Current state of digital health literacy and its association with informatics competency among nurses: a cross-sectional study

Abstract

Aim: The global promotion of digital health is accelerating the transformation of healthcare systems. Consequently, in contemporary healthcare environments characterized by information overload, nurses are increasingly demanded to possess advanced information-processing abilities to appropriately search for, critically appraise, apply, and disseminate health information. Therefore, in this study, we aimed to investigate the current state of digital health literacy among hospital nurses and examine its association with nursing informatics competency.

Methods: We conducted this cross-sectional, web-based survey between May and August 2025. We recruited participants from 50 randomly selected large hospitals (≥ 400 beds) in the Kansai region of Japan. We measured digital health literacy and nursing informatics competency using the validated Japanese versions of the Digital Health Literacy Instrument and the Nursing Informatics Competency Scale, respectively, and then described the total digital health literacy score (mean of all items) and its subscale scores. We applied Pearson correlation and multiple regression analyses to evaluate the association between these variables, adjusting for potential confounders.

Results: We included 113 nurses in the final analysis. The overall mean score for digital health literacy was 2.8. While operational skills and privacy protection scored the highest, the evaluation of reliability and addition of self-generated content were the lowest-scoring domains. Digital health literacy was positively correlated with nursing informatics competency. In the multivariable model, digital health literacy was independently and positively associated with nursing informatics competency, indicating the strongest association among all examined factors.

Conclusions: Nurses displayed moderate digital health literacy, with proficiency largely limited to basic information-access skills. Beyond demographic and occupational factors, individual digital health literacy may represent an important enabling factor for professional nursing informatics competency. Future research is needed to clarify how digital health literacy is related to nursing informatics competency and to examine the broader mechanisms and contextual factors underlying this association.

Keywords

digital health literacy / nursing informatics competency / nurse

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