Digital Health Literacy and Supportive Care Needs After Curative Esophagectomy: A Cross-Sectional Study

Recovery after esophagectomy may involve physical, informational, and psychosocial demands. This study examined whether total Digital Health literacy was associated with unmet supportive care needs.

Here, we conducted a single-center cross-sectional survey of 337 adults attending their first postoperative outpatient review, approximately 1 month after curative esophagectomy. Participants completed the 34-item Supportive Care Needs Survey Short Form and the Chinese Digital Health Literacy Instrument. SCNS-SF34 domain scores were standardized to 0-100. Pearson correlation and a prespecified hierarchical linear regression were used; HC3 and bootstrap estimates assessed the stability of the findings.

Mean total supportive care needs and digital health literacy scores were 110.27 (SD 11.52) and 59.50 (SD 11.94), respectively. Patient care and support (74.44) and physical and daily living (72.08) had the highest standardized domain scores. Total digital health literacy was inversely correlated with total supportive care needs (r = -0.856, 95% CI -0.882 to -0.825; P < 0.001; Spearman rho = -0.941). In the complete model, each 1-point higher digital health literacy score was associated with a 0.824-point lower supportive care needs score (B = -0.824, 95% CI -0.917 to -0.732; P < 0.001). The complete model explained 78.4% of outcome variance (adjusted R² = 0.759). HC3 and bootstrap estimates were similar.

Among digital-device users attending early postoperative follow-up after curative esophagectomy, higher total digital health literacy was associated with fewer reported supportive care needs. Together, these findings support considering digital capability in postoperative needs assessment, but the association should not be interpreted causally because the sample was digitally selected and cross-sectional. Longitudinal studies should include patients with limited digital access and collect relevant clinical and psychosocial covariates.