Document Type : Scientific Research
Authors
1 Associate Professor in Psychology, Faculty of Education and Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
2 Ph.D. Student in Psychology, Faculty of Education and Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
Abstract
Objective: Searching for symptoms related to health and illness, despite access to thousands of diverse information on the Internet, often causes confusion and uncertainty due to the high correlation of existing symptoms related to illnesses, and subsequently, causes cyberchondria in individuals. People with cyberchondria are very concerned about developing physical and sometimes psychological illnesses. Cyberchondria has been found to be more prevalent in young people, women, people with low education, and people with low digital literacy. The results showed that students with cyberchondria along with health problems scored high on the total scale and the subscale of confusion and uncertainty about medical services. Given the important role health plays in people's lives, it's no surprise that most people have health concerns at some point. One factor that is likely to be associated with cyberchondria is health anxiety. Health anxiety is defined as the persistent fear of developing a disease or worsening an existing disease. Given the increase in cyberchondria and health anxiety, it is very important to identify the factors that cause cyberchondria and health anxiety. Therefore, the aim of this study was to investigate the structural relationship between health anxiety and cyberchondria with the mediation of health literacy and metacognitive beliefs in students. Method: The present study was descriptive and used correlation and structural equation modeling. The statistical population of the study included all students of Khoy Azad University in the second semester of the academic year 1402-1403. Using the convenience sampling method, 200 students were selected as samples according to the inclusion and exclusion criteria of the study. Inclusion criteria: Being a student at Khoy Azad University in the academic year 2023-2024, age 18 to 30, not taking psychiatric medications and the exclusion criteria: unwillingness to continue the research and failure to complete the questionnaires completely, having a serious mental problem. While obtaining consent from the students to participate in the research, the purpose of the research was explained to them. In order to maintain ethical considerations in the research, the basic condition of informed consent to participate in the research was to maintain the subjects' personal information and confidentiality, and they were assured that their responses would only be used for research purposes. The instruments used in this study were the Cyberchondria Questionnaire of McElroy and Sholin (2014), Health Anxiety of Salkouskis and Warwick (2002), Health Literacy of Montazeri et al. (2015), and Metacognitive Beliefs of Wells and Cartwright-Haughton (2004). It should be noted that all four questionnaires were given to individuals at the same time and a brief explanation was provided if necessary. Structural equation modeling was used to analyze the data using Amos version 24 and SPSS version 24 software. Results: The results showed that there were appropriate correlations between the research variables. The correlation results show that among the exogenous variables, reading (one of the dimensions of health literacy) (-0.42) has the highest correlation coefficient with cyberchondria. In general, positive beliefs about worry (one of the dimensions of metacognitive beliefs) has the highest correlation with reading (0.56). The negative correlation means that with increasing reading, cyberchondria decreases. The fit indices of the modified model in Table 1 show that RMSEA is 0.067, CFI is 0.97, GFI is 0.94, AGFI is 0.89. The ratio of chi-square to degrees of freedom is 1.91. Comparison of the indices indicates that they have an acceptable fit..The results showed that the research model had acceptable empirical support and processing. Also, the path coefficients showed that all paths were significant (p<0.001). It can be said that health anxiety has an effect on cyberchondria through the mediation of health literacy and metacognitive beliefs. Of the health literacy components, the accessibility component (b=-0.27) had a higher effect than the other components in reducing cyberchondria. Also, of the metacognitive beliefs and health anxiety components, the need for control (b=0.22) and disease outcome (b=0.38) components have the greatest effect on the occurrence of cyberchondria in individuals, respectively. Conclusion: The results of the present study indicate the role and importance of metacognitive beliefs and health literacy education in reducing health anxiety. The present study was conducted to investigate the mediating role of health literacy and metacognitive beliefs in the relationship between health anxiety and cyberchondria. The results showed that all indicators in the hypothetical model had a good fit and the desired model was confirmed. Also, the path coefficients showed that all paths were significant. Metacognitive beliefs about uncontrollability and cognitive conflict predict health anxiety symptoms more than depression, general anxiety, anxiety sensitivity, and dysfunctional health-related beliefs. In such a way that metacognitive beliefs that can encourage maladaptive self-regulation strategies and exacerbate this anxiety in individuals. Also, low health literacy is associated with problems in the field of self-care against diseases and increased health concerns. In such a way that low health literacy leads to extreme self-care behaviors that are not only not useful but also predispose the individual to various anxiety problems and ultimately lead to frequent information search (cyberchondria). As a final conclusion, it can be stated that health literacy and metacognitive beliefs can be influential as key factors in the relationship between health anxiety and cyberchondria. It is possible to prevent the emergence of cyberchondria and reduce health anxiety by teaching how to search for information related to the symptoms of diseases on the Internet and ignoring redundant and irrelevant information related to disease and health.
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