Effect of e-health literacy on preoperative anxiety in patients undergoing gynecologic surgery: A cross-sectional study

Background: Preoperative anxiety (PA) is a common condition that can negatively affect surgical outcomes. As digital health resources become more integrated into patient care, e-health literacy (eHL) is gaining importance as a determinant of surgical readiness and emotional well-being. This study aimed to evaluate the relationship between eHL and PA in patients undergoing elective gynecologic surgery. Methods: This cross-sectional study was conducted at a tertiary hospital between June and November 2024. Patients scheduled for elective gynecologic surgery were included. Participants completed the sociodemographic form, eHealth Literacy Scale (eHEALS), and the State-Trait Anxiety Inventory (STAI-I and STAI-II) during their preoperative anesthesia consultation. Results: A total of 325 patients scheduled for elective gynecologic surgery were included. The mean eHEALS score was 35.1 ± 8.4, with 47.7% of patients classified as having high eHL. Patients with higher eHL were significantly younger ( P < 0.05), had lower BMI ( P < 0.05), and had higher educational attainment ( P < 0.05). High eHL was associated with lower state anxiety scores (38.3 ± 8.6 vs. 47.2 ± 7.7, P < 0.05) and trait anxiety scores (42.2 ± 7.7 vs. 49.4 ± 8.2, P < 0.05). Patients with higher eHL reported lower postoperative pain scores and were more likely to perceive themselves as well-informed about their surgery ( P < 0.05). Conclusions: Higher eHL is significantly associated with lower PA in patients undergoing gynecologic surgery. These findings highlight the importance of digital health competencies in surgical preparedness.