Attitude towards telemedicine and e-health literacy among health sciences faculty students
Main Article Content
Abstract
Background
Telemedicine is no longer a futuristic concept and is increasingly integrated into health care. The aim of this study was to determine the attitudes toward telemedicine in connection with e-Health literacy among students in a Faculty of Health Sciences.
Methods
This cross-sectional study was conducted involving 250 students aged 18 years and older. Data were collected using a sociodemographic information form, the Attitude Scale Toward the Use of Telehealth Services (ASTUTS), and the eHealth Literacy Scale (eHEALS). Mann-Whitney U test, the Kruskal–Wallis test, and the linear regression analysis were used. Statistical significance was set at p<0.05.
Results
Of the participants, 61.6% were aged 18–21 years, and 70.8% were female. Attitudes toward telehealth services were significantly higher among students aged 22 years and older (p<0.05). eHealth literacy scores were significantly higher among female students than among males (p<0.05) and differed significantly across academic departments (p<0.05). Regression analysis showed that attitudes toward telemedicine services were positively associated with eHealth literacy (β=0.195, p=0.002), indicating that higher telemedicine attitude scores were related to higher levels of eHealth literacy. All variables (attitudes to telemedicine, age, gender, place of residence, economic status, general health status, smoking status, alcohol use, chronic disease status, hospital appointment system used) explaining 9.1% of the variance in eHealth literacy (R²=0.091).
Conclusion
Students had moderate attitudes toward telemedicine and moderate eHealth literacy. Implementing a targeted, practical, and integrated curriculum to increase the use of telemedicine and digital health literacy in undergraduate health sciences programs could be beneficial.
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.
How to Cite
References
1. World Health Organization. WHO develops guidance to improve telemedicine services. Geneva: World Health Organization;2024.
2. Ghaddaripouri K, Mousavi Baigi SF, Abbaszadeh A, Mazaheri Habibi MR. Attitude, awareness, and knowledge of telemedicine among medical students: a systematic review of cross-sectional studies. Health Sci Rep 2023;6:e1156. doi: 10.1002/hsr2.1156.
3. Aytimur D, Mandıracıoğlu A, Batı AH, Gövsa F. Awareness of healthcare faculty students on telemedicine: a mixed methods study. Eur J Ther 2024;30:879-89. Doi:https://doi.org/10.58600/eurjther2256.
4. Aydin MO, Alper Z, Ozkaya G, Caliskan SA. Turkish medical students’ perspectives on the advantages and disadvantages of telemedicine: scale development and psychometric evaluation. BMC Med Educ 2026;26:175. doi: 10.1186/s12909-025-08515-7.
5. Kong SS, Azarfar A, Ashour A, Atkins C, Bhanusali N. Awareness and attitudes towards telemedicine among medical students in the United States. Cureus 2020;12:e11447. doi: 10.7759/cureus.11574.
6. Kunwar B, Dhungana A, Aryal B, Gaire A, Adhikari AB, Ojha R. Knowledge and attitude of telemedicine among medical students of Nepal: a cross-sectional study. Health Sci Rep 2022;5:e532. doi: 10.1002/hsr2.532.
7. Norman CD, Skinner HA. eHEALS: the eHealth literacy scale. J Med Internet Res 2006;8:e27. doi: 10.2196/jmir.8.4.e27.
8. Nakas D, Erek Kazan E. e-Health literacy levels of university students in Turkey and affecting factors. Int J Caring Sci 2020;13:2149-59.
9. Stauch L, Renninger D, Rangnow P, et al. Digital health literacy of children and adolescents and its association with sociodemographic factors: representative study findings from Germany. J Med Internet Res 2025;27:e69170. doi: 10.2196/69170.
10. Aufenberg B, Offermann J, Pauge S, Ziefle M, Greiner W. Acceptance of telemedicine among care personnel in inpatient and outpatient elderly care: a systematic review. BMC Geriatr 2025;25:1010. doi: 10.1186/s12877-025-06786-9.
11. Lu X, Zhang R. Association between eHealth literacy in online health communities and patient adherence: cross-sectional questionnaire study. J Med Internet Res 2021;23:e14908. doi: 10.2196/14908.
12. Aldekhyyel RN, Alshuaibi F, Alsaaid O, et al. Exploring behavioral intention to use telemedicine services post COVID-19: a cross sectional study in Saudi Arabia. Front Public Health 2024;12:1385713. doi: 10.3389/fpubh.2024.1385713.
13. Ghaddaripouri K, Mousavi Baigi SF, Hashemi SA, Sezavar Dokhtfaroughi S, Dahmardeh Kemmak F, Mazaheri Habibi MR. Awareness and attitude toward telemedicine of students at university of paramedical sciences. Front Health Inform 2024;13:208. doi: 10.30699/fhi.v13i0.572.
14. Aldebasi B, Alhassan AI, Al-Nasser S, Abolfotouh MA. Level of awareness of Saudi medical students of the internet-based health-related information seeking and developing to support health services. BMC Med Inform Decis Mak 2020;20:209. doi: 10.1186/s12911-020-01233-8.
15. Kazmi S, Yasmin F, Siddiqui SA, et al. Nationwide assessment of knowledge and perception in reinforcing telemedicine in the age of COVID-19 among medical students from Pakistan. Front Public Health 2022;10:845415. doi: 10.3389/fpubh.2022.845415.
16. Dean AG, Sullivan KM, Soe MM. OpenEpi: open source epidemiologic statistics for public health Version 3.01;2013.
17. Yücel M, Uyar M. Development of an attitude scale for the use of telemedicine services. Telemed J E Health 2024;30:825-34. doi: 10.1089/tmj.2023.0189.
18. Norman CD, Skinner HA. eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res 2006;8:e9. doi :10.2196/jmir.8.2.e9.
19. Coşkun S, Bebiş H. Adolesanlarda e-sağlık okuryazarlığı ölçeği: Türkçe geçerlik ve güvenirlik çalışması. Gulhane Med J 2016;57:378-84. (Türkiye) doi: 10.5455/gulhane. 157832.
20. Dolu İ, Çelik Durmuş S. The relationship of e-health literacy levels of university students studying other than health sciences with health literacy, digital literacy, media and television literacy. Turk J Public Health 2023;21:16-27. doi:10.20518/tjph.1074107.
21. Doğanyiğit PB, Keçeligil HT. The role of e-health literacy in the use of telemedicine among medical students. Turk J Fam Med Prim Care 2024;18:56-63. doi: 10.21763/tjfmpc.1331049.
22. Sainimnuan S, Preedachitkul R, Petchthai P, Paokantarakorn Y, Siriussawakul A, Srinonprasert V. Low prevalence of adequate eHealth literacy and willingness to use telemedicine among older adults: cross-sectional study from a middle-income country. J Med Internet Res 2025;27:e65380. doi: 10.2196/65380.
23. Rueda-Medina B, Gómez-Urquiza JL, Casas-Barragán A, Toledano-Moreno S, Aguilar-Ferrándiz ME, Correa-Rodríguez M. eHealth literacy, internet use and health-related behaviour among health sciences students: a cross-sectional study. Contemp Nurse 2023;59:143-52. doi: 10.1080/10376178.2023.2166547.
24. Chelly S, Omri N, Saadallah Z, et al. Knowledge, attitudes, and practices regarding blood exposure accidents and eHealth literacy among Tunisian medical students: a cross-sectional study. BMC Med Educ 2025;25:366. doi: 10.1186/s12909-024-06544-2.
25. Bakerywala A, Finkelman M, Swee G, Lerman M, Loo CY. Attitudes and opinions of telehealth in the dental school environment: a survey study. J Dent Educ 2023;87:1598-606. doi: 10.1002/jdd.13347.
26. Machleid F, Kaczmarczyk R, Johann D, et al. Perceptions of digital health education among European medical students: mixed methods survey. J Med Internet Res 2020;22:e19827. doi: 10.2196/19827.
27. Veikkolainen P, Tuovinen T, Kulmala P, et al. The evolution of medical student competencies and attitudes in digital health between 2016 and 2022: comparative cross-sectional study. JMIR Med Educ 2025;11:e67423. doi: 10.2196/67423.
28. Deshpande N, Hanna K, Caulfield B, O’Connor M. eHealth literacy and patient portal use and attitudes among hospitalized patients: cross-sectional study. JMIR Hum Factors 2023;10:e40105. doi :10.2196/40105.
29. Cho OH, Kim H, Cho Y. Attitudes and digital health literacy mediate the relationship of digital information accessibility with intention for digital healthcare service use in patients with multiple myeloma: a cross-sectional study. Eur J Oncol Nurs 2025;74:102786. doi: 10.1016/j.ejon.2025.102786.
30. Mutlu A, Onsuz MF, Kilinc A, Ozcan L, Tepetas M, Metintas S. Turkish validity and reliability of telemedicine awareness, knowledge, attitude and skills questionnaire. North Clin Istanb 2024;11:18-26. doi: 10.14744/nci.2023.79989.
31. Cheng C, Beauchamp A, Elsworth GR, Osborne RH. Applying the electronic health literacy lens: systematic review of electronic health interventions targeted at socially disadvantaged groups. J Med Internet Res 2020;22:e18476. doi: 10.2196/18476.
32. van der Vaart R, Drossaert C. Development of the digital health literacy instrument: measuring a broad spectrum of Health 1.0 and Health 2.0 skills. J Med Internet Res 2021;23:e23473. doi: 10.2196/jmir.6709.
33. Dadaczynski K, Okan O, Messer M, et al. Digital health literacy and web-based information-seeking behaviors of university students: cross-sectional study. J Med Internet Res 2022;24:e31027. doi :10.2196/24097.
34. Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: toward a unified view. MIS Q 2003;27:425-78. doi:10.2307/30036540.
35. Kruse CS, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open 2017;7:e016242. doi :10.1136/bmjopen-2017-016242.
36. Neter E, Brainin E. eHealth literacy: extending the digital divide to the realm of health information. J Med Internet Res 2012;14:e19. doi :10.2196/jmir.1619.
37. Hargittai E. Digital natives? Variation in internet skills and uses among members of the “net generation”. Sociol Inq 2010;80:92-113. https://doi.org/10.1111/j.1475-682X.2009.00317.x.
38. Chesser A, Burke A, Reyes J, Rohrberg T. Navigating the digital divide: eHealth literacy in underserved populations in the United States. Inform Health Soc Care 2016;41:1-19. https://doi.org/10.3109/17538157.2014.948171.
39. Kontos E, Blake KD, Chou WS, Prestin A. Predictors of eHealth usage: insights on the digital divide from the HINTS 2012. J Med Internet Res 2014;16:e172. doi :10.2196/jmir.3117.
40. Almeida S, Pinto E, Correia M, Veiga N, Almeida A. Evaluating e-health literacy, knowledge, attitude, and health online information in Portuguese university students: a cross-sectional study. Int J Environ Res Public Health 2024;21:271. doi: 10.3390/ijerph21030271.
41. Jiang S, Ng JYY, Choi SM, Ha AS. Relationships among eHealth literacy, physical literacy, and physical activity in Chinese university students: cross-sectional study. J Med Internet Res 2024;26:e56386. doi :10.2196/56386.
42. Paige SR, Stellefson M, Krieger JL, Anderson-Lewis C, Cheong J, Stopka C. Proposing a transactional model of eHealth literacy: concept analysis. J Med Internet Res 2018;20:e10175. doi: 10.2196/10175.