Negative Impact of Fear of COVID-19 on Health-Related Quality of Life Was Modified by Health Literacy, eHealth Literacy, and Digital Healthy Diet Literacy: A Multi-Hospital Survey

Abstract

Background: The COVID-19 pandemic has been disseminating fear in the community, which has affected people’s quality of life, especially those with health problems. Health literacy (HL), eHealth literacy (eHEAL), and digital healthy diet literacy (DDL) may have potential impacts on containing the pandemic and its consequences. This study aimed to examine the association between the fear of COVID-19 scale (FCoV-19S) and the health-related quality of life (HRQoL), and to examine the effect modification by HL, eHEAL, and DDL on this association. Methods: A cross-sectional study was conducted in 11 hospitals across Vietnam from 7 April to 31 May 2020. Data were collected on 4348 outpatients, including demographic characteristics, HL, eHEAL, DDL, FCoV-19S, and HRQoL. Multiple linear regression and interaction models were used to explore associations. Results: Patients with higher FCoV-19S scores had lower HRQoL scores (unstandardized coefficient, B = −0.78, p < 0.001). HL (B = 0.20, p < 0.001), eHEAL (B = 0.24, p < 0.001), and DDL (B = 0.20, p < 0.001) were positively associated with higher HRQoL scores. The negative impact of FCoV-19S on HRQoL was significantly attenuated by higher eHEAL score groups (from one standard deviation (SD) below the mean, B = −0.93, p < 0.001; to the mean, B = −0.85, p < 0.001; and one SD above the mean, B = −0.77, p < 0.001); and by higher DDL score groups (from one SD below the mean, B = −0.92, p < 0.001; to the mean, B = −0.82, p < 0.001; and one SD above the mean, B = −0.72, p < 0.001). Conclusions: eHealth literacy and digital healthy diet literacy could help to protect patients’ health-related quality of life from the negative impact of the fear of COVID-19 during the pandemic.

Impacts of Digital Healthy Diet Literacy and Healthy Eating Behavior on Fear of COVID-19, Changes in Mental Health, and Health-Related Quality of Life among Front-Line Health Care Workers

“…Health literacy (HL) and digital healthy diet literacy (DDL) were assessed using a 12-item short-form health literacy questionnaire (HLS-SF12) [ 27 , 28 ], and four-item digital healthy diet literacy (DDL-4) [ 19 ]. These tools were validated and used in the Vietnamese context [ 19 , 21 ]. HCWs responded to each item on a four-point Likert scale from 1 (very difficult) to 4 (very easy).…”

“…HCWs’ eHealth literacy was assessed using the eHealth literacy scale (eHEALS) with eight items [ 30 ] which was validated and used in Vietnam [ 21 , 22 ]. HCWs reported their experiences on a five-point Likert scale from 1 (strongly disagree) to 5 (strongly agree).…”

“…The fear was assessed using the seven-item fear of COVID-19 scale (FCoV-19S) [ 33 ] which was used in Vietnam [ 21 , 34 ]. HCWs responded to each item on a five-point Likert scale from 1 (strongly disagree) to 5 (strongly agree).…”

“…Digital healthy diet literacy (DDL) was linked with healthier eating behavior [ 19 ] which further modified the negative effect of COVID-19 on mental health [ 20 ]. In addition, health literacy, eHealth literacy (eHEALS), and DDL significantly modified the negative impact of COVID-19 on HRQOL [ 21 ].…”

Routine stair climbing for vascular health

“…Many environmental factors affect adherence. For example, the COVID-19 pandemic lockdown had a large negative impact on maintaining a healthy lifestyle [ 14 ]. Physical and mental stresses in daily life and/or job strain may disturb the maintenance of a good level of physical activity.…”