Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 31, 2020
Date Accepted: Aug 10, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Associations among eHealth Literacy, Satisfaction in Shared Decision-making, and Subjective Well-being: A Multi-center Cross-sectional Study
ABSTRACT
Background:
Although previous studies have shown that a high level of health literacy could improve patients’ ability to engage in health-related shared decision-making (SDM) processes and improve their quality of life, few studies have investigated the role of eHealth literacy in improving SDM and subjective well-being.
Objective:
This study aimed to investigate what factors affect patients’ eHealth literacy and whether a high level of eHealth literacy could improve patients’ satisfaction in SDM and their subjective well-being.
Methods:
Data used in this study were obtained from a multi-center cross-sectional survey in China. The Chinese version of the eHealth Literacy Scale (eHEALS), the ICEpop CAPability Measure for Adults (ICECAP-A) were used to measure eHealth literacy and subjective well-being. Satisfaction in SDM (SSDM) was assessed by using five self-made items. One-way analysis of variance (ANOVA) was used to compare the differences in eHEALS, ICECAP-A, and SDM sum scores between subgroups of participants with different characteristics. Ordinary least square (OLS) regression models were used to assess the relationship between eHealth literacy, subjective well-being, and SSDM.
Results:
A total of 569 patients participated in the survey and completed the questionnaire. Around half of the participants were male and more than 50% were aged between 30 and 60 years. Participants who were male (mean of eHEALS= 68.5), young (71.7), highly educated (69.6), single (72.5), childless (72.7), fully employed (68.5), and those who never smoked (70.2), had no chronic conditions (68.5), and indicated no depressive disorders (67.6), showed a higher level of eHealth literacy. The results of ANOVA indicated that patients who had high SDM satisfaction and felt “fully capable” of controlling their own lives reported a significantly higher (p < .001) eHEALS sum scores, compared with those who had low SDM satisfaction and felt “not capable” of controlling their own lives. The OLS model indicated a positive relationship between eHealth literacy and subjective well-being (coefficient = 8.32, p < .001) and SDM (coefficient = 0.16, p < .001) after adjusting for patients’ demographic, socioeconomic, lifestyle, and health status variables.
Conclusions:
The results of our study showed that patients with high eHealth literacy are highly likely to experience optimal SDM and improved physical, mental, and social well-being. However, medical professionals’ knowledge and online research skills may affect patients’ ability and willingness to enrich their eHealth literacy, which should be considered in future studies.
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