The Relationship of E-health Literacy with Cyberchondria: A Cross-Sectional Study on Pregnant Women

Document Type : Original Article

Authors

1 PhD, Samsun Ayvacik State Hospital, Samsun, Turkey

2 Lecturer, Kütahya Health Sciences University, Gediz Vocational School

3 Prof, Alanya Alaaddin Keykubat University, Faculty of Medicine, Department of Public Health, Alanya / Antalya.

Abstract

Background and Objective: Health literacy and cyberchondria are effective for pregnant women to make the right health decisions for themselves and their babies. The purpose of this study is to investigate the correlation between e-health literacy, cyberchondria, and the factors influencing them in pregnant women.

Materials and Methods: The cross-sectional study was conducted on a population of pregnant women who were admitted to two public hospitals located in Samsun. A questionnaire form consisting of 3 sections was used as a data collection tool in the study.  Pregnancy information form, e-health literacy scale and cyberchondria scale. The study involved analysing 400 questionnaire forms. Data were analyzed by the frequency test, One Way ANOVA, correlation analysis and multiple regression.

Results: The study participants had a mean age of 28.53 ± 6.53. Among them, 60.3% were aged 19-29, 37.3% had an associate degree, 45.3% were pregnant for the first time, and 38.3% were in their second trimester. The mean pregnancy was 1.81 ± 10.63. In the study group, the mean e-health literacy was 3.27 ± 0.99, and the mean cyberchondria was 30.29 ± 9.78. The study found a statistically significant difference in e-health literacy and cyberchondria based on age, educational status, gestational week, and number of pregnancies. Additionally, there was a statistically significant positive relationship between health literacy and cyberchondria severity.

Conclusion: The results of the study showed that the level of e-health literacy and cyberchondria of pregnant women was moderate, and that e-health literacy, age and education level would affect cyberchondria. Therefore, this problem can be prevented by providing digital health practices, e-health literacy and safe internet use training to pregnant women in health institutions and the media.

Keywords

Acknowledgments: The authors would like to thank all the participants who were interviewed for this study.


Availability of data and materials: The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.


Conflict of interest: The authors have no relevant financial or non-financial competing interests to disclose.


Consent for publication: Not applicable.


Funding: The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.


Ethics Approval and Consent to Participate: Ethical approval for the study was obtained from Alanya Alaaddin Keykubat University Non-Interventional Clinical Research Ethics Committee with the date 11.07.2023 and number 08. Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.


Author contributions: YD, SÖ and ED designed the study, YD, SÖ and ED collected the data, YD and SÖ analysed the data and wrote the manuscript, all authors contributed to manuscript revisions.

References

1. Kickbusch I, Pelikan J, Apfel F, Tsouros A. Health Literacy: The Solid Facts. WHO Regional Office for Europe. 2013;7-8.
2. Council of Europe. Guide to health literacy contributing to trust building and equitable access to healthcare. 2023.
3. Nielsen-Bohlman L, Panzer AM, Kindig DA. Health literacy: a prescription to end confusion. In: Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Health literacy. Washington, D.C: National Academies Press; 2004. https://doi.org/10.17226/10883 PMid:25009856
4. Tugut N, Yesildag Celik B, Yılmaz A. Health literacy and its association with health perception in pregnant women. Journal of Health Literacy. 2021;2(6):9-20.
 5. Sağlık Bakanlığı. https://dosyamerkez.saglik.gov.tr/Eklenti/39699/0/soya-rapor-1pdf.pdf. 2018. Türkiye Sağlık Okuryazarlığı Düzeyi ve İlişkili Faktörleri Araştırması.
6. Javanmardi M, Noroozi M, Mostafavi F, Ashrafi-Rizi H. Internet usage among pregnant women for seeking health information: a review article. Iran J Nurs Midwifery Res. 2018;23(2):79-86.
 7. Baker B, Yang I. Social media as social support in pregnancy and the postpartum. Sexual & Reproductive Healthcare. 2018 Oct;17:31-4. https://doi.org/10.1016/j.srhc.2018.05.003 PMid:30193717
 8. Bjelke M, Martinsson AK, Lendahls L, Oscarsson M. Using the Internet as a source of information during pregnancy - A descriptive cross-sectional study in Sweden. Midwifery. 2016 Sep;40:187-91. https://doi.org/10.1016/j.midw.2016.06.020 PMid:27450590
 9. Ghiasi A. Health information needs, sources of information, and barriers to accessing health information among pregnant women: a systematic review of research. The Journal of Maternal-Fetal & Neonatal Medicine. 2021 Apr 18;34(8):1320-30. https://doi.org/10.1080/14767058.2019.1634685 PMid:31216921
 10. Serçekuş P, Değirmenciler B, Özkan S. Internet use by pregnant women seeking childbirth information. J Gynecol Obstet Hum Reprod. 2021 Oct;50(8):102144. https://doi.org/10.1016/j.jogoh.2021.102144 PMid:33848646
 11. Zhu X, Zheng T, Ding L, Zhang X. Exploring associations between eHealth literacy, cyberchondria, online health information seeking and sleep quality among university students: A cross-section study. Heliyon. 2023 Jun;9(6):e17521. https://doi.org/10.1016/j.heliyon.2023.e17521 PMid:37408886 PMCid:PMC10319213
 12. Bryant AG, Narasimhan S, Bryant-Comstock K, Levi EE. Crisis pregnancy center websites: Information, misinformation and disinformation. Contraception. 2014 Dec;90(6):601-5. https://doi.org/10.1016/j.contraception.2014.07.003 PMid:25091391
 13. Yilmaz M, Tiraki Z. Sağlık Okuryazarlığı Nedir? Nasıl Ölçülür? DEUHFED. 2016;9(4):142-7.
 14. Loughnan SA, Sie A, Hobbs MJ, Joubert AE, Smith J, Haskelberg H, et al. A randomized controlled trial of 'MUMentum Pregnancy': Internet-delivered cognitive behavioral therapy program for antenatal anxiety and depression. J Affect Disord. 2019 Jan;243:381-90. https://doi.org/10.1016/j.jad.2018.09.057 PMid:30266030
 15. Gioia F, Boursier V. What Does Predict Cyberchondria? Evidence from a Sample of Women. Journal of Psychology and Psychotherapy Research. 2020;7:68-75. https://doi.org/10.12974/2313-1047.2020.07.6
16. Akça E, Gökyıldız Sürücü Ş, Akbaş M. Gebelerde Sağlık Algısı, Sağlık Okuryazarlığı ve İlişkili Faktörler. . İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi. 2020 Nov 30;8(3):630-42. https://doi.org/10.33715/inonusaglik.735467
17. Değirmenciler B, Sercekuş P, Özkan S. İnternet ve Sosyal Medya Kullanımı Gebe Kadınları Nasıl Etkiler? Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi. 2022 Dec 5;5(3):453-8. https://doi.org/10.38108/ouhcd.923961
18. Lee J, Tak SH. Factors associated with eHealth literacy focusing on digital literacy components: A cross-sectional study of middle-aged adults in South Korea. Digit Health. 2022 Jan 20;8:205520762211027. https://doi.org/10.1177/20552076221102765 PMid:35615270 PMCid:PMC9125061
19. Öztürk G, Ünlü N, Uzunkaya E, Karaçam Z. Gebelerin Bilgi Kaynağı Olarak İnternet ve Sosyal Medya Kullanım Durumları. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2020 Sep 30;4(3):210-20. https://doi.org/10.46237/amusbfd.667048
20. Uslu D, Şeremet G. Bireylerin E-Sağlık Okuryazarlık Düzeyinin Belirlenmesi. Usaysad Dergisi. 2020;6(2):386. - 394.
21. Wallwiener S, Müller M, Doster A, Laserer W, Reck C, Pauluschke-Fröhlich J, et al. Pregnancy eHealth and mHealth: user proportions and characteristics of pregnant women using Web-based information sources-a cross-sectional study. Arch Gynecol Obstet. 2016 Nov 15;294(5):937-44. https://doi.org/10.1007/s00404-016-4093-y PMid:27084763
 22. TUİK. https://www.tuik.gov.tr/. 2023. İlçe nufüsları.
 23. SİNA. https://sina.saglik.gov.tr/. 2023. Poliklinik Sayıları.
 24. Gürbüz S, Şahin F. Sosyal bilimlerde araştırma yöntemleri. Ankara: Seçkin Yayıncılık,; 2014.
 25. Norman CD, Skinner HA. eHEALS: The eHealth Literacy Scale. J Med Internet Res. 2006 Nov 14;8(4):e27. https://doi.org/10.2196/jmir.8.4.e27 PMid:17213046 PMCid:PMC1794004
 26. Tamer Gencer Z. Norman ve Skınner'ın E-Sağlık Okuryazarlığı Ölçeğinin Kültürel Uyarlaması İçin Geçerlilik ve Güvenilirlik Çalışması. İstanbul Üniversitesi İletişim Fakültesi Dergisi | Istanbul University Faculty of Communication Journal. 2017 Jul 20;52:131-45. https://doi.org/10.17064/iuifd.333165
27. McElroy E, Kearney M, Touhey J, Evans J, Cooke Y, Shevlin M. The CSS-12: Development and Validation of a Short-Form Version of the Cyberchondria Severity Scale. Cyberpsychol Behav Soc Netw. 2019 May;22(5):330-5. https://doi.org/10.1089/cyber.2018.0624 PMid:31013440
28. Yorgancioğlu Tarcan G, Karahan A, Barış Sebik N. Kısa Form Siberkondri (Css-12) Ciddiyet Ölçeğinin Geçerlik ve Güvenirliği: Sağlık Bilişimi Alanına Özel Bir Uygulama. Hacettepe Sağlık İdaresi Dergisi. 2023;26(1):207-18.
 29. TUİK. https://data.tuik.gov.tr/Bulten/Index?p=Dogum-Istatistikleri-2022-49673 . 2023.
 30. Şirin Gök M, Küçük K, Kanbur A. Gebelerde Sağlık Okuryazarlığı İle Sağlık Uygulamaları Arasındaki İlişkinin İncelenmesi. STED / Sürekli Tıp Eğitimi Dergisi. 2022 Nov 21;31(6):409-17. https://doi.org/10.17942/sted.1021910
31. Baltacı N, Kaya N, Kılıçkaya İ. Gebelerin E-Sağlık Okuryazarlığının ve Sağlıklı Yaşam Davranışlarının İncelenmesi. STED / Sürekli Tıp Eğitimi Dergisi. 2023 Oct 27;32(4):301-13.
32. Narasimhulu DM, Karakash S, Weedon J, Minkoff H. Patterns of Internet Use by Pregnant Women, and Reliability of Pregnancy-Related Searches. Matern Child Health J. 2016 Dec 25;20(12):2502-9. https://doi.org/10.1007/s10995-016-2075-0 PMid:27456311
 33. Scaioli G, Bert F, Galis V, Brusaferro S, De Vito E, La Torre G, et al. Pregnancy and internet: sociodemographic and geographic differences in e-health practice. Results from an Italian multicenter study. Public Health. 2015 Sep;129(9):1258-66. https://doi.org/10.1016/j.puhe.2015.06.012 PMid:26210071
34. Ferraz M, Almeida AM, Matias A, Farine D. The Influence of the Web on Health Related Decision-making Processes: A Survey with Portuguese Women During Pregnancy. Procedia Comput Sci. 2016;100:347-54. https://doi.org/10.1016/j.procs.2016.09.168
35. Cui GH, Li SJ, Yin YT, Chen LJ, Li JQ, Liang FY, et al. The relationship among social capital, eHealth literacy and health behaviours in Chinese elderly people: a cross-sectional study. BMC Public Health. 2021 Dec 6;21(1):45. https://doi.org/10.1186/s12889-020-10037-4 PMid:33407275 PMCid:PMC7789238
36. Özer Ö, Özmen S, Özkan O. Investigation of the effect of cyberchondria behavior on e-health literacy in healthcare workers. Hosp Top. 2023 Apr 3;101(2):94-102. https://doi.org/10.1080/00185868.2021.1969873 PMid:34461810
 37. Özkan O, Sungur C, Özer Ö. Investigation of cyberchondria level and digital literacy on women in Turkey. J Hum Behav Soc Environ. 2022 Aug 18;32(6):768-80. https://doi.org/10.1080/10911359.2021.1962776
38. Uslu Sahan F, Purtul S. Health Anxiety and eHealth Literacy as Predictors of Cyberchondria in Women. Acibadem Universitesi Saglik Bilimleri Dergisi. 2023 Jun 22;14(3):454-61. https://doi.org/10.31067/acusaglik.1285876
39. Bardus M, Keriabian A, Elbejjani M, Al-Hajj S. Assessing eHealth literacy among internet users in Lebanon: A cross-sectional study. Digit Health. 2022 Jan 9;8:205520762211193. https://doi.org/10.1177/20552076221119336 PMid:35968030 PMCid:PMC9373133
40. Şahin E, Çatıker A, Özdil K, Bulucu Büyüksoy GD. Predictors of literacy in pregnant women: A structural equation model analysis. International Journal of Gynecology & Obstetrics. 2023 Mar 8;160(3):783-9. https://doi.org/10.1002/ijgo.14416 PMid:36018076
 41. Nadeem F, Malik N, Atta M, Ullah I, Martinotti G, Pettorruso M, et al. Relationship between Health-Anxiety and Cyberchondria: Role of Metacognitive Beliefs. J Clin Med. 2022 May 5;11(9):2590. https://doi.org/10.3390/jcm11092590 PMid:35566713 PMCid:PMC9101818
 42. Starcevic V. Cyberchondria: Challenges of Problematic Online Searches for Health-Related Information. Psychother Psychosom. 2017;86(3):129-33. https://doi.org/10.1159/000465525 PMid:28490037
 43. Bajcar B, Babiak J. Self-esteem and cyberchondria: The mediation effects of health anxiety and obsessive-compulsive symptoms in a community sample. Current Psychology. 2021 Jun 11;40(6):2820-31. https://doi.org/10.1007/s12144-019-00216-x
44. McMullan RD, Berle D, Arnáez S, Starcevic V. The relationships between health anxiety, online health information seeking, and cyberchondria: Systematic review and meta-analysis. J Affect Disord. 2019 Feb;245:270-8. https://doi.org/10.1016/j.jad.2018.11.037 PMid:30419526

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