中老年居民网络健康信息使用习惯与其电子健康素养的关系研究

Habits of Using Online Health Information and eHealth Literacy in Middle-aged and Elderly Residents YUAN

背景健康科普服务的供需双方对互联网的依赖度越来越高,电子健康素养应成为慢性病患者需要掌握的主要技能。目的分析中老年居民网络健康信息使用习惯和电子健康素养的现状及存在的问题,探讨中老年居民网络健康信息使用习惯与其电子健康素养水平的关系,为提高其电子健康素养水平和发展适合的互联网健康科普服务提供借鉴。方法于2021年6—9月,采用多阶段抽样法,选取1061例来自上海市社区的中老年人作为研究对象。采用一般资料调查表、中文版电子健康素养量表(eHEALS)对其进行问卷调查,了解其网络健康信息使用习惯和电子健康素养水平。使用多重线性逐步回归分析中老年居民网络健康信息使用习惯及其他潜在候选因素对其电子健康素养水平的影响。结果共回收有效问卷1019份,问卷有效回收率为96.04%。寻求网络健康信息的渠道方面,中老年居民主要通过关注健康类账号[411例(40.33%)]寻求网络健康信息,其次是搜索功能或引擎[336例(32.97%)],对健康管理类APP或小程序[254例(24.93%)]及在线健康社区[65例(6.38%)]的利用较少;使用的网络健康信息来源方面,中老年居民使用的网络健康信息较少来自医疗机构[397例(38.96%)]和医务人员个人[187例(18.35%)]。1019例中老年居民中文版eHEALS平均总得分为(27.62±8.57)分,电子健康素养的相对薄弱之处是对如何利用网络来解答自己的健康问题的知晓度较低[在中文版eHEALS条目2上的平均得分为(3.36±1.27)分]和评价网络卫生资源信息好坏的技能较弱[在中文版eHEALS条目6上的平均得分为(3.38±1.23)分]。多重线性回归分析结果显示,年龄、同时参加基本医疗保险和商业医疗保险情况、寻求网络健康信息的渠道是否≥2种、使用的网络健康信息来源是否≥2种、转发分享网络健康信息情况、是否参加集体线上学习和是否对网络健康信息持认可态度是中老年居民电子健康素养水平的影响因素。结论中老年居民电子健康素养处于中等水平,网络健康信息使用习惯等多种因素会影响中老年居民电子健康素养水平。应向中老年居民普及权威信息整合及检索平台,注重对网络健康信息平台的监管审核和适老化改造,并通过调动社区、家庭、健康社团和商业医疗保险机构等多方资源帮助中老年居民更好地利用网络健康信息,提高其电子健康素养水平。

Background Since the Internet dependence of the supply and demand sides of health popularization is increasing,eHealth literacy has become a primary skill that chronic disease patients need to master.Objective To analyze the current situation and existing problems of online health information usage habits and eHealth literacy in middle-aged and elderly residents,and discuss the relationship between online health information usage habits and eHealth literacy,providing a reference for improving the level of eHealth literacy and developing appropriate Internet-based health popularization services for these populations.Methods From June to September 2021,a questionnaire survey was conducted among 1061 middle-aged and elderly residents in Shanghai communities selected by multistage sampling using the General Information Questionnaire and the Chinese version of the eHealth Literacy Scale(eHEALS-C)to understand their habits of using online health information and levels of eHealth literacy.Stepwise multiple linear regression was used to assess the association of habit of using online health information and other potential candidate factors with the level of eHealth literacy.Results Altogether,1019 cases(96.04%)who effectively responded to the survey were included for analysis.Following health care accounts〔411 cases(40.33%)〕was a major channel used for seeking online health information,followed by the search functionality or engines〔336 cases(32.97%)〕,while the health apps or mini programs〔254 cases(24.93%)〕,and online health communities〔65 cases(6.38%)〕were less used.The online health information was less sourced from medical institutions〔397 cases(38.96%)〕and medical workers〔187 cases(18.35%)〕.The average total score of the eHEALS-C for the respondents was(27.62±8.57).The respondents scored lower in item 2〔(3.36±1.27)points〕and item 6〔(3.38±1.23)points〕of the eHEALS-C,indicating that they had low awareness of applying online health information to health problems,and low perceived skills at evaluating the online health information.Multiple linear regression analysis showed that age,participation in both basic and commercial medical insurance,using at least two channels for seeking online health information,having at least two sources of online health information,the habit of forwarding and sharing online health information,participation in collective online learning,and having an attitude of acceptance towards online health information were influencing factors of the level of eHealth literacy.Conclusion The eHealth literacy of these middle-aged and elderly residents is at a medium level,which is affected by online health information usage habits and other factors.To help them make better use of online health information and to improve their eHealth literacy,it is suggested to spread integrated authoritative information and retrieval platforms among these populations,give priority to supervision and elderly-oriented transformation of online health information platforms,and mobilize community,family,health associations,and commercial medical insurance institutions to co-deliver health-promotion services targeting these people.