An Investigation of the Relationship Between e-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye

Erman Berk Çelik; Gülfem Ezgi Özaltın; Gökhan Aygül

doi:10.18621/eurj.1792352

An Investigation of the Relationship Between e-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye

Abstract

Objectives: The aim of this study was to determine the e-health literacy levels of physiotherapists in Türkiye and to examine their relationship with telerehabilitation awareness, knowledge, attitudes, and skills.

Methods: This descriptive and cross-sectional study included 106 physiotherapists who participated through an online survey between January and March 2024. E-health literacy was evaluated using the E-Health Literacy Scale, while telerehabilitation competencies were assessed with the Telerehabilitation Awareness, Knowledge, Attitudes and Skills Scale. Statistical analyses were conducted using multiple regression and ordinal regression models.

Results: The median e-health literacy score was 30 (min: 12-max: 40), the mean (±SD) was (28.79±6.44). A statistically significant relationship was found between e-health literacy and all subdimensions of telerehabilitation: awareness (η²ₚ=0.153, P<0.001), knowledge (η²ₚ=0.041, P=0.038), attitudes (η²ₚ=0.299, P<0.001), and skills (η²ₚ=0.178, P<0.001). E-health literacy explained 34.7% of the variance in these domains. Additionally, telerehabilitation awareness significantly predicted the frequency of telerehabilitation use (β=0.143, P<0.001).

Conclusions: E-health literacy plays a critical role in the readiness of physiotherapists to adopt telerehabilitation practices. Educational programs aimed at improving digital literacy and awareness may enhance the effective integration and implementation of e-health and telerehabilitation services in physiotherapy.

Keywords

Ethical Statement

This study was approved by the Mardin Artuklu University Non-Interventional Clinical Research Ethics Committee (Decision No: 2025/2-12; date: 18.02.2025). All procedures were conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. All participants provided informed consent before inclusion, confirming their understanding and willingness to participate under clearly defined conditions. The participants' data were kept confidential and used solely for scientific purposes.

Thanks

We thank all the physiotherapists who participated in the study for their contributions.

References

1. Haleem A, Javaid M, Singh RP, Suman R. Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sens Int. 2021;2:100117. doi: 10.1016/j.sintl.2021.100117.
2. Eşiyok A, Divanoğlu SU, Çelik R. Digitalization in Healthcare - Mobile Health (M-Health) Applications. Aksaray Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. 2023;15(2):165-174. doi: 10.52791/aksarayiibd.1241287.
3. World Health Organization. The impact of the COVID-19 pandemic on noncommunicable disease resources and services: results of a rapid assessment. 2020. https://www.who.int/publications/i/item/9789240010291. Accessed 25 September 2025.
4. Lubanga AF, Kafera G, Bwanali AN, et al. Embracing change, moving with time: exploring the role of digital technologies and accelerators in promoting community oral health in Africa. Front Oral Health. 2025;6:1443313. doi: 10.3389/froh.2025.1443313.
5. Aanes SG, Wiig S, Nieder C, Haukland EC. Implementing digital patient-reported outcomes in routine cancer care: barriers and facilitators. ESMO Real World Data DigiT Oncol. 2024;6:100088. doi: 10.1016/J.ESMORW.2024.100088.
6.Lee J, Lee EH, Chae D. eHealth Literacy Instruments: Systematic Review of Measurement Properties. J Med Internet Res. 2021;23(11):e30644. doi: 10.2196/30644.
7. Suso-Martí L, La Touche R, Herranz-Gómez A, Angulo-Díaz-Parreño S, Paris-Alemany A, Cuenca-Martínez F. Effectiveness of Telerehabilitation in Physical Therapist Practice: An Umbrella and Mapping Review With Meta-Meta-Analysis. Phys Ther. 2021;101(5):pzab075. doi:10.1093/ptj/pzab075
8. Elsabbagh L, AlQahtani H, Alsultan AA, et al. Effect of telerehabilitation assessment for adults with musculoskeletal conditions on access to care beyond the COVID-19 pandemic: A retrospective case-control analysis. Digit Health. 2024;10:20552076241288734. doi:10.1177/20552076241288734.

9. Timurtaş E, Selçuk H, Uğur Canöz E, et al. Synchronous and asynchronous telerehabilitation methods produce similar benefits in individuals with non-specific neck pain. Arch Orthop Trauma Surg. 2024;144(2):559-566. doi:10.1007/s00402-023-05083-7.
10. Erturan S, Burak M, Elbasan B. Breaking barriers: exploring physiotherapists' willingness and challenges in embracing telerehabilitation in a developing country. Ir J Med Sci. 2024;193(3):1359-1367. doi:10.1007/s11845-023-03589-y
11. Estrela M, Semedo G, Roque F, Ferreira PL, Herdeiro MT. Sociodemographic determinants of digital health literacy: A systematic review and meta-analysis. Int J Med Inform. 2023;177:105124. doi:10.1016/j.ijmedinf.2023.105124.
12. OECD, The COVID-19 Pandemic and the Future of Telemedicine, OECD Health Policy Studies, OECD Publishing, Paris. 2023. doi.org/10.1787/ac8b0a27-en.
13. Tekin HC. Kronik Hastaların Uzaktan İzlemine Yönelik Teletıp Platformu [Telemedicine Platform for Remote Monitoring of Chronic Patients]. DEUFMD. 2020;22(64):37-46. doi:10.21205/deufmd.2020226405
14. Zaimoğlu BN, Özer Z. Kronik Hastalığı Olan Bireylerde E-Sağlık Okuryazarlık ve Hasta Aktivasyon Düzeylerinin İncelenmesi [Investigation of E-Health Literacy and Patient Activation Levels in Individuals with Chronic Disease]. Nefroloji Hemşireliği Dergisi. 2023;18(1):12-21. [Article in Turkish]
15. Malema MP, Frantz J. Perceptions and Knowledge of Health Professionals about Telerehabilitation in Limpopo Province, South Africa. Open Public Health J. 2025;18:e18749445359378. doi:10.2174/0118749445359378241205104328.
16. Süzer A, Buker N. Investigation of Physiotherapists’ Awareness and Opinions on Telerehabilitation in Turkey. Turk J Health Sci Life. 2023;6(3):141-149. doi:10.56150/tjhsl.1391290.
17. Norman CD, Skinner HA. eHEALS: The eHealth Literacy Scale. J Med Internet Res. 2006;8(4):e27. doi: 10.2196/jmir.8.4.e27.
18.Uskun E, Doğan E, Önal Ö, Kişioğlu AN. e-Sağlık okuryazarlığı ölçeği: 45 yaş üstü yetişkinlerde Türkçe geçerlik ve güvenirlik çalışması [e-Health literacy scale: Turkish validity and reliability study for adults over 45]. Turk Hij Den Biyol Derg. 2022;79(4):674-689. doi:10.5505/TurkHijyen.2022.75608. [Article in Turkish]
19. Zayapragassarazan Z, Kumar S. Awareness, Knowledge, Attitude and Skills of Telemedicine among Health Professional Faculty Working in Teaching Hospitals. J Clin Diagn Res. 2016;10(3):JC01-JC4. doi:10.7860/JCDR/2016/19080.7431.
20. Mutlu A, Onsuz MF, Kilinc A, Ozcan L, Tepetas M, Metintas S. Turkish validity and reliability of telemedicine awareness, knowledge, attitude and skills questionnaire. North Clin Istanb. 2024;11(1):18-26. doi:10.14744/nci.2023.79989.
21. Mair F, Whitten P. Systematic review of studies of patient satisfaction with telemedicine. BMJ. 2000;320(7248):1517-1520. doi:10.1136/bmj.320.7248.1517.
22. Cottrell MA, Galea OA, O'Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil. 2017;31(5):625-638. doi:10.1177/0269215516645148
23. O'Neil J, van Ierssel J, King J, Sveistrup H. Telerehabilitation Implementation: Perspectives from Physiotherapists Working in Complex Care. Physiother Can. 2024;76(4):359-367. doi:10.3138/ptc-2022-0072
24. Bonet-Collantes M, Niño-Pinzón DM, Chaustre-Porras AD, Salas-Poloche YA, Angarita-Fonseca A. Enhancing physiotherapists' knowledge and perceptions of telerehabilitation: A before-after educational intervention study. Physiother Res Int. 2024;29(4):e2120. doi:10.1002/pri.2120
25. Saeed W, Asif N, Malik M, et al. Knowledge, Attitude and Skills of Physiotherapists Towards Tele-Rehabilitation. J Health Rehabil Res. 2024:4(2):43-48. doi: 10.61919/jhrr.v4i2.738.
26. Odetunde MO, Okonji AM, Adeoye AP, Onigbinde AT. Acceptance and adoption of tele-rehabilitation by physiotherapists from Nigeria, a low resource setting: a mixed-method study. Bull Fac Phys Ther. 2024;29:23. doi:10.1186/s43161-024-00181-y.

Details

Primary Language

English

Subjects

Rehabilitation

Journal Section

Research Article

Authors

Erman Berk Çelik ^*
0000-0001-6115-4669
Türkiye

Gülfem Ezgi Özaltın
0000-0003-1591-4844
Türkiye

Gökhan Aygül
0000-0003-4075-204X
Türkiye

Early Pub Date

November 17, 2025

Publication Date

-

Submission Date

September 29, 2025

Acceptance Date

November 10, 2025

Published in Issue

Year 2026 Number: Advanced Online Publication

DOI

https://doi.org/10.18621/eurj.1792352

IZ

https://izlik.org/JA93PX55BR

Cite

RIS / Bibtex

APA

Çelik, E. B., Özaltın, G. E., & Aygül, G. (2025). An Investigation of the Relationship Between e-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye. The European Research Journal, Advanced Online Publication, 439-446. https://doi.org/10.18621/eurj.1792352

AMA

1.Çelik EB, Özaltın GE, Aygül G. An Investigation of the Relationship Between e-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye. Eur Res J. 2025;(Advanced Online Publication):439-446. doi:10.18621/eurj.1792352

Chicago

Çelik, Erman Berk, Gülfem Ezgi Özaltın, and Gökhan Aygül. 2025. “An Investigation of the Relationship Between E-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye”. The European Research Journal, no. Advanced Online Publication: 439-46. https://doi.org/10.18621/eurj.1792352.

EndNote

Çelik EB, Özaltın GE, Aygül G (November 1, 2025) An Investigation of the Relationship Between e-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye. The European Research Journal Advanced Online Publication 439–446.

IEEE

[1]E. B. Çelik, G. E. Özaltın, and G. Aygül, “An Investigation of the Relationship Between e-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye”, Eur Res J, no. Advanced Online Publication, pp. 439–446, Nov. 2025, doi: 10.18621/eurj.1792352.

ISNAD

Çelik, Erman Berk - Özaltın, Gülfem Ezgi - Aygül, Gökhan. “An Investigation of the Relationship Between E-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye”. The European Research Journal. Advanced Online Publication (November 1, 2025): 439-446. https://doi.org/10.18621/eurj.1792352.

JAMA

1.Çelik EB, Özaltın GE, Aygül G. An Investigation of the Relationship Between e-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye. Eur Res J. 2025;:439–446.

MLA

Çelik, Erman Berk, et al. “An Investigation of the Relationship Between E-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye”. The European Research Journal, no. Advanced Online Publication, Nov. 2025, pp. 439-46, doi:10.18621/eurj.1792352.

Vancouver

1.Erman Berk Çelik, Gülfem Ezgi Özaltın, Gökhan Aygül. An Investigation of the Relationship Between e-Health Literacy and Telerehabilitation Awareness, Knowledge, Attitudes, and Skills of Physiotherapists in Türkiye. Eur Res J. 2025 Nov. 1;(Advanced Online Publication):439-46. doi:10.18621/eurj.1792352