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Updated: May 5, 2026

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Readability, suitability and comprehensibility in patient education materials for Swedish patients with colorectal
Frida Smith1, Eva Carlsson1, Dimitrios Kokkinakis2
1Department of Colorectal Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden.
Objective:
To characterize education materials provided to patients undergoing colorectal cancer surgery to gain a better understanding of how to design readable, suitable, comprehensible materials.
Method:
Mixed method design. Deductive quantitative analysis using a validated suitability and comprehensibility assessment instrument (SAM+CAM) was applied to patient education materials from 27 Swedish hospitals, supplemented by language technology analysis and deductive and inductive analysis of data from focus groups involving 15 former patients.
Results:
Of 125 patient education materials used during the colorectal cancer surgery process, 13.6% were rated 'not suitable', 76.8% 'adequate' and 9.6% 'superior'. Professionally developed stoma care brochures were rated 'superior' and 44% of discharge brochures were 'not suitable'. Language technology analysis showed that up to 29% of materials were difficult to comprehend. Focus group analysis revealed additional areas that needed to be included in patient education materials: general and personal care, personal implications, internet, significant others, accessibility to healthcare, usability, trustworthiness and patient support groups.
Conclusion:
Most of the patient education materials were rated 'adequate' but did not meet the information needs of patients entirely. Discharge brochures particularly require improvement.
Practice Implications:
Using patients' knowledge and integrating manual and automated methods could result in more appropriate patient education materials.
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