A reliability and validity study of the electronic health literacy scale among stroke patients in China

ABSTRACT

Background

Patients with stroke usually use smartphones to obtain online information to maintain their health. But their ability to identify, evaluate and apply this information is still unknown.

Aim

This study was designed to examine the reliability and validity of the electronic Health Literacy Scale among patients with stroke in China.

Design

This is a cross-sectional survey.

Methods

A demographic questionnaire, the electronic Health Literacy Scale (e-HLS) and the eHealth Literacy Scale (eHEALS) were administered to a sample of 648 patients with ischemic stroke recruited from December 2020 to March 2021 in a tertiary hospital.

Results

The Cronbach’α coefficient on the e-HLS-CHI was 0.907. Kappa consistency coefficient of test-retest reliability was 0.691 (p < .05). Three factors were extracted by Exploratory Factor Analysis (EFA), accounting for 90.84% of the total variance. Confirmatory Factory Analysis (CFA) revealed that three factors of e-HLS-CHI fit well (NFI = 0.979, RFI = 0.955, IFI = 0.987, TLI = 0.972, CFI = 0.987, RMSEA = 0.070, CMIN/DF = 2.586). Good simultaneous validity was suggested by the positive correlation of 0.94 (p < .001) between the e-HLS-CHI and eHEALS. When using eHEALS as the standard, the area under the ROC curve of e-HLS-CHI was 0.896 (95% CI: 0.831–0.960, p < .001). The sensitivity and specificity were 97.8% and 70.4% respectively.

Conclusions

The e-HLS can be used to evaluate electronic health literacy of patients with stroke in China after translation and cultural adaption.

KEYWORDS:

• Stroke
• instrument
• internet
• health literacy
• cross-sectional survey

Acknowledgments

We are grateful for all the participants, especially Profession Seckin.

Author contributions

Yu He completed this research and manuscript. Lina Guo helped Yu He design this study. Yanjin Liu provided Yu He suggestions about sampling and revising. Jaclene A. Zauszniewski corrected errors and grammar for this manuscript. Miao Wei, Gege Zhang, and Xiaoyu Lei helped Yu He collect the data.

Availability of data and material

Data supporting the research results can be obtained from Figshare without any administrative permissions 10.6084/m9.figshare.14298845. If anyone wants to obtain other relevant data, please contact the first author YH [email protected].

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study is funded by Medical Science and Technology Project of Henan Province [Grant No. SBGJ2018003] and Chinese Nursing Association [Grant No. ZHKY202025].