Nurses' ehealth literacy and associations with the nursing practice environment

Abstract

Aim: To report on ehealth literacy levels in nurses and to explore its associations with the nursing practice environment.

Background: Nurses increasingly use the Internet and associated technologies to seek health-relevant information and manage their health.

Introduction: High ehealth literacy is a predictor of better health outcomes in diverse populations but its levels and work-related determinants have not been adequately explored in direct-care nurses.

Methods: The sample for this cross-sectional study consisted of 200 staff nurses and nursing assistants in Greece. Participants reported during February-March 2019 their sociodemographic and work-related characteristics on a self-administered questionnaire which included the "electronic Health Literacy Scale"-eHEALS, and the "Practice Environment Scale of the Nursing Work Index"-PES-NWI. Crude and adjusted logistic regressions were performed.

Findings: In adjusted models, participants that scored higher on the "Collegial nurse-physician relationships" and "Nurse participation in hospital affairs" dimensions of the clinical environment had higher odds of reporting better ehealth literacy. The lowest item score in eHEALS was related to not being able to make health decisions using Internet information.

Discussion: Nurses' ehealth literacy was positively associated with some dimensions of the hospital practice environment. Nurses reported higher ehealth literacy scores in comparison to other studies; however, they were not confident in distinguishing reliable health information from Internet sources. This is quite alarming because it can directly impair the ability of nurses to provide relevant and up-to-date evidence-based care.

Conclusion: This is the first study to report internationally on the positive associations of a good working environment with nurses' ehealth literacy levels.

Implications for nursing and nursing policy: Nursing policy should address the ehealth literary of nurses and integrate it into continuing professional education initiatives. Special focus should be put on nurses' ambiguity in distinguishing which ehealth information is reliable and can guide nursing practice. This should be combined with efforts to improve the nursing clinical environment and increase nurses' participation in hospital decisions.

Keywords: Greece; PES-NWI; Practice Environment Scale of the Nursing Work Index; eHEALS; ehealth literacy; electronic Health Literacy Scale; hospital.