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Chen X, Qin Y, Chaimongkol N. Effectiveness of a phone-based support program on self-care self-efficacy, psychological distress, and quality of life among women newly diagnosed with breast cancer: A randomized controlled trial. Eur J Oncol Nurs 2024; 71:102643. [PMID: 38889503 DOI: 10.1016/j.ejon.2024.102643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/02/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE This study aimed to determine the effectiveness of a Phone-Based Support Program (PBSP) for newly diagnosed women with breast cancer. METHODS A two-group repeated measures randomized controlled trial was designed. Participants included 94 patients aged 18-60 years who were newly diagnosed with breast cancer and undergoing chemotherapy in a tertiary hospital in China. They were randomly assigned to the intervention and the control groups. Participants in the intervention group were enrolled in a four-session PBSP, consisting of four interactive sections: learning, discussion, ask-the-expert, and personal stories, plus the routine care. Outcomes included patients' self-care self-efficacy, psychological distress (including symptom distress, anxiety, and depression), and quality of life. These were assessed at three time points: pre-intervention (T1), post-intervention (T2), and follow-up (T3) by using the self-care self-efficacy scale, the M.D. Anderson Symptom Inventory, the hospital anxiety and depression scale, and the global health status scale. RESULTS After completion of the intervention, participants in the intervention group had significantly (p < .001) higher self-care self-efficacy (T2: Mdiff = 11.49, T3: Mdiff = 22.33), better quality of life (T2: Mdiff = 8.18, T3: Mdiff = 17.19), lower symptom distress (T2: Mdiff = -26.68, T3: Mdiff = -54.76), less anxiety (T2: Mdiff = -2.52, T3: Mdiff = -5.11), and less depression (T2: Mdiff = -3.61, T3: Mdiff = -6.71) than those in the control group. CONCLUSION These findings indicate that the PBSP is effective. Healthcare professionals, especially nurses, could utilize it to enhance self-care self-efficacy and quality of life, as well as decrease psychological distress among women newly diagnosed breast cancer. REGISTRATION The Thai Clinical Trial Registry #TCTR20230321010.
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Affiliation(s)
- Xi Chen
- The First People's Hospital of Yancheng in Jiangsu, Tinghu District, Yancheng City, Jiangsu Province, China.
| | - Yang Qin
- Jiangsu Vocational College of Medicine in Jiangsu, Yancheng City, Jiangsu Province, China.
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Zou D, Liu Y, Gong Y, Zhang X, Liu J, Shen J. Self-Efficacy's Mediating Role in the Relationship Between Self-Perceived Burden and Health-Related Quality of Life Among Older-Adult Inpatients in China: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:2157-2163. [PMID: 38736537 PMCID: PMC11088387 DOI: 10.2147/jmdh.s460151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose This study investigated the current state of self-efficacy and the association between self-perceived burden (SPB) and health-related quality of life (HRQoL) among Chinese older-adult inpatients. Methods A cross-sectional study was conducted using convenience sampling to survey Chinese older-adult inpatients. Data regarding demographic characteristics, self-efficacy, SPB, and HRQoL were collected. Pearson's correlation analysis was used to examine the correlations among the research variables. SPSS® Statistics V26.0, and SPSS® PROCESS Macro Model 4 were used to analyze the available data. The bootstrap method was used to analyze the mediating role of self-efficacy. Results Survey participants included 514 older-adult inpatients, with a mean age of 72.28±5.58 years. Self-efficacy (r=0.471, p<0.01) was positively correlated with HRQoL, whereas self-efficacy (r=-0.891, p<0.01) and HRQoL (r=-0.516, p<0.01) were negatively correlated with SPB. The mediating effect analysis revealed that self-efficacy either completely or partially mediated the effect of SPB on HRQoL, with the indirect effect accounting for 30.2% of the total. Conclusion This study provides a mediating model suggesting that SPB exerts both direct and indirect effects on the HRQoL of older-adult inpatients through self-efficacy.
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Affiliation(s)
- Dongmei Zou
- Department of Cardiovascular Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde city), Changde, People’s Republic of China
| | - Yanqiong Liu
- Department of Cardiology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, People’s Republic of China
| | - Youwen Gong
- Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, People’s Republic of China
| | - Xueqing Zhang
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
| | - Jieqiong Liu
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
| | - Jinhua Shen
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
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Liu PL. Understanding mHealth Adoption and Lifestyle Improvement: An Empirical Test of the Antecedents and Mediating Mechanisms. JOURNAL OF HEALTH COMMUNICATION 2024; 29:155-165. [PMID: 38205945 DOI: 10.1080/10810730.2024.2303641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
The potential of using mobile phones for health care service delivery has been well acknowledged. Despite that mobile health (mHealth) related research has proliferated in the past decade, mHealth is still in the fledgling stage with a low adoption rate. There is a research gap in understanding factors influencing mHealth adoption and examining the effects of mHealth use on health outcomes. The purpose of this study was thus to explore influential factors of mHealth use, and test mediation pathways through which mHealth use impacts healthy lifestyle behaviors (e.g. sleep, exercise, and social participation). Survey results from 432 online participants illustrate that performance expectancy, social influence, support conditions, and perceived reliability were significantly associated with mHealth use. However, the impact of effort expectancy on mHealth use was statistically nonsignificant. Moreover, the results indicate that mHealth use can not only contribute to the improvement of healthy lifestyle behaviors directly but also exert an impact through the mediating effect of health competence. Knowing what factors motivate people's mHealth use and how mHealth use contributes to lifestyle improvement can help trigger interventions to boost mHealth adoption and improve public health. Implications and limitations are discussed.
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Guo K, Ouyang J, Minhat HS. The mediating role of health literacy between the presence of chronic disease and psychological distress among older persons in Xi'an city of China. BMC Public Health 2023; 23:2530. [PMID: 38110936 PMCID: PMC10726590 DOI: 10.1186/s12889-023-17315-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 11/23/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The increased number of older persons in China, and the prevalence of most chronic diseases raised with age significantly increased the total disease burden. When a person ages, psychological distress happens when they are faced with stressors that they cannot cope with. Psychological distress refers to non-specific symptoms of depression, anxiety, and stress. Health literacy influences several health outcomes, such as emotional functioning among the population. The primary purpose of this study is to examine the mediator role of health literacy between the presence of chronic disease and psychological distress among older persons living in Xi'an city. Thus, this study used the Cognitive Behavior Theory (CBT) as a combination of the basic behavioral and cognitive psychology principles to explain the cognitive processes associated with psychological distress. METHODS This study employs a quantitative research design using a cross-sectional survey of 300 older persons over 60 years living in the six urban districts of Xi'an city. Data were collected using the Health Literacy Questionnaire (HLQ) and the Depression Anxiety Stress Scale (DASS-21). This study employed descriptive statistics and inferential methods to analyze the data. The inferential methods applied structural equation modeling (SEM) to test the hypothesis of the mediator role of health literacy between the presence of chronic disease and psychological distress. RESULTS In this study, chronic disease had an effect on health literacy among older persons living in Xi'an city (β=-0.047, p < 0.01); chronic disease impact on psychological distress among older persons living in Xi'an city (β = 0.047, p < 0.01); health literacy was identified effect on psychological distress among older persons in Xi'an city (β=-0.738, p < 0.001); health literacy as a partial mediator between chronic disease and psychological distress (β = 0.07, p < 0.01). CONCLUSION Psychological distress among older persons is affected by chronic disease and health literacy. Health literacy had a partial mediating effect on the presence of chronic disease and psychological distress. Improved health literacy measures should be considered when treating older persons with psychological distress.
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Affiliation(s)
- Kun Guo
- College of Humanities and management, Shaanxi university of Chinese medicine, Xianyang, Shaanxi province, China.
| | - Jing Ouyang
- College of Humanities and management, Shaanxi university of Chinese medicine, Xianyang, Shaanxi province, China.
| | - Halimatus Sakdiah Minhat
- Department of Community Health, Faculty of medicine and health sciences, University Putra Malaysia, Kuala Lumpur, Malaysia.
- Malaysian Research Institute on Ageing, University Putra Malaysia, Serving, Selangor, 43400, Malaysia.
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Wong AKC, Chan EA, Chung BPM, Lai TKH, Ho AKY. Predictors of nursing students' intentions to participate in an internationalization-at-home program: The roles of expectancies for success and subjective task value. NURSE EDUCATION TODAY 2023; 129:105918. [PMID: 37541073 DOI: 10.1016/j.nedt.2023.105918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/27/2023] [Accepted: 07/17/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Internationalization-at-home programs are a unique opportunity for those who had been planning to study abroad to learn global clinical practices and cultures at home. However, the factors influencing the motivation of students to join such programs remain unexplored. OBJECTIVE To investigate the relationship among expectancies for success, subjective task value, and the intention to participate in an internationalization-at-home program, and to identify key factors predicting such an intention among undergraduate nursing students. DESIGN A descriptive correlational design with a predictive approach was adopted. METHODS A total of 522 undergraduate and postgraduate nursing students in a Hong Kong university participated in the study. Intention to participate in the program was assessed using the Comprehensive Relative Autonomy Index. Expectancies for success and subjective task value were assessed as potential predictors. A multiple linear regression analysis was adopted to examine the predictive effects. RESULTS The participants were aged 17-31 years (mean = 20.95, SD = 2.39). Those who reported having previously participated in the program (β = 0.10, p-value = .014), greater intercultural communication competence (β = 0.14, p-value = .003), greater perceived social competence (β = 0.11, p-value = .031), and a higher subjective value of the program (β = 0.28, p-value<.001) expressed a greater intention to join the program. Collectively, the three variables accounted for 14.7 % of the variances in intention to participate in the program. CONCLUSIONS Cultural self-efficacy, intercultural communication competence, perceived social competence, individual interest, foreign language learning motivation, and subjective value of the program were found to be key factors predicting the intention of nursing students to participate in internationalization-at-home. Future studies can provide interventions to address these factors and enhance the benefits of internationalization-at-home programs.
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Affiliation(s)
| | - Engle Angel Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | | | | | - Annie Ka Ying Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
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Bayuo J, Abu-Odah H, Su JJ, Aziato L. Technology: A metaparadigm concept of nursing. Nurs Inq 2023; 30:e12592. [PMID: 37563996 DOI: 10.1111/nin.12592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
Undoubtedly, technology continues to permeate the world at an unprecedented pace. The discipline of nursing is not alien to this phenomenon as nurses continue to employ various technological objects and applications in clinical practice, education, administration and research. Despite the centrality of technology in nursing, it has not been recognised as a metaparadigm domain of interest in the discipline of nursing. Thus, this paper sought to examine if technology truly reflected a metaparadigm domain using the four requirements posited by Fawcett. Using these requirements, we examined the onto-epistemology of technology in relation to nursing and conclude that technology potentially represents a distinct domain that intersects with nursing (particularly, from the humanities perspective). Also, technology encompasses some phenomena of interest to the discipline of nursing, demonstrates perspective-neutrality, and is international in scope and substance albeit with some nuances which do not fit well with nursing onto-epistemology. Put together, it is highlighted that technology intersects with the existing metaparadigm domains (person, health, environment and nursing) which positions it as a potential phenomenon of interest to the discipline of nursing requiring further work to articulate its position and role.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Lydia Aziato
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Hohoe, Ghana
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Ayoubi-Mahani S, Eghbali-Babadi M, Farajzadegan Z, Keshvari M, Farokhzadian J. Active aging needs from the perspectives of older adults and geriatric experts: a qualitative study. Front Public Health 2023; 11:1121761. [PMID: 37397742 PMCID: PMC10311094 DOI: 10.3389/fpubh.2023.1121761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction With an increasing rate of population aging and its consequences, preparation for active aging based on older adults' needs is an unavoidable priority. Active aging needs must be identified to help strategic planning for older adults' health and wellbeing. This study aimed to explore the active aging needs from the perspectives of older adults and geriatric experts. Methods This exploratory-descriptive qualitative study was conducted in four provinces with the oldest populations in Iran. Semi-structured and focus group interviews were conducted with 41 participants (20 older adults and 21 geriatric experts), who were chosen through purposive and snowball sampling. Data were analyzed using the conventional content analysis. Results This study identified three themes and thirteen categories from the data: (1) basic individual needs with three categories of physiological, psycho-emotional, and spiritual needs; and (2) managerial needs with seven categories of political-legal, socio-economic, and cultural-spiritual infrastructures, academic strategies, an age-friendly environment; technological services, and provision of specialized services and daycare for older adults, and (3) educational needs with three categories of training self-care and self-efficacy, empowering the health care workers; and empowering the family. Conclusion The results revealed personal, managerial, and educational needs for active aging and could assist policymakers and geriatric experts to promote and meet active aging needs successfully.
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Affiliation(s)
- Shahla Ayoubi-Mahani
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ziba Farajzadegan
- Medicine Faculty, Medical Sciences of Isfahan University, Isfahan, Iran
| | - Mahrokh Keshvari
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Refahi H, Klein M, Feigerlova E. e-Health Literacy Skills in People with Chronic Diseases and What Do the Measurements Tell Us: A Scoping Review. Telemed J E Health 2023; 29:198-208. [PMID: 35671526 DOI: 10.1089/tmj.2022.0115] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Use of electronic health (e-Health) technologies has increased in the past decade and inadequate e-Health literacy may lead to health-related social inequality. This is especially true for patients living with chronic diseases who are often involved in self-care. However, the measurement of e-Health literacy represents several challenges. Among available instruments, the e-Health Literacy Scale (eHEALS) is the only instrument with available psychometric properties. Aim: To identify studies measuring e-Health literacy in adults living with chronic disease and its relationship to health-related behaviors and other perceptions such as quality of life, self-efficacy, or specific disease biomarkers, and studies analyzing the impact of educational intervention on e-Health literacy. Methods: The authors searched MEDLINE, the Cochrane Library, and Web of Science databases to identify studies published in English language until April 2022. Results: Seventeen studies involving 4,877 participants were included. A majority of the studies were cross-sectional with a lack of appropriate controls. Five of the included studies were experimental, involving 758 participants. All of them reported positive effects of educational interventions on the improvements in self-reported e-Health literacy skills. However, most studies were at risk of bias. Conclusion: Despite these limitations, the findings of this review indicate the positive relationship between e-Health literacy and various health care processes in adults with chronic diseases and highlights a need for prospective controlled studies. Promoting e-Health literacy might give better opportunities for the active involvement of people with chronic diseases in self-care and for the implementation of online interventions into existing system of care.
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Affiliation(s)
- Hélène Refahi
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France
| | - Marc Klein
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France
| | - Eva Feigerlova
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France.,INSERM UMR_S 1116-DCAC, Université de Lorraine, Nancy, France.,Centre Universitaire d'Enseignement par SIMulation (CUESim), Hôpital Virtuel de Lorraine (HVL), Medical Faculty, Université de Lorraine, Nancy, France
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Cao C, Cao W, Zheng X, Ji K, Wu Y, Hu Z, Chen R, Bai Z. Association of social capital with self-perceived eHealth literacy among community-dwelling older people: Age and gender differences. Front Public Health 2023; 11:1088863. [PMID: 37124820 PMCID: PMC10140563 DOI: 10.3389/fpubh.2023.1088863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/07/2023] [Indexed: 05/02/2023] Open
Abstract
Background Studies have confirmed that social factors, including social capital and eHealth literacy, are important in later life. Currently, few studies are available for determining the relationship between social capital and eHealth literacy, and whether such a relationship exists among older people and there are age and gender differences in the relationship remain unclear. Consequently, this study aimed to investigate the association between social capital and eHealth literacy, specifically examing its variations in age and gender. Methods A cross-sectional study of 4,257 residents aged ≥ 60 years and dwelling in the community was conducted across four cities in China. A structured questionnaire was used to collect data on general characteristics, socioeconomic status, social capital, and eHealth literacy. Generalized linear models were employed to assess these associations. Results There were 4,218 respondents (age 71.9 ± 7.2 years; 64.8% women). Overall, social participation, social connection, trust, cohesion, and reciprocity were all statistically associated with eHealth literacy (p < 0.05), while such an association was not observed for social support (p > 0.05). Specifically, a higher level of social participation was associated with better eHealth literacy scores among participants aged 70-79 years (p < 0.001), and a higher level of social connection was associated with better eHealth literacy scores for those aged 60-69 and 70-79 years (p < 0.001). Meanwhile, no gender differences in the associations were found. Conclusion There is an association between social capital and eHealth literacy in older men and women. The association varis with age. The findings provide a reference for developing targeted measures to improve self-perceived eHealth literacy among older people. It is essential for achieving active and healthy aging and developing the knowledge and understanding of relevant theories, concepts, and evidence within the field of health and social capital.
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Affiliation(s)
- Chenglin Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Wenwen Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Xin Zheng
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Kai Ji
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Yunwei Wu
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Zhi Hu
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
- *Correspondence: Zhi Hu,
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- Ruoling Chen,
| | - Zhongliang Bai
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- Zhongliang Bai,
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Wang X, Luan W. Research progress on digital health literacy of older adults: A scoping review. Front Public Health 2022; 10:906089. [PMID: 35991040 PMCID: PMC9389004 DOI: 10.3389/fpubh.2022.906089] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
With the rapid development of digital health today, the lack of digital health literacy in older adults is an urgent problem. It is crucial that older adults adapt to the digital reform in medical treatment, pension, health management, and other fields. Therefore, we reviewed the current development status of digital health literacy among older adults. A total of 47 articles were included in this scoping review. Our findings revealed that research on digital health literacy in older adults is still in its infancy. Further development is warranted especially in terms of assessment tools and intervention methods.
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Affiliation(s)
- Xinxin Wang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Wei Luan
- Department of VIP Service, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Wei Luan
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Association of eHealth Literacy with Health Promotion Behaviors of Community-Dwelling Older People: The Chain Mediating Role of Self-Efficacy and Self-Care Ability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106092. [PMID: 35627627 PMCID: PMC9140768 DOI: 10.3390/ijerph19106092] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 02/03/2023]
Abstract
In the digital age, electronic health literacy (eHealth literacy) of community-dwelling older people plays a potentially important role in their health behaviors which are critical for health outcomes. Researchers have documented that self-efficacy and self-care ability are related to this relationship. This study aimed to assess the relationship between eHealth literacy and health promotion behaviors among older people living in communities and explore the chain mediating role of self-efficacy and self-care ability. For this cross-sectional study, we used data from 425 older adults at 3 communities in Qingdao, Shandong Province in Northeastern China, from June to September 2021. Path analysis using the structural equation model was performed. We found that eHealth literacy was significantly associated with health promotion behaviors in older people. Additionally, eHealth literacy indirectly affected health promotion behaviors through self-efficacy and self-care ability, respectively. In addition, the chain mediation effect was identified in the relationship of eHealth literacy and health promotion behaviors: eHealth literacy→ self-efficacy→ self-care ability→ health promotion behaviors. These findings offer promising directions for developing interventions to modify older adults' health behaviors through enhancing their eHealth literacy. These interventions should integrate components that target improving the self-efficacy and self-care ability of older people.
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