The 21st century has been characterized by significant advances in technology permeating most spheres of life. It affects how we behave, communicate, interact, and carry out our daily activities. Technology plays an important role in each feasible field. In the field of education, these technologies are becoming more and more integrated into the teaching and learning process, especially in higher education (1, 2).
Additionally, the revolution in computers of various types or smart phones and the advent of the internet networks can facilitate the use of the Internet to access much information in various fields by resorting to search devices and websites, which are characterized by ease of access. According to global internet statistics, internet users around the world constitute nearly 8 billion users (January 2022), and with regard to the Arab Republic of Egypt, internet users in general reached (51.9%). This indicates that the internet has become an important means in disseminating many messages and information to a large segment of individuals (3).
As a result of the above, and with the availability of the Internet, there are 7% daily searches on Google that are related to the search for health information, nearly 70,000 searches per minute, where many individuals tend to use websites to learn how to maintain their health and inquire about potential health threats and self-diagnosis in an attempt to reassure themselves, and at other times there is a misunderstanding of health symptoms, which may cause the individual to worry about his health condition and link these symptoms to symptoms of a serious disease, which results in him being exposed to the problem of cyberchondria (4, 5).
Nursing students are gaining diverse and valuable information during their education about serious diseases and conditions, these students tend to diagnose themselves when learn about different illnesses, both in formal education settings and on the Internet which can result in health anxiety. Students who frequently seek health information online often perceive themselves as having serious illnesses or fear developing them. This behavior is linked to higher levels of health anxiety. Research indicates that individuals with high health anxiety are more prone to searching for health-related information online, which can exacerbate their anxiety. This phenomenon is termed cyberchondria, characterized by heightened distress and anxiety (6, 7).
Additionally, cyberchondria is a relatively new phenomenon that is characterized by excessive or frequent internet searching for health-related information about symptoms and to diagnose serious illnesses. The internet may be a helpful resource for health information, but it can also have unintended negative effects, making those who are predisposed to hypochondria feel anxious and stressed out. According to Starcevic et al (8), a nationally representative survey of adult Americans revealed that 35 percent of participants had self-diagnosed a medical issue online in the preceding year.
Cyberchondria have a negative impact on nursing students. It can lead to heightened anxiety, stress, and even hypochondria (9). This can affect their ability to focus on their studies and perform effectively in clinical settings. Additionally, relying solely on online sources for health information can lead to misinformation and potentially harmful self-diagnosis or treatment. It is important for nursing students to learn how to critically evaluate online health information and seek guidance from healthcare professionals when needed (10).
It is generally recognized that nursing schools are demanding and put students under a lot of psychological strain, impacting their physical and emotional well-being and academic achievement. Because they study critical diseases extensively and have novel practical experiences, nursing students are more likely to suffer anxiety. According to Shadid et al (11), this disorder is sometimes referred to as hypochondriasis, nursing students' syndrome, or health anxiety.
Health literacy plays a crucial role in how individuals engage with online health information. It can either empower individuals to make informed health decisions or leave them susceptible to cyberchondria if they struggle to effectively evaluate the information encountered. Therefore, promoting and enhancing Health literacy skills among individuals, including nursing students, is essential in mitigating the negative impacts of cyberchondria and fostering healthier online health information behaviors. When individuals can effectively evaluate the credibility and relevance of online health information, they are less likely to succumb to excessive health anxiety or unnecessary worry based on their online searches (12).
Health anxiety is a psychiatric condition marked by intense anxiety in which students mistakenly connect the nebulous symptoms they experience to the symptoms of a specific disease they are studying, leading to a dread of having that sickness. Furthermore, based on their current clinical rotation, the students may revise the diagnosis of their disease. Sadly, these anxieties continue even after receiving medical assurance, which stresses the students out and impairs their ability to focus throughout training (13).
Numerous variables, including age and gender, have been related to cyberchondria. Moreover, one of the main causes of cyberchondria is smartphone addiction. Information and communications technology is employed to advance health literacy. Consequently, health literacy has increased in importance (14). People with a high level of health literacy might feel more confident in themselves since they are well-informed and follow the proper procedures. Consequently, the severity of cyberchondria may decrease. Therefore, it is essential to consider students' health literacy skills to enhance health outcomes and lessen the effects of cyberchondria on both a personal and a social level (15).
The capacity to comprehend and apply health information to make well-informed decisions about one's health is known as health literacy. It is a collection of personal competencies that enable individuals to obtain and utilize knowledge for self-care and healthcare decision-making (16). Thus, health literacy includes knowing and assessing the adequacy of health-related information and making decisions on self-care and illness management. It also involves using health services, drugs, and informed consent forms appropriately. On the other hand, low health literacy can result in a rise in drug abuse, unhealthy habits, inadequate disease management, and limited access to care services. These factors can eventually raise the risk of illness and death, worsen personal quality of life, and raise societal expenses (17).
There are many factors that can affect a student's health literacy, including their age, gender, socioeconomic status, and parent education level. However, one of the most important factors is the quality of health education they receive in university. A study by the World Health Organization found that students who received high-quality health education had better health literacy skills than those who did not. The study also found that health education can help to prevent chronic diseases, improve mental health, and reduce risky behaviors, and unwanted effects of cyberchondria (18).
A growing body of research that suggests a relationship between cyberchondria, health anxiety and low health literacy among nursing students. Nursing students who have low health literacy may be more likely to rely on the internet for health information, which can lead to anxiety and confusion about their health (19). It is important for nursing students to develop strong health literacy skills so that can effectively navigate the vast amount of health information available online and make informed decisions about their health. This can be achieved through education and training programs that focus on improving health literacy skills and providing nursing students with the tools need to critically evaluate health information found online (20).
Despite the global interest and growing body of research on cyberchondria and health literacy in various populations, including healthcare professionals and students, there is a scarcity of studies examining these phenomena specifically in Egypt. This lack of research limits our understanding of how Egyptian nursing students perceive and utilize online health information, and how this may influence their levels of health anxiety and cyberchondria.
Given the increasing reliance on digital health resources and the potential implications for healthcare education and practice, there is a clear opportunity for researchers in Egypt to explore these relationships. Future studies could investigate the prevalence of cyberchondria among nursing students, assess their levels of health literacy, explore the mediating role of health anxiety, and consider cultural factors that may shape these dynamics uniquely in the Egyptian context.
AIM OF THE STUDY
Investigate the mediating effect of health anxiety between Cyberchondria and Health Literacy among first year Nursing Students.