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☐ ☆ ✇ Journal of Advanced Nursing

eHealth Literacy Mediating Social Support and Technology Acceptance Among Patients With Chronic Illnesses: A Cross‐Sectional Study

Por: Lian‐Shin Shiu · Yu‐Shan Huang · Chieh Yu Liu · Yu‐Shan Cheng · Yu‐Chi Chen — Septiembre 9th 2025 at 08:32

ABSTRACT

Aim

To examine the relationships among social support, eHealth literacy and eHealth technology acceptance among patients with chronic illnesses, and investigate whether eHealth literacy plays a mediating role.

Design

A cross-sectional correlational study.

Methods

A total of 202 patients with chronic illnesses were recruited from outpatient clinics and communities in Taiwan. Data were collected via structured questionnaires and analysed using SPSS and PROCESS macro with 1000 bootstrap samples.

Results

eHealth literacy was the strongest predictor of technology acceptance. Although social support was positively associated with eHealth literacy, it did not directly predict technology acceptance after controlling for eHealth literacy, indicating a full mediation effect.

Conclusions

eHealth literacy is a crucial mechanism through which social support influences health technologies acceptance. Interventions to improve eHealth literacy, particularly those integrated with social support strategies based on different cultural backgrounds, enhance digital engagement among chronic illnesses.

Implications for Profession and/or Patient Care

Healthcare professionals and policy-makers should design literacy-sensitive interventions that leverage social networks and involve significant others to promote meaningful eHealth engagement in disease management.

Impact

eHealth literacy fully mediates the relationship between social support and eHealth technology acceptance, proving that social support alone does not directly increase adoption without improving eHealth literacy. eHealth literacy is the strongest predictor of eHealth technology acceptance, emphasising its central role in bridging the gap between social support and eHealth engagement.

Reporting Method

This study followed the STROBE checklist guideline.

Patient or Public Contribution

No patient or public involvement.

☐ ☆ ✇ Journal of Clinical Nursing

What are the roles of eHealth literacy and empowerment in self‐management in an eHealth care context? A cross‐sectional study

Por: Lian‐Shin Shiu · Chieh‐Yu Liu · Cheng‐Jui Lin · Yu‐Chi Chen — Septiembre 5th 2023 at 13:51

Abstract

Aims

To examine the relationship among eHealth literacy, empowerment and self-management and the mediating effects of empowerment in diabetic kidney disease (DKD) patients in the eHealthcare context.

Background

Self-management is an essential aspect of healthcare in delaying disease progression for DKD. In the eHealthcare era, health services providing self-management are transforming. The ability and confidence of patients to use eHealth services is a critical issue that impacts the effectiveness of self-management, but little is known about the role of eHealth literacy and empowerment in self-management.

Design

A cross-sectional study guided by the STROBE.

Methods

Overall, 127 Taiwanese patients were enrolled using convenience sampling. Data collection used structured questionnaires and chart reviews. Multiple regression was used to infer self-management predictors, and SPSS PROCESS macro and bootstrapping verified the mediating effects.

Results

Empowerment and eHealth literacy both showed significant positive correlations with self-management. Empowerment was the main predictor of self-management and had a complete mediating effect between eHealth literacy and self-management.

Conclusion

Increasing patients' eHealth literacy can improve empowerment and prevent health inequality issues. Healthcare providers should consider improving patients' eHealth literacy to enhance their self-management.

Relevance to Clinical Practice

Healthcare service systems need to create user-friendly eHealthcare environments, and healthcare professionals can provide multifaceted instructions that fit patients' eHealth literacy levels to enhance their motivation and confidence in disease care, thus cultivating positive self-management behaviours.

Impact

The popularity of eHealthcare services aimed at promoting self-management behaviours is increasing. However, the level of eHealth literacy is an essential factor that affects the effectiveness of self-management in the healthcare environment. In addition, empowerment is a major critical influence factor of self-management and a completely mediating variable between self-management and eHealth literacy. Consequently, healthcare providers should consider promoting patients' eHealth literacy to empower people using eHealthcare services for implementing self-management.

Reporting Method

The Strengthening the Reporting of Observational Studies in cross-sectional studies (STROBE) checklist was used to ensure comprehensive reporting.

Patient or Public Contribution

Patients were diagnosed with DKD in the study hospital. Physicians and case managers transferred patients to research assistants who screened them for the inclusion criteria and invited them to participate in this study if they met the requirements. After participants signed informed consent, the research nurse encouraged participants to respond to the research questionnaire face to face.

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