The Relationship Between eHealth Literacy and Stress, Anxiety, and Depression Among University Students
Authors
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Faeze Sobhanifar
MSc of Psychiatric Nursing, Department of Nursing, University Social welfare and Rehabilitation Sciences, Tehran, Iran; 2 PhD Student in Nursing, Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
https://orcid.org/0000-0002-0269-4806
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Reza Ahmadi Jirandeh
MSc of Psychiatric Nursing, Department of Nursing, University Social welfare and Rehabilitation Sciences, Tehran, Iran.
https://orcid.org/0009-0008-8182-2095
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Sajad Javanbakht
MSc of Psychiatric Nursing, Department of Nursing, University Social welfare and Rehabilitation Sciences, Tehran, Iran.
https://orcid.org/0000-0002-6541-7849
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Mohsen Vahedi
Assistant Professor, Department of Biostatistics and Epidemiology, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
https://orcid.org/0000-0002-4645-6770
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Abolfazl Rahgoi
Instructor, Department of Nursing, University Social welfare and Rehabilitation Sciences, Tehran, Iran.
https://orcid.org/0000-0002-9657-4724
DOI:
https://doi.org/10.22100/sjms.v11i2.1248Keywords:
Health literacy, Anxiety, Depression, Stress, Mental health, StudentsAbstract
Background: The growing use of the internet and low eHealth literacy may contribute to increased mental health issues such as stress, anxiety, and depression among university students, who are a key group in society. This study explored the relationship between eHealth literacy and stress, anxiety, and depression among undergraduate students at the University of Social Welfare and Rehabilitation Sciences.
Methods: This descriptive correlational study was conducted with the participation of 300 undergraduate students from the University of Social Welfare and Rehabilitation Sciences, Tehran, in 2024, using convenience sampling. The research instrument was an electronic questionnaire consisting of a demographic checklist, the Norman eHealth Literacy Scale, and the Depression, Anxiety, and Stress Scale (DASS). The results were analyzed using SPSS version 25 and statistical tests including Levene’s test, independent t-test, ANOVA, Welch’s ANOVA, Pearson’s correlation coefficient, and multiple regression.
Results: The mean and standard deviation of eHealth literacy were 31.15±3.60, indicating a favorable level. The mean and standard deviation of stress, anxiety, and depression among undergraduate students were 13.43±9.01, 13.58±8.83, and 15.15±9.01, respectively, indicating normal, moderate, and moderate levels, respectively. Pearson’s correlation coefficient test revealed a significant inverse correlation between eHealth literacy and stress (r=-0.402), anxiety (r=-0.351), and depression (r=-0.353) (P-value<0.001).
Conclusions: E-Health literacy is associated with and can predict levels of stress, anxiety, and depression. Therefore, it is necessary and essential to develop educational programs, including media literacy and eHealth literacy training, which can have a positive impact on mental health.
References
Alfonso S, Lonigan C. Trait anxiety and adolescent's academic achievement: The role of executive function. Learning and Individual Differences 01/01 2021;85:101941. doi: 10.1016/j.lindif.2020.101941
Abdel Wahed, Wafaa Yousif, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria Journal of Medicine 2017/03/01/ 2017;53(1):77-84. doi: 10.1016/j.ajme.2016.01.005
Abbasi M, Dargahi S, Mohammad alipor Z, Mehrabi A. The Role of Student Stressors in Predicting Procrastination and Academic Burnout among Nursing Students. Original research article. Iranian Journal of Medical Education 2015;15(0):293-303.
Ramón-Arbués E, Gea-Caballero V, Granada-López JM, Juárez-Vela R, Pellicer-García B, Antón-Solanas I. The Prevalence of Depression, Anxiety and Stress and Their Associated Factors in College Students. International Journal of Environmental Research and Public Health Sep 24 2020;17(19). doi: 10.3390/ijerph17197001
World Health Organization. Stress. Accessed July 4, 2023. https://www.who.int/news-room/questions-and-answers/item/stress
Ketheesan S, Rinaudo M, Berger M, et al. Stress, allostatic load and mental health in Indigenous Australians. Stress (Amsterdam, Netherlands) Sep 2020;23(5):509-518. doi: 10.1080/10253890.2020.1732346
Aazami Y, Khanjani M, Sader MM. Confirmatory Factor Structure of Depression, Anxiety and Stress Scale in Students. Journal of Mazandaran University of Medical Sciences 2017;27(154):94-106.
Xie F XZ, Chen X, Zhang L. The effects of self-esteem, test anxiety and general anxiety. Sex Roles 2019;81:44-235. doi: 10.1007/s11199-018-0982-9
American Psychiatric Association. What is depression? Accessed july 4, 2023. https://www.psychiatry.org/patients-families/depression/what-is-depression
Aghajani Liasi G, Mahdi Nejad S, Sami N, Khakpour S, Ghorbani Yekta B. The prevalence of educational burnout, depression, anxiety, and stress among medical students of the Islamic Azad University in Tehran, Iran. BMC Medical Education 2021/09/05 2021;21(1):471. doi: 10.1186/s12909-021-02874-7
Kim H, Xie B. Health literacy in the eHealth era: A systematic review of the literature. Patient Education and Counseling Jun 2017;100(6):1073-1082. doi: 10.1016/j.pec.2017.01.015
Sajadi M, Ebrahimabadi M, Khosravi S, Seif K, Rafiei F. The effect of stress management on the anxiety, depression and stress of nursing students in the first clinical experience. Quantitative-Research. 2 Journal of Nursing Education 2018;7(4):18-24.
Isazadeh M, Asadi ZS, Jamshidian A, Khademi Geshlagh R. The Relationship Between Students' E-Health Literacy and General Health in a Military University of Medical Sciences. AJAUMS-MCS 2019;6(3):228-237. doi: 10.29252/mcs.6.3.9
Norman CD, Skinner HA. eHEALS: The eHealth Literacy Scale. Journal of medical Internet research Nov 14 2006;8(4):e27. doi: 10.2196/jmir.8.4.e27
Ivanitskaya L, O'Boyle I, Casey AM. Health information literacy and competencies of information age students: results from the interactive online Research Readiness Self-Assessment (RRSA). Journal of Medical Internet Research Apr 21 2006;8(2):e6. doi: 10.2196/jmir.8.2.e6
Ivanitskaya L, Brookins-Fisher J, I OB, Vibbert D, Erofeev D, Fulton L. Dirt cheap and without prescription: how susceptible are young US consumers to purchasing drugs from rogue internet pharmacies? Journal of Medical Internet Research Apr 26 2010;12(2):e11. doi: 10.2196/jmir.1520
Internet World Stats. Iran Internet Stats and Telecommunications Reports. Accessed June 27, 2023. https://www.internetworldstats.com/me/ir.htm
Dehghan Naiery N, Adib Hajbaghery M. Effects of relaxation techniques on stress and the quality of life of dormitory students. Feyz 2006;10(2):50-57.
Asif S, Mudassar A, Shahzad TZ, Raouf M, Pervaiz T. Frequency of depression, anxiety and stress among university students. Pakistan Journal of Medical Sciences Jul-Aug 2020;36(5):971-976. doi: 10.12669/pjms.36.5.1873
Kalyani MN, Pourjam E, Jamshidi N, Karimi S, Kaylani VN. Survey of stress, anxiety, depression and self-concept of students of Fasa University of medical sciences, 2010. Journal of Advanced Biomedical Sciences 2013;3(3):235.
Mahmoodi SMH, Ahmadzad-Asl M, Eslami M, Abdi M, Hosseini Kahnamoui Y, Rasoulian M. Mental Health Literacy and Mental Health Information-Seeking Behavior in Iranian University Students. Frontiers in Psychiatry 2022;13:893534. doi: 10.3389/fpsyt.2022.893534
Krejcie RV, Morgan DWJE, measurement p. Determining sample size for research activities. 1970;30(3):607-610. doi: 10.1177/001316447003000308
Bazm S, Mirzaei M, Fallahzadeh H, Bazm R. Validity and Reliability of the Iranian Version of eHealth Literacy Scale. SSU 2016;5(2):121-130.
Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. Psychology Foundation of Australia; 1996. doi: 10.1037/t01004-000
Sahebi A, Asghari MJ, Salari RS. Validation of Depression Anxiety and Stress Scale (DASS-21) for an Iranian Population. JIP 2005;1(4):36-54.
Shamsaei F, Yaghmaei S, Sadeghian E, Tapak L. Survey of Stress, Anxiety and Depression in Undergraduate Nursing Students of Hamadan University of Medical Sciences. IJPN 2018;6(3):26-31.
Ramazani S, Aramjoo H, Ramazani A, Hajipoor R, Naseri M. Survey of Stress, Anxiety and Depression in Paramedical students of Birjand University of Medical Sciences, 2016. Horizon of Medical Education Development 2020;11(1):5-14.
Soleimaninejad A, Asadi Z, Fathi Manesh S, Moqaddas AJHE, Promotion H. Correlation between Electronic Health Literacy and Health Promoting Behaviors in Elderly. 2021;9(4):387-393.
Kim KA, Hyun MS, De Gagne JC, Ahn JA. A cross-sectional study of nursing students' eHealth literacy and COVID-19 preventive behaviours. Nursing Open Feb 2023;10(2):544-551. doi: 10.1002/nop2.1320
Kim SH, Son YJ. Relationships Between eHealth Literacy and Health Behaviors in Korean Adults. Computers, informatics, nursing : CIN Feb 2017;35(2):84-90. doi: 10.1097/CIN.0000000000000255
Mengestie ND, Yilma TM, Beshir MA, Paulos GK. eHealth Literacy of Medical and Health Science Students and Factors Affecting eHealth Literacy in an Ethiopian University: A Cross-Sectional Study. Applied clinical informatics Mar 2021;12(2):301-309. doi: 10.1055/s-0041-1727154
Akingbade O, Adeleye K, Fadodun OA, et al. eHealth literacy was associated with anxiety and depression during the COVID-19 pandemic in Nigeria: a cross-sectional study. Frontiers in Public Health 2023;11:1194908. doi: 10.3389/fpubh.2023.1194908
Soleimaninejad A, Asadi ZS, Fathi Manesh S, Moqaddas A. Correlation between Electronic Health Literacy and Health Promoting Behaviors in Elderly. MDRSJRNS 2021;9(4):387-393.
Khabbaz Mafinezhad M, Hosseini S, Hazar N. Stress, Anxiety and Depression frequency among medical students of Shahid Sadoughi University of Medical Sciences in 2019. TRJUMS-JHRD 2024;2(1):1-15. doi: 10.61186/jhrd.2.1.1
Kim S, Oh J. The Relationship between E-Health Literacy and Health-Promoting Behaviors in Nursing Students: A Multiple Mediation Model. International Journal of Environmental Research and Public Health May 28 2021;18(11). doi: 10.3390/ijerph18115804
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