Wu Jie, Wang Xin-Xin, Xu Min, Liu Kang-Ping, Xu Li-Ling, Zhang Ying
Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, 214000, Jiangsu, China.
Center for Community Health Care, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.
BMC Oral Health. 2025 Jun 5;25(1):919. doi: 10.1186/s12903-025-06297-4.
Oral frailty can cause many adverse consequences, including by impairing basic oral functions such as chewing and speaking; furthermore, it is closely related to overall systemic health. In the digital age, this study explores the relationship between eHealth literacy and oral frailty, alongside the mediating effects of self-efficacy and oral health on this relationship, providing theoretical support for eHealth-based oral frailty interventions.
A multicentre, cross-sectional analysis was conducted from July to November 2024. A total of 636 older adults were recruited from Changning District, Shanghai, China. The eHealth Literacy Scale, the Geriatric Self-Efficacy Scale for Oral Health, the Oral Health Assessment Tool, and the Oral Frailty Index-8 were used to assess the participants’ eHealth literacy, self-efficacy, oral health, and oral frailty. Spearman’s correlation analysis was conducted to examine the relationships among these variables. A structural equation model was used to analyse the mediating effects.
The study included 636 participants (55.7% female; median age: 70 years (IQR: 65–75)), whose median Oral Frailty Index-8 score was 5 (IQR: 3–6). Significant correlations were observed among eHealth literacy, self-efficacy, oral health, and oral frailty ( < 0.001). eHealth literacy directly affected oral frailty ( =- 0.161, 95% CI: -0.233, -0.085) via three mediating pathways: the self-efficacy pathway ( = -0.147, 95% CI: -0.188, -0.107), the oral health pathway ( = -0.152, 95% CI: -0.222, -0.100), and the serial mediation pathway via both self-efficacy and oral health (β = -0.105, 95% CI: -0.136, -0.081), which accounted for 26.0%, 26.9%, and 18.6% of the total effect, respectively.
eHealth literacy is negatively correlated with oral frailty, in which context self-efficacy and oral health serve as important serial mediating factors. It is essential for health care providers to focus on eHealth literacy among older adults and to support the development of age-friendly oral digital health technologies that require lower levels of eHealth literacy, thus improving the accessibility and equity of digital oral health technologies. This approach may serve as an effective intervention to prevent/delay oral frailty in older adults.
The online version contains supplementary material available at 10.1186/s12903-025-06297-4.
口腔功能衰弱会导致许多不良后果，包括损害咀嚼和说话等基本口腔功能；此外，它与整体全身健康密切相关。在数字时代，本研究探讨了电子健康素养与口腔功能衰弱之间的关系，以及自我效能感和口腔健康在这种关系中的中介作用，为基于电子健康的口腔功能衰弱干预提供理论支持。
于2024年7月至11月进行了一项多中心横断面分析。从中国上海长宁区招募了636名老年人。使用电子健康素养量表、老年人口腔健康自我效能量表、口腔健康评估工具和口腔功能衰弱指数-8来评估参与者的电子健康素养、自我效能感、口腔健康和口腔功能衰弱。进行Spearman相关性分析以检验这些变量之间的关系。使用结构方程模型分析中介效应。
该研究纳入了636名参与者（女性占55.7%；中位年龄：70岁（四分位间距：65 - 75岁）），其口腔功能衰弱指数-8的中位得分为5（四分位间距：3 - 6）。在电子健康素养、自我效能感、口腔健康和口腔功能衰弱之间观察到显著相关性（<0.001）。电子健康素养通过三条中介途径直接影响口腔功能衰弱（=-0.161，95%置信区间：-0.233，-0.085）：自我效能感途径（=-0.147，95%置信区间：-0.188，-0.107）、口腔健康途径（=-0.152，95%置信区间：-0.222，-0.100）以及通过自我效能感和口腔健康的序列中介途径（β=-0.105，95%置信区间：-0.136，-0.081），它们分别占总效应的26.0%、26.9%和18.6%。
电子健康素养与口腔功能衰弱呈负相关，在这种情况下，自我效能感和口腔健康是重要的序列中介因素。医疗保健提供者必须关注老年人的电子健康素养，并支持开发对电子健康素养要求较低的适老化口腔数字健康技术，从而提高数字口腔健康技术的可及性和公平性。这种方法可能是预防/延缓老年人口腔功能衰弱的有效干预措施。
在线版本包含可在10.1186/s12903-025-06297-4获取的补充材料。
