Patients with combined aphasia read significantly lower (4-6th grade) than other patients (p=0.001).
  
  
  CONCLUSIONS
  Only a small proportion of patients and carers received written materials about stroke and the readability level and content and design characteristics of most materials required improvement.
  
  
  CONCLUSIONS
  When developing and distributing written materials about stroke, health professionals should consider the reading ability and informational needs of the recipients, and the reading level and content and design characteristics of the written materials. A computer system can be used to generate written materials tailored to the informational needs and literacy skills of patients and carers.
authors.affiliation: Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld 4072, Australia. t.hoffmann@uq.edu.au
authors.forename: Tammy
authors.initials: T
authors.lastname: Hoffmann
authors.forename: Kryss
authors.initials: K
authors.lastname: McKenna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D017028:Caregivers / Q000193:education / Q000523:psychology; D032882:Comprehension; D004522:Educational Status; D005190:Family; D005260:Female; D006301:Health Services Needs and Demand; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000592:standards*; D011932:Reading; D012959:Socioeconomic Factors; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013664:Teaching Materials / Q000592:standards*; D014956:Writing