Background The Internet offers diverse opportunities for disease management, through information websites (Health 1.0) and interactive applications such as peer support forums, e-consults and insight into electronic medical records (Health 2.0). However, it requires various skills to use the Internet in a meaningful way, so-called “eHealth literacy”. Our objective was to study the eHealth literacy of patients with rheumatic diseases and the types of problems they encounter when using the Internet in relation to their disease.
Methods In two studies, eHealth literacy was observed. In study 1, 15 patients (aged 39-74) performed six information-retrieval tasks on the Internet (Health 1.0). In study 2, 16 patients (aged 24-72) performed three Health 2.0 tasks on a hospital-based online web portal and two Health 2.0 tasks on interactive websites. Participants were asked to think aloud while performing the assignments, and screen activities were recorded. Types and frequency of problems were categorized by two independent researchers.
Results Nearly all participants experienced difficulties, and a substantial number of participants was not able to complete all assignments. Encountered problems could be divided into six sequential categories: (1) operating the computer and Internet browser, (2) navigating and orientating on the Web, (3) utilizing search strategies, (4) evaluating relevance and reliability, (5) adding content to the Web, and (6) protecting and respecting privacy. Most severe difficulties occurred in levels 3 and 4; in formulating a search query, evaluating the source of the information, and in scanning a website for relevant information.
Conclusions Many patients have insufficient skills to properly use Web 1.0 and Web 2.0. Our findings may contribute to the consensus between online applications and patients' eHL. For example, via the development of a toolbox for health professionals or a course for patients with low eHealth literacy. Furthermore, these results provide input for the development of an instrument to measure eHealth literacy skills in a efficient and valid manner.
Disclosure of Interest None declared
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