Thursday, May 9, 2013

Plainly Rude


Asthma Management plan for Sarah Lechner; at first glance this document seems very official.  It has my doctor’s name, the severity of the condition and steps on how to deal with asthma.  However, on a second look, the Asthma Management plan is not as official as it appears.  This document has clear instructions on how to deal with asthma and the medicine that is prescribed to treat the condition.  This combination of plain style and medical terminology gives it an average grade level of 20.6 and a Flesch-Kincaid Reading Ease of 24.1.  According to the numbers, this is very complex information, but the words are oversimplified and the pictures are elementary.  My name is printed on top along with my date of birth and my physician knows that I am obtaining a college education.  While I can understand the need to make this document simple and easy to read, I personally find it insulting.  I have had asthma for about thirteen years and I understand the physiology and treatment of the condition.  With its plain phrasing, this document would be effective in educating new asthma sufferers with low education levels despite the high grade level. 

The flyer starts out with three different zones, they are simply named Go, Caution, and Danger, following those names are the colors green, yellow, and red.  Under each of these zones are symptoms that are associated with that zone.  If you are breathing normally and able to sleep, eat, and play the doctor recommends using albuterol inhaler fifteen minutes before exercise.  The Yellow zone has coughing and wheezing with problems sleeping, eating, and playing.  During this one should take their albuterol inhaler every four hours and use their nebulizer as needed.  If you are in the Danger stage, or red zone, and are unable to speak due to difficulty breathing and are gasping for air, prednisone should be used daily for five days.  Accompanying all these descriptions are photos of a little boy.  The first one shows him riding a bike, the second the boy in pain with his mouth partially open, and the last one is the boy shirtless and clearly in distress.  

As an educated young adult, by educated I am referring to someone who has graduated high school and has attended some level of higher education, I find this oversimplified document tiresome.  I understand the flyer perfectly, I have no need for the illustrations or the simple language and accompanying zones.  The bullet point symptoms within the zones are useful and easy to understand.  If I have any of these symptoms, I am in this zone and that means I should follow the instructions with that zone.  In this regard, the Plain Style has achieved its goal.  I understand the flyer completely, even though I may feel it is oversimplified. 

I also understand the same flyer is used for a wide range of patient ages and educational levels. The illustration and the zones are useful in making the medical terminology understandable for less educated clients.  I think the intended audience is parents with young children because of the pictures and the simple words.  It would be very easy for a parent to look at the flyer and ask their children about the symptoms they are experiencing.  According to the journal of American Academy of Family Physicians the average medical document is writen at a sixth grade reading level.  That is a grade lower than the national reading level, which is seventh grade. Even though this instructional handout has a high reading level, the use of the illustrations and bulleted zones make it very effective for less educated adults or even adults and children who cannot read.  If you cannot read or have a low reading level these pictures would be quite effective.  If you do not understand what “wheezing” means, but can see the picture of the shirtless distressed boy and notice that your child looks similar, these pictures could save that child. 

Even though this document is simple, it has a high reading level.  The medical terminology contradicts the Plain Style.  If the creators of this document really wanted to keep in spirit of the Plain Style movement, they could have used pictures for the medicine needed.  It seems inconsistent with the rest of the document.  A picture of what the medicine looks like would be helpful to people who could not read.  Descriptions of what the medicine does would also be useful education.  They may not understand why their child or they needs to be taking albuterol before exercise. 

While Asthma management plan is effective and fits with the Plain style movement, I do not approve of the structure of this document.  The different zones and pictures, while keeping with the Plain Style movement, are insulting to educated people and the medical terminology takes away from the Plain Style.  Creators of medical education handouts and the physicians and nurses who distribute them would be wise to keep in mind the very wide variation in educational levels of the patients they treat. Medical terminology does not easily lend itself to the plain style but the importance of the material to the health of the clients demands its use in educational handouts. A wider variety of handouts from simple illustrations to more complex explanations could be available for distribution based on assessment of clients educational level.

By: Sarah Lechner


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