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Readability of advance directive documents
1Villanova University, College of Nursing, PA 19085, USA.
Purpose:
To assess the readability of advance directive documents.
Design:
Descriptive.
Sample:
Convenience, 10 advance directive documents from various sources.
Methods:
Advance directive documents were electronically scanned in 1994 then evaluated using three readability formulas: Flesch-Kincaid Grade Level, Flesch Reading Score, and Gunning's Fog Index.
Findings:
The average readability (in school grade levels) of the 10 documents was 11.3 using the Flesch-Kincaid Grade Level and 18.2 using the Gunning's Fog Index.
Conclusions:
All documents were above reading levels usually recommended for patients.
Clinical Implications:
Patients must be able to read and understand advance directive documents before signing them. Refinement of the documents is recommended to support patient understanding and autonomy in end-of-life care.