Abstract
OBJECTIVE: To explore the relationships among continuity of care needs, patient empowerment and eHealth literacy in patients with stable chronic obstructive pulmonary disease (COPD), and to further identify the potential mediating role of eHealth literacy. DESIGN: Cross-sectional study. SETTING: A tertiary care hospital (Level 3A, the highest level in the Chinese hospital classification system) in Shanghai, China. PARTICIPANTS: The study participants consisted of 219 patients with stable COPD who visited or underwent follow-up at the outpatient clinic between December 2023 and May 2024. OUTCOME MEASURES: The Continuity of Care Needs Questionnaire, COPD Patient Empowerment Evaluation Scale and eHealth Literacy Scale (eHEALS) were used to assess 219 patients with stable COPD. Univariate analysis, Pearson correlation analysis and mediation analysis were performed. RESULTS: The mean Continuity of Care Needs score was 24.17 (SD=2.74), with medication guidance needs being the highest-scoring domain. The COPD Patient Empowerment score was 84.37 (SD=11.58), and the eHEALS score was 23.37 (SD=6.06). Pearson correlation analysis showed that continuity of care needs were negatively correlated with patient empowerment (r=-0.930, 95% CI -0.946 to -0.910) and eHealth literacy (r=-0.976, 95% CI -0.982 to -0.969), while patient empowerment was positively correlated with eHealth literacy (r=0.919, 95% CI 0.895 to 0.937) (all p<0.001). Mediation analysis suggested that eHealth literacy partially mediated the relationship between patient empowerment and continuity of care needs, with an indirect effect of -0.169 (95% CI -0.247 to -0.091), accounting for 74.91% of the total effect. The direct effect was -0.051 (95% CI -0.067 to -0.035) and the total effect was -0.220 (95% CI -0.231 to -0.208). CONCLUSIONS: Patients with stable COPD demonstrated high continuity of care needs, with eHealth literacy partially mediating the relationship between patient empowerment and continuity of care needs. Healthcare providers should consider patients' eHealth literacy to enhance patient empowerment and develop personalised continuity of care strategies.