A Comparative Investigation of Methods Used to Document Seizures for People With Epilepsy and Learning Disabilities

Recent research findings by Wilson et al. (1998) have demonstrated that patient information leaflets affect health outcomes. However, the provision of patient leaflets is an under-utilised resource by health professionals and many are inadequately written. The literature in this area reveals that there is very little research which goes beyond the application of readability formulae to written information. This paper aims to address factors that affect readability and comprehensibility by involving patients in the evaluation process of patient information.Written material has been extensively used with patients to provide instruction for self-help, manual-guided therapy or simply to provide information (Glasgow & Rosen, 1978). Based on the concept of self-efficacy (Bandura, 1977), results of a study by Tyrer et al. (1993) suggested that the 'personal control of therapy that is intrinsic to self-help is of major therapeutic benefit.' This is in accordance with a study by Borkovec & Mathews (1988) who suggest that faith in an approach, in addition to an ability to conceptualise one's own problem in a different manner, is important. A self-help approach can lead to information being transmitted more effectively than therapist input alone (White, 1995). Readability formulae are commonly used by researchers to examine information leaflets given to patients in health-care settings (Reed et al. 1993). For example. Cole (1979) found that the readability of a selection of fifteen health education leaflets ranged fi'om an estimated readability of 25% or less to 75% or more of the target population. Although a low readability score indicates that revisions need to be made, understanding of information may not necessarily become easier (Ley, 1982). Comprehensibility of written self-help materials is still largely assessed in terms of readability measures only (Turvey, 1985). Several factors in addition to readability affect user comprehension, text processing and satisfaction (Sturmey, 1990). This could be further assessed by asking readers to relate what they have read (Wilson et al. 1998) or by asking them to rate how much of the information they understood. Self- help Materials For Depression and Anxiety The co-morbidity of anxiety and depression is increasingly accepted as a common phenomenon (Stavraki & Vargo, 1986 & Paykel & Priest, 1992). The literature has mentioned that there is a need for the development and evaluation of self-help materials directed at both anxiety and depression (Holdsworth et al. 1994). The Clinical Psychology department at Dykebar Hospital, Paisley have formulated 'Emotion Regulation' leaflets based on the work of Marsha Linehan (1993) with a view to implementing them as self-help materials in conjunction with therapist input. There are eight separate steps that comprise the complete programme of learning for the development of emotion regulation skills. These skills can be applied to a range of emotions experienced in many adult mental health problems. It is the department's aim to distribute the leaflets for such jfrequently referred problems as depression and anxiety. A leaflet for each step has been developed to help the patient with proper mastery of the strategies. However the leaflets have not been assessed by users of the service