Background Although subjective expressions and linguistic fluency have been shown as important factors in processing and interpreting textual facts, analyses of these traits in textual health information for different audiences are lacking. We analyzed the readability and linguistic psychological and emotional characteristics of different textual summary formats of Cochrane systematic reviews. Methods We performed a multitrait-multimethod cross-sectional study of Press releases available at Cochrane web site ( n = 162) and corresponding Scientific abstracts ( n = 158), Cochrane Clinical Answers ( n = 35) and Plain language summaries in English ( n = 156), French ( n = 101), German ( n = 41) and Croatian ( n = 156). We used SMOG index to assess text readability of all text formats, and natural language processing tools (IBM Watson Tone Analyzer, Stanford NLP Sentiment Analysis and Linguistic Inquiry and Word Count) to examine the affective states and subjective information in texts of Scientific abstracts, Plain language summaries and Press releases. Results All text formats had low readability, with SMOG index ranging from a median of 15.6 (95% confidence interval (CI) 15.3–15.9) for Scientific abstracts to 14.7 (95% CI 14.4–15.0) for Plain language summaries. In all text formats, “Sadness” was the most dominantly perceived emotional tone and the style of writing was perceived as “Analytical” and “Tentative”. At the psychological level, all text formats exhibited the predominant “Openness” tone, and Press releases scored higher on the scales of “Conscientiousness”, “Agreeableness” and “Emotional range”. Press releases had significantly higher scores than Scientific abstracts and Plain language summaries on the dimensions of “Clout”, and “Emotional tone”. Conclusions Although the readability of Plain language summaries was higher than that of text formats targeting more expert audiences, the required literacy was much higher than the recommended US 6th grade level. The language of Press releases was generally more engaging than that of Scientific abstracts and Plain language summaries, which are written by the authors of systematic reviews. Preparation of textual summaries about health evidence for different audiences should take into account readers’ subjective experiences to encourage cognitive processing and reaction to the provided information. Electronic supplementary material The online version of this article (10.1186/s12874-019-0716-x) contains supplementary material, which is available to authorized users.

Modern health has become a defining facet of contemporary life managed by health policy. The COVID-19 pandemic has significantly affected mental health, resulting in stress and anxiety in doctors’ professional and private life. Since the beginning of the pandemic, doctors have been facing chronic stress, which was reported to the hospital managers and health-care agencies, but nothing was done in the practice to protect them. Although doctors are trained to stay emotionally restrained, a large number of patients in intensive care, along with the personal concerns for their families, has led to burnout. This article highlights the need for health politics to take responsibility for dealing with burnout in health-care workers with a new approach that should help doctors recognize, understand, and manage work-related stress with additional support in the pandemic.

Background The European Charter of Patients' Rights (ECPR) presents basic patients' rights in health care. We analysed the characteristics of patients' complaints about their rights submitted through the official complaints system and to a non-governmental organization in Croatia. Methods The official system for patients’complaints in Croatia does not have a common pathway but offers different modes for addressing patient complaints. In this cross-sectional study, we analysed the reports about patients’ complaints from the official regional committees sent to the Ministry of Health. We also analysed the complaints received by the Croatian Association for the Protection of Patient’s Rights (CAPR) and mapped them to the ECPR. Results The aggregated official data from the Ministry of Health in 2017 and 2018 covered only 289 individual complaints from 10 out of 21 counties. Complaints were most frequently related to secondary and tertiary healthcare institutions and details were not provided. CAPR received a total of 440 letters, out of which 207 contained 301 complaints about violations of patients’ rights in 2017–2018. The most common complaint was the Right of Access to health care (35.3%) from the ECPR, followed by the Right to Information (29.9%) and the Right to Safety (21.7%). The fewest complaints were about the Right to Complain (1.9%), Right to Innovation (1.4%), Right to Compensation (1.4%), and Right to Preventive Measures (1.0%). Conclusions Reporting and dealing with patients’ complaints about violations of their patients’ rights does not appear to be effective in a system with parallel but uncoordinated complaints pathways. Mapping patient's complaints to the ECPR is a useful tool to assess the perception of patients’ rights and to plan actions to improve the complaints system for effective health care.

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