Digital and Navigational Health Literacy in Surgical Patients: Vulnerabilities in the Transition to Post-Discharge...

The digitalization of healthcare in general, and particularly of surgical care, increasingly requires patients to navigate online information and digital follow-up systems. Limited digital or navigational health literacy may hinder safe recovery and exacerbate health inequities. This study aimed to assess levels of digital and navigational health literacy and their associations in a sample of surgical patients.

A cross-sectional study was conducted with ninety-four adults undergoing elective or emergency surgery, using the validated HLS19-DIGI (digital health literacy) and HLS19-NAV (navigational health literacy) instruments. Data collection took place between March 2025, and 28 August 2025, at a hospital in the Lisbon district. Descriptive analyses, bivariate analysis, and multiple regression were used to identify sociodemographic and clinical predictors.

Digital literacy varied significantly across age groups (p = 0.038), with median scores declining from 87.5 (31-45 years) to 31.2 (>65 years). Navigational literacy was lower in emergency versus elective surgery patients (41.7 vs. 83.3; p = 0.036). In adjusted models, self-employment predicted lower digital literacy (β = -36.06, p = 0.009), while emergency surgery remained the only predictor of navigational literacy (β = -31.07, p = 0.018). Digital and navigational literacy were strongly correlated (ρ = 0.859).

The surgical patients in this study demonstrated marked literacy deficits, particularly older adults and those undergoing emergency procedures. Digital and navigational literacy appear to reflect overlapping competencies. As healthcare shifts toward digital models, it is essential to develop age-adapted strategies to promote equity and prevent exclusion.