Research On EHealth Literacy And Online Health Information Seeking Behavior Among Patients With Systemic Lupus Erythematosus

Objective(1)To evaluate the suitability of e Health Literacy Scale(e HEALS)in the patients with systemic lupus erythematosus(SLE);(2)To investigate the current ehealth literacy level among the SLE patients;(3)To learn more about how SLE patients obtain and utilize online health information and resources and their ideas about what is an ideal network information platform.And to compare the differences of their preferences for online health information between patients with high level and low level of ehealth literacy.It is expected to offer evidences for future intervention in SLE patients' ehealth literacy and provide the patients with targeted online health information support and services.Methods This study consisted of two stages and combined the quantitative method with qualitative method.The first stage was a cross-sectional survey of ehealth literacy level among patients with SLE.Firstly,we selected the suitable valuation tool(e HEALS)to measure ehealth literacy through reviewing the relevant studies.Then the reliability and validity of the Chinese version of e HEALS were tested among 167 SLE patients.The reliability of the scale was tested by calculating the Cronbach's ? coefficient,split-half reliability coefficient and retest reliability coefficient,and the validity of e HEALS was evaluated by the content validity,construct validity and discrimination validity.After that,the scale was used to investigate the level of ehealth literacy among 313 SLE patients.SPSS 22.0 was used to analyze the data.The second stage was a qualitative study of online health information seeking behavior among the patients with SLE.On the basis of the cross-sectional survey,20 patients with both high and low level of ehealth literacy were selected by purposive sampling and were invited to participate in the individual semi-structured interviews.The qualitative study was conducted to understand how SLE patients obtain,utilize and appraise online health information and their expectations of an ideal online information platform.The differences in their preferences for online health information were compared between the patients with high and low level of ehealth literacy.The inductive content analysis was adopted to analyze and extract themes.Results Stage ?:(1)The Chinese version of e HEALS had good reliability and validity among SLE patients.The Cronbach's ? coefficient of the e HEALS was 0.900,split-half reliability coefficient was 0.924 and intra-class correlation coefficient of retest reliability was 0.831(P<0.01).The correlation coefficients of each item score and the total score were 0.718~0.808(P<0.01).One common factor which could explain59.24% amount of variability was extracted from the 8-item scale by exploratory factor analysis.Factor load coefficients varied from 0.693~0.819.Among the 167 respondents,48 patients belonged to the high score group,while 54 patients were in the low score group.All item scores of the SLE patients in high score group were statistically higher than those in low score group(P<0.01).(2)The total score of ehealth literacy among313 patients with SLE was 8~40,the average score was(26.49 ± 6.92).When using 26 as the cut-off point,186(59.4%)patients had high-level ehealth literacy,127(40.6%)patients had low-level ehealth literacy.Item 3: I know how to find helpful health resources and information on the Internet and item 5: I know how to use the health information I find on the Internet to help me had the highest scores,(3.42 ± 0.98)and(3.36 ± 0.96)respectively.While item 6: I have the skills I need to evaluate the health resources and information I find on the Internet and item 8: I feel confident in using information from the Internet to make health decisions had the lowest scores,(3.23 ±1.00)and(3.24 ± 1.01)respectively.Stage ?: Five themes were extracted from the data,SLE patients:(1)had many ways to seek online health information and sought extensive contents;(2)had doubts about the quality of online health information,but they lacked the ability to evaluation information;(3)considered social media as an important way to obtain disease-related knowledge and emotional support;(4)had different preferences for online health information due to different ehealth literacy;(5)expected an all-around content,up-to-date,multifunctional and professional information platform.Conclusion(1)The Chinese version of e HEALS can be used to assess SLE patients' ehealth literacy in Chinese culture.More than half of the SLE patients had high level of ehealth literacy,but the ability to evaluate information was a weak link in utilizing online health information.Clinical health education providers should take steps to improve the ability of information evaluation and help patients obtain benefit from online resources.(2)Internet has become an important way for SLE patients to obtain disease-related information and social support,and social media plays an increasingly important role in peer communication.Clinical health educators should take advantages of social media to carry out peer support education and attempt to build a high-quality and professional online information platform for SLE patients.(3)The preferences for the ways and contents of online health information seeking between the patients with high-level and low-level ehealth literacy were different.Clinical health educators should provide targeted online information support and services according to the preferences of the patients with different levels of ehealth literacy.