Gözüm Sebahat, Asi Ercan, Şıklaroğlu Merve, Şahin Süleyman, Öncel Selma, İmamoğlu Demet, Kanlı Suzan
Department of Public Health Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey.
Department of Public Health Nursing, Faculty of Health Sciences, Kafkas University, Kars, Turkey.
Res Nurs Health. 2025 Jun;48(3):324-336. doi: 10.1002/nur.22450. Epub 2025 Jan 30.
e-Pulse is an electronic personal health record system known as e-Nabız in Turkey. This study compares the effect of European Health Literacy-based e-Pulse education and e-Pulse instructional materials on the health literacy levels of adults aged 45-64 with inadequate and problematic-limited health literacy levels. This single-blind, randomized controlled trial was conducted from June 2023 to September 2023. It included 140 participants, assigned to either the intervention group (n = 70) or the active control group (n = 70). The intervention group received HLS-EU-based e-Pulse education, which consisted of two 45-min sessions over 6 weeks, along with the e-Pulse user guide and introduction video. The active control group only received the e-Pulse user guide and introduction video, and each participant was individually briefed on the e-Pulse system content for 5-10 min. Results were measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and the eHealth Literacy Scale (eHEALS) at baseline and the sixth week. Both the intervention and active control groups showed an increase in health literacy and eHealth literacy scores, but the mean change was greater in the intervention group. A statistically significant difference was found in the effects of HLS-EU-based e-Pulse education and e-Pulse instructional materials on both health literacy (F (1, 137) = 25.215; p < 0.001) and eHealth literacy (F (1, 137) = 36.134; p < 0.001). HLS-EU-based e-Pulse education significantly improved health literacy (d = 0.8492; p < 0.001) and eHealth literacy (d = 1.0175; p < 0.001) compared to e-Pulse instructional materials. The intervention group demonstrated significantly higher rates of sufficient (32.9%) and excellent (12.9%) health literacy. Notably, a medium correlation (r = 0.602; p < 0.001) was observed between health literacy and eHealth literacy. Trial Registration: ClinicalTrials.gov (ID: NCT05831254) https://clinicaltrials.gov/study/NCT05831254.
电子脉搏（e-Pulse）是土耳其一种名为电子脉搏（e-Nabız）的电子个人健康记录系统。本研究比较了基于欧洲健康素养的电子脉搏教育和电子脉搏教学材料对健康素养水平不足且存在问题的45-64岁成年人健康素养水平的影响。这项单盲随机对照试验于2023年6月至2023年9月进行。研究共纳入140名参与者，分为干预组（n = 70）和积极对照组（n = 70）。干预组接受基于欧洲健康素养量表（HLS-EU）的电子脉搏教育，包括在6周内进行的两次45分钟课程，以及电子脉搏用户指南和介绍视频。积极对照组仅收到电子脉搏用户指南和介绍视频，并且每位参与者针对电子脉搏系统内容接受了5-10分钟的单独讲解。在基线和第六周时，使用欧洲健康素养调查问卷（HLS-EU-Q47）和电子健康素养量表（eHEALS）来测量结果。干预组和积极对照组的健康素养和电子健康素养得分均有所提高，但干预组的平均变化更大。基于HLS-EU的电子脉搏教育和电子脉搏教学材料对健康素养（F(1, 137) = 25.215；p < 0.001）和电子健康素养（F(1, 137) = 36.134；p < 0.001）的影响存在统计学显著差异。与电子脉搏教学材料相比，基于HLS-EU的电子脉搏教育显著提高了健康素养（d = 0.8492；p < 0.001）和电子健康素养（d = 1.0175；p < 0.001）。干预组具有足够健康素养（32.9%）和优秀健康素养（12.9%）的比例显著更高。值得注意的是，健康素养与电子健康素养之间存在中等程度的相关性（r = 0.602；p < 0.001）。试验注册：ClinicalTrials.gov（ID：NCT05831254）https://clinicaltrials.gov/study/NCT05831254 。
