Association between eHealth literacy and anxiety and depression in Chinese patients scheduled for combined orthodontic and orthognathic treatment

Abstract

To investigate the level of eHealth literacy among patients scheduled for combined orthodontic and orthognathic treatment, and to explore its association with anxiety and depression, providing a basis for clinical interventions. A cross-sectional study was conducted with a final sample of 111 patients. Questionnaires including the eHealth Literacy Scale (eHEALS), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) were administered to patients scheduled for combined orthodontic and orthognathic treatment at a tertiary stomatological hospital from June 2023 to April 2025. The mean eHealth literacy score among patients was 25.76 ± 5.46. The incidence rates for anxiety and depression symptoms were 16.2% and 13.5%, respectively. Logistic regression analysis revealed that lower per capita annual household income was significantly associated with an increased risk of anxiety (OR = 9.16, 95% CI [2.30–36.52], p = 0.002) and depression symptoms (OR = 8.83, 95% CI [1.08–72.46], p = 0.042). Additionally, eHealth literacy scores were negatively correlated with anxiety (OR = 0.82, 95% CI [0.73–0.93], p < 0.001) and depression symptoms (OR = 0.64, 95% CI [0.47–0.86], p = 0.003). Our findings demonstrate that patients scheduled for combined orthodontic and orthognathic treatment experience significant psychological distress, with lower-income individuals exhibiting more severe symptoms. Better eHealth literacy appears to reduce emotional issues. These findings indicate that healthcare providers should assess patients’ ehealth literacy before treatment and focus on low-income patients.