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The eHealth literacy and its sociodemographic determinants among adult inpatients in Web 3.0 context: a cross-sectional study.

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Title: The eHealth literacy and its sociodemographic determinants among adult inpatients in Web 3.0 context: a cross-sectional study.
Authors: Feng X; School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.; Xiangya School of Nursing, Central South University, Changsha, Hunan, China., Jiang J; Xiangya School of Nursing, Central South University, Changsha, Hunan, China., Liu M; Xiangya School of Nursing, Central South University, Changsha, Hunan, China., Tian L; Department of Health Management Center, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China. tianlingyun@ustc.edu.cn.; Department of Nursing, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China. tianlingyun@ustc.edu.cn., Li Y; Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China. yuyan0202@sina.com.; National Clinical Research Center for Geriatric Diseases, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China. yuyan0202@sina.com.
Source: BMC public health [BMC Public Health] 2026 Jun 04; Vol. 26 (1). Date of Electronic Publication: 2026 Jun 04.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BioMed Central, [2001-
MeSH Terms: Health Literacy*/statistics & numerical data , Inpatients*/statistics & numerical data , Inpatients*/psychology , Telemedicine*, Computer Literacy/statistics & numerical data ; Humans ; Cross-Sectional Studies ; Female ; Male ; Adult ; Middle Aged ; China ; Digital Health ; Aged ; Sociodemographic Factors ; Young Adult ; Adolescent ; Internet ; Socioeconomic Factors
Abstract: Background: The rise of Web 3.0 in healthcare has made eHealth literacy essential. Patients experiencing prolonged hospital stays encounter unique challenges with digital tools. However, a critical gap remains in understanding their eHealth literacy due to the absence of assessment instruments tailored to contemporary healthcare systems.
Objective: This study aimed to evaluate eHealth literacy and identify its sociodemographic determinants among adult inpatients.
Methods: A cross-sectional study was conducted among 532 adult inpatients in Hunan, China, using randomized cluster sampling. Data were collected with the Adult Inpatient eHealth Literacy Scale, an instrument developed to assess multiple literacy domains relevant to digital healthcare use in the Web 3.0 context. Multiple linear stepwise regression was performed to identify factors associated with eHealth literacy.
Results: The mean score of eHealth literacy was 141.12 ± 35.03, with a scoring rate of 64.15%. The scoring rates for traditional literacy, information literacy, media literacy, health literacy, computer literacy, and scientific literacy were 68.37%, 63.82%, 60.86%, 67.13%, 61.65%, 65.25%, respectively. Lower eHealth literacy was associated with older age, lower educational level, fewer years of electronic device use, limited experience with eHealth tools, lower perceived usefulness, higher perceived ease of use, and lower willingness to learn (P < 0.05). The final regression model explained 62.20% of the total variability.
Conclusions: Adult inpatients demonstrated an overall moderate level of eHealth literacy, with notable deficiencies in media, computer, and information literacy. Tailoring eHealth tools to individuals from diverse backgrounds is essential to mitigate health disparities. Healthcare professionals are well positioned to serve as critical facilitators in supporting inpatients' engagement with emerging digital technologies. Patient-centered training programs aimed at strengthening foundational digital and information-processing skills are warranted to promote the safe, effective, and equitable use of eHealth services and improve health outcomes.
(© 2026. The Author(s).)
Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was obtained from the Institutional Review Board of School of Nursing, Central South University, Hunan, China (No. E202373). The study adhered to the Declaration of Helsinki. We ensured the data confidentiality, and informed consent was obtained from all participants enrolled in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
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Children (Basel). 2023 Apr 08;10(4):. (PMID: 37189947)
JAMA Otolaryngol Head Neck Surg. 2024 Jun 1;150(6):457-458. (PMID: 38635259)
J Gerontol A Biol Sci Med Sci. 2014 Sep;69(9):1117-21. (PMID: 25116923)
J Med Internet Res. 2016 Jul 11;18(7):e161. (PMID: 27400726)
Front Public Health. 2023 Oct 23;11:1259158. (PMID: 37937072)
J Med Internet Res. 2025 Oct 14;27:e75657. (PMID: 41086421)
Support Care Cancer. 2022 Jan;30(1):117-126. (PMID: 34236506)
Front Surg. 2022 Mar 14;9:862322. (PMID: 35360424)
Telemed J E Health. 2024 Apr;30(4):e1138-e1147. (PMID: 37851981)
Interact J Med Res. 2017 Dec 12;6(2):e24. (PMID: 29233802)
J Med Internet Res. 2021 Sep 13;23(9):e14908. (PMID: 34515638)
Front Public Health. 2022 Nov 07;10:1036366. (PMID: 36420014)
J Geriatr Oncol. 2020 Jul;11(6):1020-1022. (PMID: 31917114)
Z Gesundh Wiss. 2021 Oct 09;:1-10. (PMID: 34660175)
J Med Libr Assoc. 2017 Jan;105(1):61-68. (PMID: 28096748)
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J Med Internet Res. 2015 Mar 17;17(3):e70. (PMID: 25783036)
BMC Nurs. 2023 Oct 16;22(1):383. (PMID: 37845648)
J Med Internet Res. 2006 Jun 16;8(2):e9. (PMID: 16867972)
J Med Internet Res. 2018 Feb 12;20(2):e36. (PMID: 29434011)
BMC Public Health. 2022 Jun 1;22(1):1088. (PMID: 35642028)
J Clin Hypertens (Greenwich). 2020 Feb;22(2):135-141. (PMID: 31955505)
J Med Internet Res. 2012 Jan 27;14(1):e19. (PMID: 22357448)
J Med Internet Res. 2021 May 6;23(5):e25600. (PMID: 33822734)
J Neurointerv Surg. 2023 Dec 19;16(1):4-7. (PMID: 37438101)
J Appl Gerontol. 2020 Feb;39(2):141-150. (PMID: 30353776)
Psychol Aging. 2013 Sep;28(3):614-24. (PMID: 23957225)
J Med Internet Res. 2017 Jan 19;19(1):e9. (PMID: 28104579)
Nurse Educ Today. 2023 Oct;129:105917. (PMID: 37506622)
Transl Behav Med. 2021 Jul 29;11(7):1330-1338. (PMID: 34160612)
JMIR Cardio. 2023 Jul 21;7:e43940. (PMID: 37477976)
J Cardiovasc Nurs. 2021 Jul-Aug 01;36(4):E11-E19. (PMID: 33833189)
J Cancer Surviv. 2020 Apr;14(2):244-252. (PMID: 31820215)
J Appl Gerontol. 2022 Jul;41(7):1675-1685. (PMID: 35466732)
J Neuroeng Rehabil. 2022 Aug 24;19(1):93. (PMID: 36002898)
Nat Med. 2024 Feb;30(2):595-602. (PMID: 38317020)
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J Med Internet Res. 2006 Nov 14;8(4):e27. (PMID: 17213046)
Nurse Educ Pract. 2021 Jan;50:102934. (PMID: 33278702)
J Med Internet Res. 2021 Mar 29;23(3):e25042. (PMID: 33626015)
Grant Information: 72304261 National Natural Science Foundation of China; 2025M782290 China Postdoctoral Science Foundation
Contributed Indexing: Keywords: Cross-sectional study; Healthcare innovation; Inpatients; Web 3.0; eHealth literacy
Entry Date(s): Date Created: 20260604 Date Completed: 20260809 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC13455462
DOI: 10.1186/s12889-026-27903-2
PMID: 42243755
Database: MEDLINE
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  Data: The eHealth literacy and its sociodemographic determinants among adult inpatients in Web 3.0 context: a cross-sectional study.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Feng+X%22&quot;&gt;Feng X&lt;/searchLink&gt;; School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.; Xiangya School of Nursing, Central South University, Changsha, Hunan, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Jiang+J%22&quot;&gt;Jiang J&lt;/searchLink&gt;; Xiangya School of Nursing, Central South University, Changsha, Hunan, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Liu+M%22&quot;&gt;Liu M&lt;/searchLink&gt;; Xiangya School of Nursing, Central South University, Changsha, Hunan, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Tian+L%22&quot;&gt;Tian L&lt;/searchLink&gt;; Department of Health Management Center, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China. tianlingyun@ustc.edu.cn.; Department of Nursing, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China. tianlingyun@ustc.edu.cn.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Li+Y%22&quot;&gt;Li Y&lt;/searchLink&gt;; Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China. yuyan0202@sina.com.; National Clinical Research Center for Geriatric Diseases, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China. yuyan0202@sina.com.
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– Name: Abstract
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  Data: Background: The rise of Web 3.0 in healthcare has made eHealth literacy essential. Patients experiencing prolonged hospital stays encounter unique challenges with digital tools. However, a critical gap remains in understanding their eHealth literacy due to the absence of assessment instruments tailored to contemporary healthcare systems.&lt;br /&gt;Objective: This study aimed to evaluate eHealth literacy and identify its sociodemographic determinants among adult inpatients.&lt;br /&gt;Methods: A cross-sectional study was conducted among 532 adult inpatients in Hunan, China, using randomized cluster sampling. Data were collected with the Adult Inpatient eHealth Literacy Scale, an instrument developed to assess multiple literacy domains relevant to digital healthcare use in the Web 3.0 context. Multiple linear stepwise regression was performed to identify factors associated with eHealth literacy.&lt;br /&gt;Results: The mean score of eHealth literacy was 141.12 &#177; 35.03, with a scoring rate of 64.15%. The scoring rates for traditional literacy, information literacy, media literacy, health literacy, computer literacy, and scientific literacy were 68.37%, 63.82%, 60.86%, 67.13%, 61.65%, 65.25%, respectively. Lower eHealth literacy was associated with older age, lower educational level, fewer years of electronic device use, limited experience with eHealth tools, lower perceived usefulness, higher perceived ease of use, and lower willingness to learn (P &amp;lt; 0.05). The final regression model explained 62.20% of the total variability.&lt;br /&gt;Conclusions: Adult inpatients demonstrated an overall moderate level of eHealth literacy, with notable deficiencies in media, computer, and information literacy. Tailoring eHealth tools to individuals from diverse backgrounds is essential to mitigate health disparities. Healthcare professionals are well positioned to serve as critical facilitators in supporting inpatients&#39; engagement with emerging digital technologies. Patient-centered training programs aimed at strengthening foundational digital and information-processing skills are warranted to promote the safe, effective, and equitable use of eHealth services and improve health outcomes.&lt;br /&gt; (&#169; 2026. The Author(s).)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Declarations. Ethics approval and consent to participate: Ethical approval was obtained from the Institutional Review Board of School of Nursing, Central South University, Hunan, China (No. E202373). The study adhered to the Declaration of Helsinki. We ensured the data confidentiality, and informed consent was obtained from all participants enrolled in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
– Name: Ref
  Label: References
  Group: RefInfo
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– Name: GrantInfo
  Label: Grant Information
  Group: Grant
  Data: 72304261 National Natural Science Foundation of China; 2025M782290 China Postdoctoral Science Foundation
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: &lt;i&gt;Keywords: &lt;/i&gt;Cross-sectional study; Healthcare innovation; Inpatients; Web 3.0; eHealth literacy
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260604 &lt;i&gt;Date Completed: &lt;/i&gt;20260809 &lt;i&gt;Latest Revision: &lt;/i&gt;20260813
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  Group: Date
  Data: 20260813
– Name: PubmedCentralID
  Label: PubMed Central ID
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  Data: PMC13455462
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1186/s12889-026-27903-2
– Name: AN
  Label: PMID
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  Data: 42243755
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42243755
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    Identifiers:
      – Type: doi
        Value: 10.1186/s12889-026-27903-2
    Languages:
      – Code: eng
        Text: English
    Subjects:
      – SubjectFull: Computer Literacy statistics & numerical data
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Cross-Sectional Studies
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Adult
        Type: general
      – SubjectFull: Middle Aged
        Type: general
      – SubjectFull: China
        Type: general
      – SubjectFull: Digital Health
        Type: general
      – SubjectFull: Aged
        Type: general
      – SubjectFull: Sociodemographic Factors
        Type: general
      – SubjectFull: Young Adult
        Type: general
      – SubjectFull: Adolescent
        Type: general
      – SubjectFull: Internet
        Type: general
      – SubjectFull: Socioeconomic Factors
        Type: general
      – SubjectFull: Health Literacy statistics & numerical data
        Type: general
      – SubjectFull: Inpatients statistics & numerical data
        Type: general
      – SubjectFull: Inpatients psychology
        Type: general
      – SubjectFull: Telemedicine
        Type: general
    Titles:
      – TitleFull: The eHealth literacy and its sociodemographic determinants among adult inpatients in Web 3.0 context: a cross-sectional study.
        Type: main
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      – PersonEntity:
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            NameFull: Feng X
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            NameFull: Jiang J
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            NameFull: Liu M
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            NameFull: Tian L
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            NameFull: Li Y
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          Dates:
            – D: 04
              M: 06
              Text: 2026 Jun 04
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1471-2458
          Numbering:
            – Type: volume
              Value: 26
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: BMC public health
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