Psychometric evaluation of the danish version of the electronic health literacy scale (eHEALS) in patients treated with percutaneous coronary intervention (PCI): A cross-sectional validation study

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction As many use the internet as a major source of health information, eHealth literacy has emerged as a potential concept for digital health care consumption. Therefore, healthcare professionals need to consider the eHealth literacy of patients when delivering health information to cardiac patients. Purpose The aim of this study was to translate and evaluate the psychometric properties of the Danish version of the Electronic Health Literacy Scale (eHEALS) in a population of Danish PCI treated patients. Methods The eHEALS was translated into Danish from the original English version, including forward translation, synthesis, backward translation and expert group consensus. The questionnaire was applied to a group of Danish PCI treated patients to be answered during hospital stay. Psychometric properties were assessed including internal consistency by Cronbach α, and confirmatory factor analysis (CFA) with a priori specified 1-, 2- and 3-factor models were performed to explore construct validity. Socio-demographic and patient-reported outcomes including health literacy, health-related internet use, and health status were collected to examine correlations with eHEALS scores. Results A total of 1473 PCI treated patients were included in the analysis. The mean age was 66 years (SD 10.70) and more patients were males (n=1130, 78%). The mean value for the eHEALS score was 28.87 (SD 6.34), and the Cronbach α 0.94. The CFA indicated a good fit for three out of four of the goodness-of -fit indices. A mean difference on the eHEALS score between patients with the highest and lowest educational level was found to be 4.64 (95%CI, 2.43-6.85), p<0.0001. Strong correlations were observed between eHEALS scores and "ability to find good information"(r=0.636), "Understanding health information well enough to know what to do" (r=0.505), ‘patients’ perceived usefulness’ (r= 0.650) and ‘importance of using the internet’ (r=0.621). Moderate correlations were observed to ‘having used the internet to find information about health’ (r=0.464), and "Appraisal of health information" (r=0.462), and weak correlations to self-rated physical health (r=0.119), self-rated mental health (r=0.110), and social support (r=0.207). Conclusion The psychometric evaluation indicates that the Danish version of the eHEALS questionnaire is a valid instrument to measure eHealth literacy in patients treated with PCI, suggesting a multidimensional construct.