University of Tabuk

Faculty of Applied Medical Sciences

Department of Nursing
Week 10:
Literacy and Readability
a. Reading Levels of Client
 Patients often read two to three
levels below the last completed
year of school.

Patient Educational Materials (PEM’s)

-pamphlets, booklets, information
sheets and consent forms
 Levels of Literacy
Level Description
Level 1 • Ranges from nonliterate in english to the ability to
Below Basic find simple information in a prose text.
• Can perform simple math such as addition.

Level 2 • Understand information in short prose texts with

Basic everyday language.
• Can use numbers to solve simple one-step arithmetic
problems such as comparing two prices.

Level 3 •Understand and can locate information in fairly dense

Intermediate prose and documents and can make simple inferences
from them.
• Can solve quantitative problems even when the
necessary process are not obvious.

Level 4 • Understand complex prose and analyzes complex

Proficient documents.
• Can solve multi-step arithmetic problems.
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Factors that contributes to reading
difficulty of Patient Educational
Materials (PEM’s) and web sites:

Long sentences and polysyllabic words

Complex sentences and paragraph
structure
Used of technical terminologies
Inclusion of abstract concepts
Mechanical factors: print size and type,
color, contrast, and density of the text.
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b. Assessing Literacy Levels
Clues of People with Low Literacy:
 Not even attempting to read printed
materials;
 Asking to take PEMs home to discuss
with a SO;
 Claiming that eyeglasses were left at
home;
 Stating that they cannot read something
because they are too tired or they do not
feel well;
 Avoiding discussion of written material or
not asking questions about it;
 Mouthing words as they try to read it.
c. Teaching People with Low
Literacy
1. Set objectives that are realistic for the
person’s level of understanding.
2. Choose information that will meet the
objectives and pare it down to the
minimum amount that is necessary.
3. Keep instructions simple.
4. Use more than one teaching method.
5. Use examples and analogies with which
the person can relate.
6. Be creative in the way you evaluate
learning.
d. Developing Printed
Educational Materials
Organizational Factors
1. Include a short but descriptive title.
2. Use brief headings and subheadings.
3. Incorporate only one idea per paragraph,
and be sure the first sentence is the
topic sentence.
4. Divide complex instructions into small
steps.
5. Consider using a question-answer
format.
6. Address no more than three to four main
points.
7. Reinforce main points with summary at
the end.
Linguistic Factors
1. Keep the reading level at grade 5 or 6 to
make the material understandable to most
low-literate person.
2. Use mostly one or two syllable words and
short sentences.
3. Use a personal a conversational style.
4. Define technical terms if they must be used.
5. Use words consistently throughout the text.
6. Avoid to use idioms that might mean
different things to different people.
7. Use graphics and language that are
culturally and age relevant for the intended
audience.
8. Use active rather than passive boys.
9. Incorporate examples and simple analogies
to illustrate concepts.
Appearance Factors
1. Avoid cluttered appearance by
including enough white spaces.
2. Include simple diagrams or
graphics that are well labeled.
3. Use upper and lower case letters.
4. Use 12- to 14- point type in plain
font (serif if preferred).
5. Place emphasized words in bold or
underline them, but do not use
capitals because they are difficult to
read.
6. Use lists when appropriate.
7. Try to limit line length to no more
than 50 or 60 characters.
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