Health Literacy: Analysis of an Advance Health-care Directive Document


The document in question is dedicated to walking patients through the creation of an Advance Health-care Directive. The issue of Advance Health-care Directives is both important and sensitive. For this reason, due consideration needs to go into the message as well as the design of the document. The document outlines what exactly an Advance Health Directive is, the legal precedent that underlines its existence, and the different decisions one has to make before creating one.

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Message Content

Message content is confined to a limited number of messages in the document. All necessary information was included, and any that was not absolutely necessary taken out. The information is divided into sections, although what is most important in this instance is not at the beginning of the document. The author also failed to give a recap of the major points, instead opting to go directly into the form. To his or her credit, though, the document includes action steps that a person who wants to create an advanced directive should take.

Text Appearance

The text appearance facilitates the reader’s ability to understand the message, although some changes need to be made to enhance it even further. While the document features a print that is large enough and margins that are at least half an inch thick, the text appearance could have been improved by making use of serifs and orienting the text towards the left rather than the center. Also, while the author made use of bold and italics to highlight text, and consciously avoided the use of all caps, he or she could have created greater impact by restricting the line length of the columns to between 40 and 50 characters of space.

Layout & Design

Despite some shortcomings in the textual representation of the material, the layout and design of the piece ensure that the information is presented in an order that is logical to the audience. The only issue with the content was that they made use of the term agent before describing what role such a person holds. Still, with the use of headings and subheadings and by explaining technical and medicine related jargon, most of the text was easy to understand. By far, the best aspect of the document was the use of a conversational tone that must have made the topic approachable, even for the masses.


Another plus about the document derives from its understandability. Through the use of simple language, explanation of words and phrases, and elucidation of responsibilities of each person mentioned in the document, the author makes a conscious effort to make the piece as understandable as possible. The use of relatively simple language means that it is likely that readers will understand everything the author outlines, a critical element considering the importance of the message.


One of the most glaring oversights in the document relates to the lack of visuals. Visuals serve an important role in making the textual aspects of the representation more understandable. However, the author makes no effort to include visuals to aid his message. Not only does he or she fail to include a cover, but he or she also fails to include figures, images, tables, or any other visuals that would have clarified his message. According to Eadie (2014), extant research suggests that low literacy levels may increase with age, resulting in people who are over 60 year of age having difficulty reading and understanding instructions. For this reason, including visuals is important since it will aid their comprehension of instructions. If the author intended to bolster his or her readers understanding of the text, it would have been wise to include visuals to help explain the messages found in the text, place them next to the related text, and include captions that would convey the main points of the included visuals.


Another mistake that the author makes relates to the failure to translate the document. According to the Centers for Disease Control and Prevention (2010), messages that work well with an English-speaking audience may not work for an audience that speaks a different language. Thus, it is important to translate to ensure that the fidelity of the message is preserved. Since the piece conveys important information, and there is every likelihood that people who are not proficient with English would need the information it contains, the authors could have done more to translate the document. Despite the limitation, the author showed immense consideration by ensuring that the language and content culturally appropriate.


Centers for Disease Control and Prevention. (2010). Simply put: A guide for creating easy-to-understand materials (3rd ed.). Retrieved from

Eadie, C. (2014). Health literacy: A conceptual review. MEDSURG Nursing, 23(1), 1-13.

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