Chen Haoyang, Wang Bin, Liu Yongqing, Liu Qiaoyun, Bai Jiayan, Yao Lijuan, Shen Biyu
Nantong Second People's Hospital, 298 Xinhua Road, Nantong, China.
Nantong Third People's Hospital, Nantong, China.
BMC Health Serv Res. 2025 May 8;25(1):657. doi: 10.1186/s12913-025-12695-9.
Given the increasing prevalence of digital health management, eHealth literacy plays a crucial role in the self-management of diabetes. eHealth literacy refers to an individual's ability to use electronic devices and online resources to manage health issues. In diabetes self-care, the way patients effectively access and apply health information directly impacts disease management outcomes. However, limited research has examined eHealth literacy among diabetes patients, and there is insufficient evidence to show its specific impact on diabetes distress. Therefore, this study aims to assess the eHealth literacy of diabetes patients and explore its relationship with diabetes distress.
This cross-sectional study was conducted from November 2022 to July 2023 and involved 260 diabetes patients from three tertiary hospitals in Nantong, China. The participants were selected using convenience sampling, and all participants were adults aged 60 years or younger who were capable of communicating in Chinese. Individuals with severe mental illness, hearing or visual impairments, or physical conditions that hindered their participation were excluded. The eHealth Literacy Scale (eHEALS) was used to assess the participants' eHealth literacy. Additionally, data were collected on social support, anxiety, depression, and diabetes distress (DDS). Structural equation modeling (SEM) was used to analyze the data and explore the pathways through which eHealth literacy influences diabetes distress.
eHealth literacy was significantly negatively correlated with anxiety, depression, and diabetes distress (r = - 0.408, p < 0.01; r = - 0.294, p < 0.01; and r = - 0.398, p < 0.01, respectively). Additionally, eHealth literacy was significantly positively correlated with social support (r = 0.346, p < 0.01). The results of the mediation analysis revealed that social support and psychological factors (anxiety and depression) played mediating roles in the relationship between eHealth literacy and diabetes distress.
This study shows that eHealth literacy significantly influences the perception of distress among patients with diabetes, with social support and psychological status playing important mediating roles. Enhancing eHealth literacy, especially patients' ability to access and apply health information, may help reduce diabetes distress. Future research should explore more representative samples and long-term study designs to validate these findings and evaluate the effectiveness of various interventions.
鉴于数字健康管理的日益普及，电子健康素养在糖尿病自我管理中起着至关重要的作用。电子健康素养是指个人使用电子设备和在线资源管理健康问题的能力。在糖尿病自我护理中，患者有效获取和应用健康信息的方式直接影响疾病管理结果。然而，针对糖尿病患者电子健康素养的研究有限，且缺乏证据表明其对糖尿病困扰的具体影响。因此，本研究旨在评估糖尿病患者的电子健康素养，并探讨其与糖尿病困扰的关系。
本横断面研究于2022年11月至2023年7月进行，纳入了来自中国南通三家三级医院的260名糖尿病患者。采用便利抽样法选取参与者，所有参与者均为60岁及以下、能够用中文交流的成年人。排除患有严重精神疾病、听力或视力障碍或身体状况妨碍其参与的个体。使用电子健康素养量表（eHEALS）评估参与者的电子健康素养。此外，收集了关于社会支持、焦虑、抑郁和糖尿病困扰（DDS）的数据。采用结构方程模型（SEM）分析数据，探讨电子健康素养影响糖尿病困扰的途径。
电子健康素养与焦虑、抑郁和糖尿病困扰显著负相关（r分别为-0.408，p<0.01；r为-0.294，p<0.01；r为-0.398，p<0.01）。此外，电子健康素养与社会支持显著正相关（r = 0.346，p<0.01）。中介分析结果显示，社会支持和心理因素（焦虑和抑郁）在电子健康素养与糖尿病困扰的关系中起中介作用。
本研究表明，电子健康素养显著影响糖尿病患者的困扰感知，社会支持和心理状态起重要中介作用。提高电子健康素养，特别是患者获取和应用健康信息的能力，可能有助于减轻糖尿病困扰。未来的研究应探索更具代表性的样本和长期研究设计，以验证这些发现并评估各种干预措施的有效性。
