Attitudes toward distance healthcare services in the general population: a cross-sectional study from Alanya, Türkiye

Distance healthcare services have gained importance worldwide, particularly following the COVID-19 pandemic. They offer opportunities to improve access for disadvantaged groups such as the elderly, the chronically ill, and people with disabilities. Understanding the factors shaping these attitudes is essential for designing effective, equitable digital health services. This study aimed to determine such attitudes in a general population sample. This cross-sectional descriptive study was conducted between December 2025 and January 2026. Participants were attendees of the Family Medicine Outpatient Clinics of Alanya Training and Research Hospital, Türkiye. Data were collected through face-to-face interviews and an online questionnaire using the Distance Healthcare Attitude Scale (DHAS). This scale was originally developed by Alp and colleagues for healthcare workers and applied here to a general population. Confirmatory factor analysis, internal consistency analysis, and hierarchical binary logistic regression examined attitude structure and its association with e-Nabız use. The overall attitude score was moderate-to-high, with the Trust subscale showing the lowest mean. Participants accepted the system’s functionality but were less inclined to prefer distance over face-to-face care. They also remained more sceptical about its capacity to convey clinical information. Significant educational-group differences emerged in all four subscales and the total score, with primary school graduates scoring higher than associate and bachelor’s degree graduates. Age differences were significant only for the Knowledge and Competence subscale, whereas sex, chronic disease, and disability status showed no significant associations. Active e-Nabız users reported significantly higher attitude scores than nonusers. In hierarchical logistic regression, demographic variables alone did not predict e-Nabız use. Adding the attitude subscales significantly improved model fit, although the full model remained marginally non-significant. Attitudes toward distance healthcare appear multidimensional rather than unidimensional, reflecting a complex interplay of cognitive, emotional, sociodemographic, and experiential factors. The relatively low Trust scores point to a key obstacle to broader adoption. This obstacle concerns confidence in clinical equivalence rather than technical flaws, as participants doubted the platform’s ability to replace in-person consultations. Prior experience with digital health platforms was the strongest correlate of positive attitudes, although the cross-sectional design precludes causal inference.