Luke A. Mueller|Kevin Reid|Paul S. Mueller
Readability of state-sponsored advance directive forms in the United States: a cross sectional study
Mayo Clinic|Winneshiek Medical Center|Mayo Clinic|Winneshiek Medical Center|Mayo Clinic
state governments provide preprinted advance directive forms general public however many adults united states us lack skills necessary read comprehend health carerelated materials study sought determine readability state governmentsponsored advance directive forms cross sectional study design used readability advance directive forms available online 50 us states district columbia determined using 6 validated readability scales overall 62 advance directive forms obtained 47 states forms available way governmentsponsored web sites average sd readability fleschkincaid score forms grade level 119 26 similar results obtained readability scales form readability score 5th grade level lower level recommended national work group literacy health readability forms exceeded level average 69 grade levels 95 confidence interval 6376 p 001 5 forms readability score 8th grade level lower average reading skill level us adults readability forms exceeded level average 39 grade levels 95 confidence interval 3346 p 001 readability us state governmentsponsored advance directive forms exceeds readability level recommended national work group literacy health average reading skill level us adults forms may inhibit advance care planning therefore patient autonomy