Associations between e-Health literacy, self-efficacy, and quality of life among hemodialysis patients: A cross-sectional study from Northern Jordan

Introduction: Chronic kidney disease (CKD) is a growing global health issue that significantly impairs quality of life (QoL), particularly among patients undergoing dialysis. This study examines the relationships between e-health literacy, self-efficacy, and QoL in this vulnerable population. Objectives: To examine associations among e-health literacy, self-efficacy, and health-related quality of life (HRQoL) among patients receiving hemodialysis in Northern Jordan. Methods: A cross-sectional study was conducted among 184 adult HD patients recruited from four hospitals in Northern Jordan. Data were collected using validated Arabic versions of the eHealth Literacy Scale (eHEALS), the Self-Efficacy for Managing Chronic Disease Scale (SEMCD-6), and the Kidney Disease Quality of Life-36 (KDQOL-36). Spearman correlation was used to examine associations between variables. Multiple linear regression was performed to identify independent predictors of KDQOL-36 total scores. Results: Among 184 participants (mean age 49.9 years, 65% male), the mean self-efficacy score was 25.52 (SD = 1.8) and the mean e-health literacy score was 3.62 (SD = 0.58). The mean KDQOL‑36 total score was 105 ± 17, with domain scores of 39 ± 7 for Symptoms/Problems, 25 ± 6 for Effects of Kidney Disease, 11 ± 3 for Burden of Kidney Disease, 29 ± 5 for Social Function, 12 ± 3 for the Physical Component Summary, and 21 ± 4 for the Mental Component Summary. Multivariable regression identified independent predictors of higher quality of life: graduate-level education (B = 8.06, 95% CI: 2.32–13.80, p = 0.006) and employment (B = 7.14, 95% CI: 2.10–12.20, p = 0.006). Diabetes was independently associated with lower quality of life (B = −5.92, 95% CI: −10.90 to −0.95, p = 0.020). Although significant in unadjusted analyses, e-health literacy and self-efficacy were not independent predictors after adjustment for socioeconomic and clinical factors. Conclusion: Health-related quality of life among HD patients appears to be influenced primarily by socioeconomic and clinical factors, particularly educational attainment, employment status, and diabetes mellitus. Although e-health literacy and self-efficacy were associated with HRQoL in unadjusted analyses, these associations were attenuated after adjusting for socioeconomic and clinical characteristics. Interventions that address educational disparities, support patient engagement, and optimize comorbidity management may improve health outcomes among patients receiving hemodialysis.