BackgroundThe Internet, with its capacity to provide information that transcends time and space barriers, continues to transform how people find and apply information to their own lives. With the current explosion in electronic sources of health information, including thousands of websites and hundreds of mobile phone health apps, electronic health literacy is gaining an increasing prominence in health and medical research. An important dimension of electronic health literacy is the ability to appraise the quality of information that will facilitate everyday health care decisions. Health information seekers explore their care options by gathering information from health websites, blogs, Web-based forums, social networking websites, and advertisements, despite the fact that information quality on the Internet varies greatly. Nonetheless, research has lagged behind in establishing multidimensional instruments, in part due to the evolving construct of health literacy itself.ObjectiveThe purpose of this study was to examine psychometric properties of a new electronic health literacy (ehealth literacy) measure in a national sample of Internet users with specific attention to older users. Our paper is motivated by the fact that ehealth literacy is an underinvestigated area of inquiry.MethodsOur sample was drawn from a panel of more than 55,000 participants maintained by Knowledge Networks, the largest national probability-based research panel for Web-based surveys. We examined the factor structure of a 19-item electronic Health Literacy Scale (e-HLS) through exploratory factor analysis (EFA) and confirmatory factor analysis, internal consistency reliability, and construct validity on sample of adults (n=710) and a subsample of older adults (n=194). The AMOS graphics program 21.0 was used to construct a measurement model, linking latent factors obtained from EFA with 19 indicators to determine whether this factor structure achieved a good fit with our entire sample and the subsample (age ≥ 60 years). Linear regression analyses were performed in separate models to examine: (1) the construct validity of the e-HLS and (2) its association with respondents’ demographic characteristics and health variables.ResultsThe EFA produced a 3-factor solution: communication (2 items), trust (4 items), and action (13 items). The 3-factor structure of the e-HLS was found to be invariant for the subsample. Fit indices obtained were as follows: full sample: χ2 (710)=698.547, df=131, P<.001, comparative fit index (CFI)=0.94, normed fit index (NFI)=0.92, root mean squared error of approximation (RMSEA)=0.08; and for the older subsample (age ≥ 60 years): χ2 (194)=275.744, df=131, P<.001, CFI=0.95, NFI=0.90, RMSEA=0.08.ConclusionsThe analyses supported the e-HLS validity and internal reliability for the full sample and subsample. The overwhelming majority of our respondents reported a great deal of confidence in their ability to appraise the quality of information obtained from the Internet, yet less than half reported performing quality check...

While the data do not allow for the testing of causal relationships, the data do suggest that providing adequate staffing, perceived fair pay, sufficient work resources (e.g., towels, gowns), management support and adequate training may result in less direct-care worker burnout on the job.

How do women who seek psychosocial support on the Internet by participating in cancer peer support groups respond to the process of coping with cancer? The current study examines whether older women with cancer have different perceptions about and are influenced to a different extent by online peer support than younger women. The study also explores age-based variations in outlook on coping with cancer as a result of using online support. Separate multivariate regression models estimated the effects of covariates on (1) positive coping affect (PCA) (2) positive coping affect-hopeful (PCA-H), and (3) positive coping affect-proud (PCA-P). A stratified analysis examined variations within age-based subsamples (≥51 and ≤50). Positive coping affect includes feeling proud about coping with cancer from a position of strength and empowerment rather than being a victim and being hopeful for a healthier future postdiagnosis. Online support was found to increase PCA significantly. This finding is consistent across age groups but was more pronounced for older patients. The only exception is that younger women perceive more benefit from using online support in terms of feeling proud. As severity of the symptoms increased, though the younger women increased the amount of time they were online, the older women increased the number of groups they participated in. The study concludes that the Internet might be particularly helpful for older adults who feel helpless to cope with cancer in old age. Online peer support services may help improve the patients' outlook on fighting with cancer and help them to feel more in control of their health.

The ability of this composite measure to provide information about the extent to which computer-connected patients view digital peer support as an empowerment tool makes it a valuable addition to the literature in health informatics, supportive cancer care, and health quality of life research.

No abstract

No abstract

ObjectivesWe explored the influence of e-trust, e-health literacy, e-health information seeking, and e-health information consumerism on medical satisfaction and positive health perceptions.MethodsOur sample consisted of 499 randomly selected panel members aged 40–93. We employed hierarchical ordinary least squares (OLS) regression analyses and structural equation modeling (SEM). We examined the moderating role of age on the relationship between medical satisfaction and positive health perceptions.ResultsA significant interaction was found between age and medical satisfaction in predicting positive health perceptions in the OLS regression models. Medical satisfaction has a stronger association with self-care, health-related quality of life, and health status in the older adult sample as compared with the middle-aged sample. SEM analyses revealed that e-health information seeking has an indirect effect on both medical satisfaction and positive health perceptions through its significant direct effect on e-health information consumerism. Both e-trust and e-health consumerism were significant predictors. The e-health literacy and e-trust measures were significant predictors of the positive health perception index in the OLS regression models.DiscussionThe results contribute to our understanding of the potential benefits information technologies have for the health and well-being of computer-connected aging adults.

No abstract