Health literacy, digital literacy and eHealth literacy in Danish nursing students at entry and graduate level: a cross sectional study

BACKGROUND: The increasing number of people living with one or more chronic conditions imposes a growing demand on healthcare providers. One way to handle this challenge is by re-orientating the way care is provided, empower people and increase their ability to manage their condition. This requires, amongst other factors, sufficient level of health literacy (HL) and digital competences among both patients and the healthcare providers, who serve them. The focus of this study is the level of HL, digital literacy (DL), and eHealth literacy (eHL) in nursing students in Denmark. The objective was to examine the level of these three literacies in entry- and graduate-level nursing students and examine sociodemographic characteristics and self-rated health (SRH) associations. METHODS: A cross sectional study was conducted among 227 students at entry-level and 139 students at graduate-level from a nursing program. The survey consisted of the health literacy questionnaire (HLQ (nine scales)), the eHealth Literacy Assessment toolkit (eHLA (seven scales)), the eHealth Literacy Questionnaire (eHLQ (seven scales)), questions soliciting sociodemographic data, and a single item assessing the students’ SRH. Pearson’s chi-square test and the Mann-Whitney test were used to examine the differences in HL, DL, and eHL and between groups, and Kendall’s tau-b test to examine correlations between SRH and HL, DL, and eHL. RESULTS: The level of HL, DL and eHL tended to be higher among graduate-level students than in entry-level students and was satisfactory. Age, sex, country of origin, and parents’ educational level and occupational background influenced students’ HL levels. SRH was higher in students at the graduate level. Amongst entry-level students, SRH was positively associated to seven HLQ, four EHLA and four eHLQ, amongst graduate-level students, SRH was positively associated to seven HLQ and six eHLQ. CONCLUSIONS: Educators must be aware of how sociodemographic factors affects students’ literacies and increase learning opportunities by mixing students when planning activities. Considering the higher SRH in graduate-level students, HL, DL, and eHL levels indicate that current curricula and study activities are appropriate, but there is still room for improvement.