The Relationship Between Nurses' Digital Health Literacy and Their Educational Levels, Professional Roles, and Digital Attitudes: A Cluster Analysis Based on a Cross-Sectional Study

Aim: The current study aimed to identify digital health literacy levels among nurses with respect to their education, role and attitude towards digital technologies. Design: Cross-sectional study. Methods: Through convenience sampling, all Registered Nurses, managers/leaders and nurse researchers employed in Hospitals, University Hospitals and Districts were recruited and surveyed using an online questionnaire. The data collection tool assessed: (I) demographics, (II) Digital Health Literacy (DHL) with the Health Literacy Survey19 Digital (HLS19-DIGI) instrument including DHL dealing with digital health information (HL-DIGI), interaction with digital resources for health (HL-DIGI-INT) and use of digital devices for health (HL-DIGI-DD); (III) attitudes on the use of digital technologies in clinical practice. The multiple correspondence analysis was applied to identify three clusters for the education/professional role (A, B, C) and three for digital technologies' use (1, 2, 3). The one-way nonparametric analysis of variance (Kruskal-Wallis test) was applied to compare HL-DIGI, HL-DIGI-INT and the HL-DIGI-DD scores among clusters. Results: Among 551 participants, the median scores of the HL-DIGI, the HL-DIGI-INT and the HL-DIGI-DD questionnaires were 70.2, 72 and 2.00, respectively. The distribution in the clusters 'educational/professional role' was A, (58.8%); B, (16.5%); and C, (24.7%). Nurses in a managerial or coordinator role and with a postgraduate degree used digital resources with greater frequency. The distribution in the clusters 'use of digital technologies' was: 1, (54.6%); 2, (12.2%); and 3, (33.2%). The HL-DIGI-DD and HL-DIGI scores of clusters 1, 2 and 3 differed significantly. Conclusion: DHL among nurses is strongly influenced by the education level, professional role, habits and attitude towards digital technologies. Nurses with coordinator roles used digital technologies with greater frequency and had a higher level of DHL. Reporting method: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were used for reporting. Patient or public contribution: No Patient or Public Contribution. Trial registration: Local Ethical Committee of the Polyclinic of Bari (code: DHL7454, date: 21/09/22).