The mediating role of digital health literacy on the relationship of social isolation and digital technology anxiety among older cancer patients

Digital health technology has become increasingly important in cancer care and health management. However, older cancer patients may experience technology anxiety, which can reduce their willingness to use digital health services and limit access to technology-supported care. This study aimed to examine the mediating role of digital health literacy in the relationship between social isolation and technology anxiety among older cancer patients. A cross-sectional survey was conducted among older cancer patients hospitalized at five tertiary hospitals in Guangdong Province, China. Using convenience sampling, a total of 319 valid questionnaires were collected. Data analysis was performed using SPSS 26.0 and AMOS 26.0, and structural equation modeling was used to test the hypotheses. The total scores of technology anxiety, social isolation, and digital health literacy of older cancer patients were 45.90 ± 9.21, 19.36 ± 5.46, and 44.19 ± 12.55, respectively, all at a moderately high level. Technology anxiety was negatively related to social connectedness (r=-0.268, p < 0.001) and digital health literacy (r=-0.292, p < 0.001). Digital health literacy mediated the relationship between social isolation and technology anxiety, where the mediated effect was − 0.096 (95% CI: -0.165-0.049). Older cancer patients may experience considerable technology anxiety, particularly when they are socially isolated and have limited digital health literacy. Social isolation may be associated with higher technology anxiety partly through reduced digital health literacy. Healthcare professionals, especially nurses, should identify patients with limited social support and provide family-involved digital skills training and individualized guidance. Improving digital health literacy and reducing technology anxiety may promote older cancer patients’ use of telemedicine, patient portals, online appointment systems, and other digital health services, thereby supporting continuity of cancer care.