Development, validation, and usefulness of patient information leaflet for women undergoing Caesarean section

Patient information leaflets (PILs) are simple, inexpensive, and an effective means of providing information to patients. Leaflets allow patients to understand what to expect and what to know at their own pace. This study aimed to prepare, validate, and evaluate the efficacy of a PIL for female patients undergoing elective Caesarean section.

After approval from the hospital ethics committee, a PIL was prepared in English. Readability and design of the leaflet were checked using standard tests: Flesch Reading Ease test (FRE), Flesch-Kincaid Grade Level (FKGL), and Baker Able Leaflet Design (BALD). It was translated into two regional languages. The PIL was tested among patients using a questionnaire. A total of 240 adult female patients scheduled for elective Caesarean section were included. Patient knowledge through pre-test and post-test was compared using the paired t test. The influence of age and education level on the usefulness of the PIL was analyzed.

The English leaflet had a FRE score of 76 and a FKGL score of 4.36 which indicated good readability. The English PIL had a BALD score of 26, whereas both regional languages had a score of 22. The mean age was 26.61 ± 4.75 years with a range from 18 to 40 years. The knowledge scores increased from 40 ± 19.06 in the pretest to 69.52 ± 13.85 in post-test. Younger age (negative effect; P value 0.023) and intermediate level of education were the strongest predictors of greater knowledge gain.

PILs are an economical and convenient tool for patient education. The intervention was effective across all education levels, with the largest effect sizes in the intermediate level of education group.