Association Between Health Literacy, Electronic Health Literacy, Disease-Specific Knowledge, and Health-Related Quality of Life Among Adults With Chronic Obstructive Pulmonary Disease: Cross-Sectional Study

Abstract

Background Despite the relatively high prevalence of low health literacy among individuals living with chronic obstructive pulmonary disease (COPD), limited empirical attention has been paid to the cognitive and health literacy–related skills that can uniquely influence patients’ health-related quality of life (HRQoL) outcomes. Objective The aim of this study was to examine how health literacy, electronic health (eHealth) literacy, and COPD knowledge are associated with both generic and lung-specific HRQoL in people living with COPD. Methods Adults from the COPD Foundation’s National Research Registry (n=174) completed a cross-sectional Web-based survey that assessed sociodemographic characteristics, comorbidity status, COPD knowledge, health literacy, eHealth literacy, and generic/lung-specific HRQoL. Hierarchical linear regression models were tested to examine the roles of health literacy and eHealth literacy on generic (model 1) and lung-specific (model 2) HRQoL, after accounting for socioeconomic and comorbidity covariates. Spearman rank correlations examined associations between ordinal HRQoL items and statistically significant hierarchical predictor variables. Results After adjusting for confounding factors, health literacy, eHealth literacy, and COPD knowledge accounted for an additional 9% of variance in generic HRQoL (total adjusted R 2 =21%; F 9,164 =6.09, P <.001). Health literacy ( b =.08, SE 0.02, 95% CI 0.04-0.12) was the only predictor positively associated with generic HRQoL ( P <.001). Adding health literacy, eHealth literacy, and COPD knowledge as predictors explained an additional 7.40% of variance in lung-specific HRQoL (total adjusted R 2 =26.4%; F 8,161 =8.59, P <.001). Following adjustment for covariates, both health literacy ( b =2.63, SE 0.84, 95% CI 0.96-4.29, P <.001) and eHealth literacy ( b =1.41, SE 0.67, 95% CI 0.09-2.73, P <.001) were positively associated with lung-specific HRQoL. Health literacy was positively associated with most lung-specific HRQoL indicators (ie, cough frequency, chest tightness, activity limitation at home, confidence leaving home, sleep quality, and energy level), whereas eHealth literacy was positively associated with 5 of 8 (60%) lung-specific HRQoL indicators. Upon controlling for confounders, COPD knowledge ( b =−.56, SE 0.29, 95% CI −1.22 to −0.004, P <.05) was inversely associated with lung-specific HRQoL. Conclusions Health literacy, but not eHealth literacy, was positively associated with g...

Social Media Use, eHealth Literacy, Disease Knowledge, and Preventive Behaviors in the COVID-19 Pandemic: Cross-Sectional Study on Chinese Netizens

“…It has been defined as “the ability to seek, find, understand, and appraise health information from electronic sources and to apply the knowledge gained to addressing or solving health problems [ 35 ].” eHealth literacy is becoming increasingly important as individuals continue to seek medical advice from various web-based sources, especially social media. Empirical studies have also found that eHealth literacy positively influences health outcomes, such as health-promoting behaviors among people with diabetes [ 36 ] and people’s health-related quality of life [ 37 ]. College students with higher eHealth literacy were found to be less likely to consume unhealthy food [ 38 ].…”

Relationships Between Mobile eHealth Literacy, Diabetes Self-care, and Glycemic Outcomes in Taiwanese Patients With Type 2 Diabetes: Cross-sectional Study

“…A mediation analysis by Schulz et al [ 25 ] found that eHealth literacy is weakly associated with health system utilization, though the premise of health literacy resembles eHealth literacy. Additionally, low eHealth literacy is associated with poor quality-of-life outcomes in patients with chronic lung disease [ 34 ]. Another research group found that mHealth apps users with heart disease or diabetes have a higher level of eHL [ 35 ].…”

“…To sum up, health literacy has not yet been shown to accurately serve the needs of patients with diabetes who rely heavily upon the internet and mobile technology. An eHL measure [ 22 , 34 ] merely reflects internet use without specifically covering mobile apps. Also, the eHL measure has been questioned because it only reflects individuals' perceived performance of online tasks without necessary objective reports [ 31 , 36 ].…”

Relationships among hope, meaning in life, and post‐traumatic growth in patients with chronic obstructive pulmonary disease: A cross‐sectional study

“…Patients with COPD suffer from physiological problems due to the decline in lung function, such as breathlessness, expectoration, and coughing (Global Initiative for Chronic Obstructive Lung Disease, 2020). Exacerbation in COPD leads to economic burden, frequent hospitalization, and complications (Lisspers et al., 2018; Overington et al., 2014; Stellefson, et al., 2019). Moreover, diagnosis and treatment of COPD have widely negative effects on the patients’ mental health, including depression and anxiety (Economou et al., 2018).…”