Study On The Relationship Between Electronic Health Literacy And Quality Of Life Among Patients With Chronic Diseases In Tai’an City

BackgroundAs the major global public health problems in the 21st century,chronic diseases not only seriously affect the health-related quality of life among the patients,but also bring heavy economic burdens to society,families and individuals.With the arrival of the "Internet+" era,electronic health information technology based on the Internet has attracted extensive attention and high expectations in the field of medical care,and the electronic health literacy has emerged as the times require.Studies have shown that the health literacy is closely related to the quality of life among the patients with chronic diseases.However,the impact and path of electronic health literacy on health-related quality of life are unclear.Therefore,this study aims to explore the relationship between electronic health literacy and quality of life in patients with chronic diseases.ObjectivesThis study aims to understand the current situation of electronic health literacy,and fully understand the current situation of health-related quality of life among the patient with chronic diseases and analyze its influencing factors.Then we try to explore the relationship between electronic health literacy and quality of life,and study the multiple intermediary effects of exercise frequency and social support between electronic health literacy and quality of life.To provide a theoretical basis for improving the level of electronic health literacy of patients with chronic diseases in Tai’an City and further improving their health-related quality of life.MethodsThe data of this study was from the general project of National Natural Science Foundation of China:Optimizing Design and Strategy of Family Doctor Contract Service from the Perspective of Behavioral Economics:An Empirical Study on Urban-Rural Supply and Demand(71974118).A total of 8542 people were selected from a cross-sectional study conducted in 160 towns/subdistricts from 6 counties and cities in Tai’an City,Shandong Province.Data were collected by using self-designed questionnaire and general scales with face-to-face interview surveys in the form of household surveys,which includes the sociodemographic characteristics,economic status,health-related behaviors,and health status.Epidata 3.1 was used for data entry,Stata 14.0 and Amos 21.0 were used for data analysis.First,descriptive statistical analysis was used to describe the general sociodemographic characteristics of patients with chronic diseases.Then,rank-sum test was used for univariate analyses.Third,tobit regression model was conducted to find out the potential risk factors of health utilities index.Fourth,Pearson correlation test was used to explore the relationship between electronic health literacy and health-related quality of life.Finally,the Structural Equation Model was performed to analysis the direct and indirect effects between electronic health literacy,exercise frequency,social support,and health-related quality of life.ResultsThis study focused on respondents who had chronic diseases with a sample of n=4229.The results of this study showed that the average score of electronic health literacy was 12.24 points among the patients with chronic diseases,the health utilities index was 0.919,Tobit regression results indicated that with young age,having high level of social support,with better self-rated economic status,quitting smoking,drinking,doing regular exercise,having good sleep quality,no tendency to depression,having better self-rated health status,with less number of chronic diseases were have positively significant effects on health-related quality of life(P<0.05);the average self-rated health score was 76.27 points.The marginal effect values of the five dimensions of the EQ-5D scale that caused the self-rated health score to decrease were:5.17 points for the anxious/depression,4.27 points for the pain/discomfort,3.72 points for the self-care,3.32 points for the usual activity,and the mobility was not significantly different.Pearson correlation analysis showed that there was a significant positive correlation between the three dimensions of electronic health literacy,the five dimensions of quality of life,exercises frequency,and social support(P<0.05);and there was a significant positive correlation between the five dimensions of quality of life,exercise frequency,and social support(P<0.05).Structural equation model analysis showed that exercise frequency and social support had multiple mediating effects between electronic health literacy and quality of life.Among them,the total effect value of electronic health literacy on the quality of life was 0.158;the direct effect value was 0.116;the indirect effect value was 0.042;the indirect effect value through exercise frequency was 0.016;through social support was 0.024.ConclusionThere was a significant relationship between electronic health literacy and health-related quality of life among the patient with chronic diseases in Tai’an City,and exercise frequency and social support played multiple intermediary effects.Electronic health literacy not only directly affects the quality of life,but also indirectly affect the quality of life through exercise frequency and social support.In order to improve the level of electronic health literacy and further improve their health-related quality of life,the following suggestions are put forward:(1)Seizing the opportunity of the "Internet+" era and establishing a chronic disease management platform with new era characteristics;(2)Taking electronic health literacy as the starting point to improve the health literacy of patients with chronic diseases;(3)Strengthen the physical exercise of patients with chronic diseases to promote the establishment and formation of a healthy lifestyle;(4)Improving the patients’health-related quality of life in many ways based on strengthen social support and mental health construction.