eHealth literacy and decisional conflict in patients with coronary heart disease: chain mediation of cyberchondria and psychological inflexibility and a latent profile analysis.

BACKGROUND

Coronary heart disease (CHD) is the leading cause of cardiovascular mortality worldwide, and its management requires patients to make complex, preference-sensitive treatment decisions. Decisional conflict is common in this population and adversely affects treatment adherence and outcomes, yet its association with eHealth literacy and the underlying psychological mechanisms remain unclear.

OBJECTIVE

This study examined the association between eHealth literacy and decisional conflict in patients with CHD, tested the chain-mediating roles of cyberchondria and psychological inflexibility, and identified latent profiles of eHealth literacy.

METHODS

A cross-sectional design was employed, and patients with CHD were recruited from tertiary Grade A hospitals. The survey battery comprised the eHealth Literacy Scale, the Decisional Conflict Scale, the Cyberchondria Severity Scale, the psychological inflexibility subscale of the Multidimensional Psychological Flexibility Inventory, and requisite demographic items.

RESULTS

eHealth literacy was significantly and negatively associated with decisional conflict, and this association was mediated by cyberchondria and psychological inflexibility. From a person-centered perspective, two latent subgroups of eHealth literacy were identified: a high eHealth literacy profile and a low eHealth literacy profile. One-way analysis of variance indicated that the optimal latent profiles differed significantly in decisional conflict, cyberchondria, and psychological inflexibility.

CONCLUSION

This study not only helps identify priority targets for interventions addressing decisional conflict in patients with CHD, but also elucidates the psychological pathways through which eHealth literacy shapes treatment decision-making, thereby informing heterogeneity-informed, tailored clinical interventions.