ABSTRACT
Introduction Printed patient educational materials (PEM) are often written above the recommended sixth- to eighth-grade reading levels, resulting in decreased client understanding and subsequent poor health literacy. Researchers have demonstrated that it is possible to improve readability to enhance clients' understanding and health literacy. The purpose of this study was to evaluate the readability of physical therapy (PT) PEM with and without modifications for improvement. Methods A convenience sample of 38 PT PEM of at least 10 sentences was obtained from a large suburban hospital system in the Midwestern region of the United States. Original and three modified versions (exclusion, revision, and combined exclusion/revision of words with >3 syllables) of the documents were assessed with the Simple Measure of "Gobbledygook" (SMOG). All document means were compared to the recommended reading levels, and the original document means were compared with modified conditions. Results A majority of the documents were above an eighth-grade reading level. All modified conditions resulted in statistically significant reading level decreases, but only the combined modified condition decreased to the eighth-grade level. Conclusion Even with modifications, most PEM were above the recommended reading levels. Additional methods for improving readability and increased education about health literacy for healthcare professionals may be necessary to improve client comprehension.
ABSTRACT
Breast cancer and its treatments can cause detrimental effects to function and quality of life (QoL). These patients do not conventionally receive physical therapy services until impairments and functional limitations have become extensive. Emerging treatment models advocate for early rehabilitation screenings and proactive interventions, which are termed prospective surveillance. The purpose of this case report was to describe two prospective surveillance screenings at initial diagnosis and survivorship and subsequent physical therapy episodes of care for a patient with breast cancer. A 39-year-old female was diagnosed with invasive ductal carcinoma of the right breast. Approximately three months after the initial diagnosis, the patient had a right nipple-sparing mastectomy and immediate reconstruction with an expander. In addition, one lymph node was removed and underwent a biopsy, which was negative for metastases. The patient was screened by a physical therapist after her initial cancer diagnosis at the breast multidisciplinary clinic. This was after her mastectomy with an expander; the therapist recommended an episode of outpatient physical therapy due to impairments in pain, fatigue, loss of range of motion, weakness, and limitations in performance of her activities of daily living. The patient was seen initially for five visits. She underwent her final reconstructive surgery one month after discharge from physical therapy. Six months after her final reconstructive surgery, she was screened by the same physical therapist in the cancer survivorship clinic. Once again, therapy was recommended due to pain as well as deficits to her range of motion, strength, and functional status. The second episode of care lasted 14 visits and the patient showed improvements in pain, range of motion, shoulder strength and gains in the patient-specific functional scale and upper extremity functional index. This case reflects the importance of prospective surveillance screenings to overall patient outcomes. This patient may not have otherwise received physical therapy and its associated benefits without the prospective screenings by the physical therapist.
