Readability of Anesthesia Informed Consent Forms in Türkiye: A National Multicenter Comparative Analysis of University, Public, and Private Hospitals

Objective: This study aimed to evaluate the readability levels of anesthesia informed consent forms used in Türkiye, applying the Ateşman and Bezirci-Yılmaz formulas, and to compare forms across university, public, and private hospitals.

Methods: A total of 100 Turkish anesthesia consent forms, each obtained from a different healthcare institution, were analysed across all seven geographical regions of Türkiye. Forms were classified by institution type: university (n=25), public (n=45), and private (n=30). The Ateşman readability formula and the Bezirci-Yılmaz readability index were used. The Kruskal-Wallis H test, post-hoc Mann-Whitney U tests with Bonferroni correction, and Spearman correlation analysis were applied.

Results: The overall mean Ateşman score was 35.60±15.63 (median: 36.24). Of the forms, 75.0% were classified as “Difficult,” 16.0% as “Very Difficult,” 5.0% as “Moderate,” and 4.0% as “Easy.” Overall, 91.0% of forms were at “Difficult” or harder levels. No statistically significant differences were found among the three groups for Ateşman scores (H=1.170; p=0.557) or Bezirci-Yılmaz index (H=0.531; p=0.767). Post-hoc pairwise comparisons with Bonferroni correction also revealed no significant differences (all adjusted p>0.05). A moderate negative correlation was found between mean sentence length and Ateşman score (rs=−0.549; p<0.001).

Conclusion: A total of 91% of Turkish anesthesia consent forms are written at a readability level above that recommended for patient materials, and this problem is systemic regardless of institution type. As this study assessed textual readability rather than measured comprehension, these findings indicate a potential barrier to understanding rather than demonstrated comprehension failure. Redesigning forms with shorter sentences and plain language is recommended.