Digital health literacy and quality of life in epilepsy: The mediating role of self-management.

OBJECTIVE: Digital health literacy, defined as the ability to seek, understand, evaluate, and apply health information obtained from digital resources, has emerged as an important determinant of chronic disease management. However, the behavioral mechanisms linking digital health literacy to quality of life in epilepsy remain unclear. This study aimed to examine whether self-management mediates the relationship between digital health literacy and quality of life in adults with epilepsy. METHODS: In this cross-sectional study, 143 adults with epilepsy completed the eHealth Literacy Scale (eHEALS), the Epilepsy Self-Management Scale (ESMS), and the Quality of Life in Epilepsy Inventory (QOLIE-31). Pearson correlations were conducted to examine bivariate associations. Multiple linear regression analyses were performed controlling for age, educational attainment, number of ASMs, and seizure frequency. Mediation analysis was conducted using 5,000 nonparametric bootstrap resamples and was adjusted for age, seizure frequency, number of antiseizure medications, and educational attainment. RESULTS: Seizure frequency was negatively correlated with quality of life (r = - 0.322, p < 0.001). Self-management showed the strongest positive correlation with quality of life (r = 0.547, p < 0.001). In regression analysis, seizure frequency (B = - 4.366, p = 0.008) and self-management (B = 0.416, p < 0.001) were significant independent predictors, and the model explained 37.9% of the variance in QOLIE-31 scores (R2 = 0.379). Digital health literacy was not a significant independent predictor after adjustment (p = 0.208). The covariate-adjusted indirect effect of digital health literacy on quality of life through self-management was statistically significant (B = 0.575, 95% bootstrap CI [0.331, 0.874]), whereas the direct effect was not significant. CONCLUSIONS: Digital health literacy was associated with quality of life in epilepsy, with self-management accounting for a significant indirect association. These findings highlight the potential value of combining digital health literacy initiatives with structured self-management support.