Factors influencing diabetic clients' ability to read and comprehend printed diabetic diet material

Factors related to diabetic clients' abilities to read and comprehend printed diabetic diet material were explored by collecting data on social and demographic variables, prior knowledge, reading ability (using the Nelson-Denny Test), and comprehension of the diet (using the cloze technique) from 58 outpatient diabetic clients. A mean estimated reading grade level of 8.9 was obtained for the printed material, based on the use of three readability formulas. Analysis of cloze scores revealed that 62% of the clients scored less than 40%, indicating that the material was too difficult for them to comprehend; 21% scored between 40% and 59%, suggesting the need for supplemental instruction; and 17% scored 60% or above, indicating ability to fully comprehend. Clients scoring less than 40% tended to be older and obtained lower scores on the Nelson-Denny, as compared with those in the highest cloze category. Results of a stepwise regression analysis indicated that the Nelson-Denny vocabulary score, client age, and duration of diabetes were the strongest predictor variables for comprehension of the diet material.