Inadequate Digital Health Literacy – Conceptual Validity of a Nursing Diagnosis Proposal

Purpose To evaluate the conceptual validity of the proposed nursing diagnosis, Inadequate digital health literacy . Methods A concept analysis was conducted following Walker & Avant's methodological framework. An integrative literature review supported the analysis. Searches were performed in PubMed, BVS, CINAHL, Web of Science, Scopus, and Embase for studies published from 2000 onward in English, Portuguese, or Spanish. The SPIDER framework guided the search strategy and eligibility criteria. Two reviewers independently screened titles, abstracts, and full texts. Extracted data included attributes, antecedents, consequences, prevalence estimates, and empirical measures related to inadequate digital health literacy. Identified elements were organized according to the NANDA International (NANDA-I) diagnostic structure, including defining characteristics, related factors, and at-risk populations. Findings Ten essential attributes supported the development of the diagnostic definition. Seventeen consequences informed the identification of 14 defining characteristics. Sixteen antecedents supported the identification of 11 related factors and 5 at-risk populations. Empirical referents were primarily self-report instruments used to assess digital health literacy, including the eHealth Literacy Scale, the Digital Health Literacy Instrument, the eHealth Literacy Questionnaire, and the eHealth Literacy Assessment Toolkit. A model case and a contrary case were developed. Conclusions The findings support the conceptual validity of Inadequate digital health literacy as a distinct human response not fully represented by existing NANDA-I diagnoses. The proposed structure clarifies defining characteristics, related factors, and at-risk populations. Implications for Nursing Practice Recognizing Inadequate digital health literacy as a nursing diagnosis may support more accurate clinical assessment and guide interventions aimed at improving clients’ ability to access, appraise, and use digital health resources.