Factors influencing digital health literacy in stroke patients based on social cognitive theory: a mixed-methods systematic review.

BACKGROUND: Digital health literacy is crucial for stroke patients to effectively access and utilize digital health information and services, thereby facilitating health management and improving health outcomes. However, digital health literacy among stroke patients is often inadequate and influenced by multiple factors. This study aimed to systematically identify the factors associated with digital health literacy in stroke patients, so as to provide evidence for the development of tailored intervention strategies. METHODS: Eight databases (PubMed, Cochrane Library, Web of Science, Embase, SinoMed, China National Knowledge Infrastructure, Wanfang, VIP) were searched from inception to April 2026. The eligible studies were synthesized using the convergent integrated approach recommended by the Joanna Briggs Institute (JBI), and the integrated findings were subjected to thematic analysis guided by the Social Cognitive Theory (SCT). RESULTS: A total of 16 studies were included (12 quantitative studies and 4 qualitative studies). Guided by the Social Cognitive Theory, the synthesized findings indicated that the factors influencing digital health literacy in stroke patients could be classified into three dimensions: personal, environmental, and behavioral factors. Personal factors encompassed sociodemographic and health-related characteristics, psychological and self-regulation characteristics, and technology-related attitudes and digital health capability. Environmental factors included family and social support as well as the information and service environment. Behavioral factors comprised proactive information behaviors and interactive and communication behaviors. CONCLUSION: Digital health literacy in stroke patients is influenced by the combined effects of personal, environmental, and behavioral factors. In clinical practice, particular attention should be given to digitally disadvantaged populations, and targeted interventions tailored to patients' individual characteristics and digital health needs should be implemented to improve their digital health literacy and capacity to use digital health resources. Further high-quality studies are warranted to inform the development of precise intervention strategies and the optimization of rehabilitation management. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261412446, identifier PROSPERO (CRD420261412446.