Proposing a Transactional Model of eHealth Literacy: Concept Analysis.
Proposing a Transactional Model of eHealth Literacy: Concept Analysis.
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DOI：
10.2196/10175
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发表时间：
2018-10-02
影响因子：
7.4
通讯作者：
Stopka C
中科院分区：
文献类型：
--
作者：
Paige SR;Stellefson M;Krieger JL;Anderson-Lewis C;Cheong J;Stopka C
2006年，电子健康素养被定义为互联网用户查找、评估和处理基于网络的健康信息的能力。现在，电子医疗技术的进步为患者提供了访问、共享和监控健康信息的交易机会。然而，经验证据表明，现有的模式和措施的电子卫生扫盲有限的理论基础，反映了电子卫生的交易能力。本文介绍了一个概念模型的基础上的transmittance模型的通信（TMC），其中电子健康素养被描述为一个内在的技能，假设是动态的，互惠的，并塑造了社会，关系和文化背景。我们的研究的目的是系统地研究电子健康素养的定义，模型和措施，提出一个完善的概念和操作的定义TMC的基础上。步行者和先锋的概念分析方法被用来指导系统的审查电子健康素养的定义（n=10），评级量表（n=6），模型（n=4），同行评议的模型应用程序（n=16）。随后的聚类分析显示了各定义的突出主题。尺寸，前因，并反映在模型和措施的后果提取和演绎分析的基础上与TMC的代码一致。系统性审查证据显示，与模型和措施中包含的识字率相比，定义中包含的业务电子保健识字率之间存在不一致。电子卫生知识的理论基础也仍然令人沮丧。尽管电子保健具有交易能力，但“通信”在电子保健扫盲中的作用仍然不发达，没有考虑到多方交易所需的身体和认知处理能力。提出了电子健康素养的交易模型和相应的定义。在这种新的模式中，电子健康素养包括一个层次化的个人内部技能，介导的相互影响的上下文因素（即，面向用户和面向任务）对患者参与医疗保健。更具体地说，自我认知技能抵消了社会和关系背景产生的“噪音”（或障碍）的负面影响。跨越健康和技术素养，电子健康素养的个人内部技能组合通过与离散操作技能相对应的四种素养来操作：（1）功能（即，定位和理解）;（2）沟通（即，交流）;（3）关键（即，评估）;和（4）翻译（即，应用）。
Electronic health (eHealth) literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information. Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth. This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts. The objective of our study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC. Walker and Avant’s concept analysis method was used to guide the systematic review of eHealth literacy definitions (n=10), rating scales (n=6), models (n=4), and peer-reviewed model applications (n=16). Subsequent cluster analyses showed salient themes across definitions. Dimensions, antecedents, and consequences reflected in models and measures were extracted and deductively analyzed based on codes consistent with the TMC. Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal. Despite the transactional capabilities of eHealth, the role of “communication” in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions. The Transactional Model of eHealth Literacy and a corresponding definition are proposed. In this novel model, eHealth literacy comprises a hierarchical intrapersonal skillset that mediates the reciprocal effect of contextual factors (ie, user oriented and task oriented) on patient engagement in health care. More specifically, the intrapersonal skillset counteracts the negative effect of “noise” (or impediments) produced by social and relational contexts. Cutting across health and technology literacies, the intrapersonal skillset of eHealth literacy is operationalized through four literacies that correspond with discrete operative skills: (1) functional (ie, locate and understand); (2) communicative (ie, exchange); (3) critical (ie, evaluate); and (4) translational (ie, apply).
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