title: Online Tonsillectomy Resources: Are Parents Getting Consistent and Readable Recommendations?
abstract: Objective Parents frequently refer to information on the Internet to confirm or broaden their understanding of surgical procedures and to research postoperative care practices. Our study evaluated the readability, comprehensiveness, and consistency around online recommendations directed at parents of children undergoing tonsillectomy. Study Design A cross-sectional study design was employed. Setting Thirty English-language Internet websites. Subjects and Methods Three validated measures of readability were applied and content analysis was employed to evaluate the comprehensiveness of information in domains of perioperative education. Frequency effect sizes and percentile ranks were calculated to measure dispersion of recommendations across sites. Results The mean readability level of all sites was above a grade 10 level with fewer than half of the sites (n = 14, 47%) scoring at or below the eight-grade level. Provided information was often incomplete with a noted lack of psychosocial support and skills-training recommendations. Content analysis showed 67 unique recommendations spanning the full perioperative period. Most recommendations had low consensus, being reported in 5 or fewer sites (frequency effect size <16%). Conclusion Many online parent-focused resources do not meet readability recommendations, portray incomplete education about perioperative care and expectations, and provide recommendations with low levels of consensus. Up-to-date mapping of the research evidence around recommendations is needed as well as improved efforts to make online information easier to read.
authors.affiliation: 1 Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada.
authors.forename: Lori
authors.initials: L
authors.lastname: Wozney
authors.affiliation: 2 Pediatric Research in Perioperative Care Lab, IWK Health Centre, Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.|3 Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Jill
authors.initials: J
authors.lastname: Chorney
authors.affiliation: 1 Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada.|4 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Huguet
authors.affiliation: 3 Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Song
authors.affiliation: 5 Departments of Otolaryngology-Head and Neck Surgery and Health Policy and Management, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Emily F
authors.initials: EF
authors.lastname: Boss
authors.affiliation: 2 Pediatric Research in Perioperative Care Lab, IWK Health Centre, Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.|3 Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Hong
mesh_terms: D000328:Adult; D057189:Checklist; D002648:Child; D002675:Child, Preschool; D032882:Comprehension; D003430:Cross-Sectional Studies; D005260:Female; D057220:Health Literacy / Q000379:methods*; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008490:Medical Informatics / Q000379:methods*; D010290:Parents / Q000193:education*; D011786:Quality Control; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*
keywords: ehealth; health literacy; patient education; perioperative; tonsillectomy