Digital health literacy as a predictor of cyberchondria trajectories: evidence from novice and advanced nursing cohorts

Abstract

BACKGROUND: The growing integration of digital technologies in healthcare has led nursing students to increasingly seek health information online. While this supports self-directed learning, it also raises concerns about cyberchondria anxiety triggered by excessive or unregulated online health information searching. Health literacy is central to how students evaluate and interpret such information, yet little is known about how this relationship varies across academic stages, particularly within Arab nursing populations. AIM: This study examined the relationship between digital health literacy and cyberchondria among nursing students in Saudi Arabia and Jordan and assessed whether academic level moderates this relationship. METHODS: A cross-sectional descriptive correlational design involving 600 nursing students from health colleges in Saudi Arabia and Jordan was utilized. Validated tools measured e-health literacy and cyberchondria. The data were analyzed via descriptive statistics, Pearson correlation, and moderation analysis via the PROCESS macro in SPSS. RESULTS: A significant negative correlation was found between digital health literacy and cyberchondria (r = - 0.838, p < 0.001), indicating that higher health literacy was associated with lower cyberchondria levels. Academic level significantly moderated this relationship (B = 0.75, SE = 0.30, p = 0.014). Novice students were more vulnerable to cyberchondria when health literacy was low, whereas advanced students showed more adaptive responses, suggesting that academic progression enhances digital discernment and reduces susceptibility to digital health-related anxiety. CONCLUSIONS: Higher digital health literacy was associated with lower cyberchondria among nursing students, and this relationship varied by academic level. Academic progression may strengthen students' ability to critically evaluate online health information and reduce anxiety related to online health searches. IMPLICATIONS: The findings highlight the importance of early integration of digital health literacy training, critical appraisal skills, and resilience strategies into nursing curricula to reduce cyberchondria and promote digital well-being in academic and clinical settings. CLINICAL TRIAL NUMBER: Not applicable.