1

SCHOOL OF NURSING

RESEARCH PROPOSAL
KNOWLEDGE ON E-HEALTH AMONG NURSING STUDENTS IN IIHS
SRI LANKA.

Authors’ Names –
Yewona Rodrigo, Minoshi Peiris, Kavindi Jayasinghe, Ashani Kavindya.
Admission Numbers –
HDN01035
HDNO1040
HDNO1016
HDNO1032
Module –
Sociology
Telephone Numbers –
0712799710
0761059151
0711269976
0742400077
Email Address –
yewona300@icloud.com
Minoshipeiris28@gmail.com
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Rasangikakavindi8@gmail.com
Akweerasingha1228@gmail.com
Supervisor’s Name – Ms Rebecca Desilva
This Research is Carried out as Part of the Coursework, Followed at the International Institute
of Health Sciences, Sri Lanka
Date of Submission -2023/12/15

Contents
Acknowledgment............................................................................................................................2
1) Introduction............................................................................................................................4
1.1) Background......................................................................................................................4
1.2) Justification......................................................................................................................6
1.3) Problem statement............................................................................................................7
1.4) Research questions...........................................................................................................7
1.5) Objectives..........................................................................................................................7
1.6) Problem analysis tree (fishbone diagram)..........................................................................8
2) Literature review....................................................................................................................9
3) Methodology..........................................................................................................................12
3.1) Hypothesis..........................................................................................................................12
3.1) Study design.......................................................................................................................12
3.2) study population.................................................................................................................13
3.4) study sample.......................................................................................................................13
3.5) Inclusion and exclusion criteria......................................................................................13
3.6) Data collection and Data collection methods...................................................................14
3.7) Data analysis plan.............................................................................................................14
3.8) Operationalization of variable..........................................................................................14
3.9) conceptual framework.......................................................................................................15
3.10) Reliability and validity.....................................................................................................15
3.11) Ethical considerations.....................................................................................................16
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3.12) Maintenance and fate of data.........................................................................................16

3.13) Dissemination of data......................................................................................................16
3.14) Limitation.........................................................................................................................17
4) References.............................................................................................................................17
5) Appendices...............................................................................................................................21
5) Annexure...............................................................................................................................22
Part I – Information sheet........................................................................................................22
Part II - CERTIFICATE OF CONSENT................................................................................24
6) Annexure- II..........................................................................................................................25
6.1) eHealth Literacy Scale (eHEALS)....................................................................................29
6.2) Permission letter................................................................................................................29

1) Introduction
1.1) Background
E-health is characterized as the application of information and communication technologies
(ICT) to the advancement of health to increase the efficacy and efficiency of healthcare
administration and provision. E-health supports equity in the provision of healthcare by
enhancing health surveillance health system management, health decision-making, and
standardized exchange of health information. E-health has the potential to increase healthcare
worker retention in locations with limited resources reduce professional isolati8on, and improve
access to healthcare. Additional advantages of e-health include the potential for online health
education, the expansion of healthcare delivery options health compliance, follow-up, and
appointments. (Chen Wang, 2022) E-health is a crucial component of effective healthcare
administration and delivery in all countries, and it improves access to information for healthcare
professionals to improve the results of health interventions. However and if medical personnel
have a favourable attitude toward e-health and have the ability to use information and
communication technology tools and it may be possible to employ e-health tools effectively.
(Hesse, 2007) Although e-health has the potential to increase the efficacy and efficiency of
healthcare administration and delivery and it has been noted that despite playing crucial roles in
healthcare practices, acceptability of e-health among healthcare professionals remained
restricted. If an evaluation of the attributes of e-health leads to its approval, healthcare
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professionals might use the innovation to improve the quality of healthcare service delivery. In
addition to the five characteristics of innovation proposed by Rogers, we introduced healthcare
professionals ICT skill in the model. We hypothesized that ICT skills will positively influence
the adoption of e-health. In our model the level of ICT use by healthcare professionals was
considered as the dependent variable. (Bartosiewicz, 2021) Therefore and it is unknown if
attitudes or ICT proficiency affect healthcare workers' use of e-health. The purpose of this study
was to ascertain the relationship between the attitudes of healthcare professionals and e-health.
E-health plays a key role in healthcare decision making and disease prevention practices such as
hand hygiene and mask use and other preventative measures. The term E-health is used to
describe the active rise in internet users actively seeking for and using health information.
(Geoffrey, 2015)
The importance of improving health literacy has been recognized as a key goal for the 21st
century. This involves understanding how people access and use health information, especially
through electronic resources like the internet. Such resources are increasingly crucial for the
general population and are particularly valued by Youngers. These sources of health information
empower individual by helping them make informed decisions and take charge of their health.
(Tubaishat, 2016)
A number of changes have been made to the nursing field over the past few decades, and more
will be made in the future. Patients are being cared for at home, hospitals are becoming more
specialised, and primary care will play a significant role. Every one of the nursing core
competencies must include health informatics and all forms of eHealth. (Anderberg, 2019)
E-health may involve inter-professional contact, such as online referrals, prescriptions, and the
sharing of patient health documentation. Additionally, it can promote the availability of
databases, expertise, and information for doctors that aid in the delivery of health services.
Internet heath sites can strengthen patient participation in the management plan, replace in-
person consultations, and enforce more patient participation. (Fahad Alazmi, 2017)
And also especially mobile health, often known as mHealth, is the use of mobile devices to
enable patients to electronically request services, use apps to validate information, and manage
or monitor therapy, difficulties or health- related issues. The use of telecommunication
technologies to advance patient care and professional training in the region is known as
telehealth. Telehealth is also including under the E-health. E-health strategies must be developed
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in an integrated manner, including the creation of norms, laws or regulations in order to

successfully execute the use of information technologies in healthcare. This condition is true for
telehealth and mHealth as well as for ore areas like electronic medical records or health literacy.
And also E-health become a crucial component of healthcare system because it addresses a
number of medical challenges, such as lowering errors and delivering better services with more
precise outcomes. (Fonseca, 2021)

1.2) Justification

The use of information technology has fundamentally altered many peoples' working and
thinking processes. Technology has advanced to a new level throughout time and is now
available everywhere. India and other developing nations have kept up with global technological
advancement. Because they are essential to e-health, healthcare practitioners cannot ignore the
use of information technology to healthcare any longer. With the aim of evaluating healthcare
professionals' understanding, use and necessity of computers this study was done to shed light on
the perspective and consequences of computers among healthcare professionals. 240 healthcare
professionals, including doctors, nurses, lab technicians, and pharmacists, participated in a cross-
sectional study. Semi structured pretested interview questions were used with each participant.
57.91% of the 240 healthcare workers were computer literate. 22.08% of them possessed in-
depth understanding, and 35.83% had only incomplete knowledge. The age group of 20 to 25
years had higher computer expertise (high knowledge: 43.33%; partial knowledge: 46.66%). Of
the 99 males, 21.21 percent had good knowledge, and 42.42 percent had some knowledge. Most
medical professionals, including nurses used computers for research. The remaining healthcare
professionals primarily utilized it for email, Internet, and amusement. The majority of healthcare
workers (95.41%) asked for computer training, believing that it would improve both their
knowledge of computers and their ability to have a brighter future. In India, 240 healthcare
professionals participated in a cross-sectional study that included interviews and a pretested,
 6

semi structured Performa. In terms of computer knowledge, 58% had some knowledge, 22% had
good knowledge, and 36% had only some knowledge. Men who owned computers and those
aged 20 to 25 had higher levels of computer literacy. Most doctors and nurses used computers
for their studies, and a bigger percentage of healthcare workers (95%) thought that getting
computer skills would help them in their careers. (Srivastava, 2010)

This study aids individuals in self-awareness of their level of expertise and mind-
set regarding e-health. This topic hasn't yet been the subject of any in-depth investigation in Sri
Lanka. It is essential to conduct this research because of this. It is crucial to pay attention to
students in general, especially nursing students, due to their position in society and
understanding of fundamental medical issues. They are essential individuals who possess a high
degree of knowledge, a perspective on health and care concerns, and experience in these fields.
Then, for the benefit of the next generation, they can alter their understanding and attitude
regarding e-health. (Fatjona Kamberi, 2022)

1.3) Problem statement

E-health has grown in importance in modern healthcare settings and refers to the use of digital
technology and electronic systems in healthcare. In order to successfully adapt to the changing
healthcare landscape, nursing students, as future healthcare professionals, need to have the
necessary knowledge and attitudes towards e-health. Regarding the current level of knowledge
and attitudes among nursing students about e-health, there is, however, a lack of thorough
comprehension.

Examining nursing students' current level of familiarity with e-health technologies, their
perceptions of the advantages and difficulties of e-health, and their attitudes toward integrating e-
health into nursing education and practice, this research aims to investigate the knowledge and
attitudes of nursing students toward e-health.

1.4) Research questions

1. What is the level of knowledge among nursing students regarding e-health?

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2. What are the attitudes of nursing students towards the adoption and utilization of e-health
technologies?

3. What are the potential factors influencing the knowledge and attitude of nursing students
towards e-health?

1.5) Objectives

General Objectives.

 To assess the knowledge and attitude on E-health among nursing students in IIHS.

Specific Objectives.

 To assess the knowledge on E-health among nursing students in IIHS.

 To assess the attitude on E-health among nursing students in IIHS.

1.6) Problem analysis tree (fishbone diagram)

Limited resources Lack of exposure

Inadequate
during academic Technological barriers
training

Outdated training materials

Lack of quality less support lack of data
Less communication lack of programs limited access Limited
knowlede
to technology regarding
E-health
among
Lack of clear nursing
students
Communication poor coordination limited economic factors

Limited patient Ineffective Limited career Ineffective

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Document errors limited professional connection

Poor management
Unclear roles
 9

2) Literature review
The nursing profession has undergone numerous changes over the past few decades, and more
changes are on the horizon. Patients are being cared for at home, hospitals are becoming more
specialized, and primary care will play a significant role in the future.(Burzyńska et al., 2023)
All nursing core competencies require a strong foundation in health informatics and E-health in
all of its forms. We will define E-health as ‘’’the use of information and communication
technologies [ICT] for health’’ by the world health organization [WHO]. (Peter, 2019)

The benefits of new technology can include better quality of life, safer and more efficient
healthcare, and higher socioeconomic efficiency. Though health- related information is
particularly sensitive, and improper management of data can have major repercussions for the
individual, greater digitization and development in the E-health sector provide new ways of
producing knowledge and providing care.(Jin & Kim, 2018) Disease may be prevented, medical
quality and patient safety can be improved, and health care can become more effective,
coordinated, accessible, and transparent with the help of the information that is now digitally
available. Nursing students must be knowledgeable about E-health and new technology to fulfil
future expectations. Although undergraduate students nowadays are regarded as digital natives,
there is still a need to improve education in the subject. (Peter, 2019)

Information and communication technology has been referred to as the tool for E-health to
improve healthcare management. Many industrialized nations, particularly those who made
significant investment in their E-health systems, saw the use of technology in healthcare settings
as a critical objectives for delivering high quality healthcare services. It was discovered that E-
health has a beneficial impact on raising the effectiveness and calibre of healthcare services.
Furthermore, it has been demonstrated that E-health or digital health technologies offer chances
to improve health system. E-health is becoming more and more necessary.(Atinga et al., 2020)
E-health provide a contribution to healthcare services by making sure that they are delivered in a
safe and affordable way. One of the first stages toward the adoption of digital technology is the
deployment on E-health in healthcare services. (Grood, 2016) The lack of clarity in the definition
and usage of words linked to E-health was noted despite the potential advantages of E-health will
 10

improve healthcare systems, there are obstacles to its implementation. In addition, the E- health
activities go beyond advantages. (Sarah, 2022)

Nurses are crucial in teaching patients and their families how to obtain and assess the reliability
of E-health information since they are managers of health communication. Because they are
responsible for health communication in their nursing practice, nursing students themselves must
also have a high degree of E-health literacy. The most important period for health is during
college since adopting desirable lifestyles and healthy activities is simple. Thus, implementing
health-promoting behaviours is essential at this age to ensure good health for rest of one’s life.
Additionally, nursing students have the chance to become role models for health promotion after
graduating and becoming healthcare professionals with the obligation to improve others health
(Alanezi, 2021). Therefore, it is crucial to teach nurses healthy habit. Investigating hoe E-health
literacy affects nursing student engagement in health- promoting behaviours is crucial to achieve
this. (Sunghee Kim, 2021)

More students are becoming aware of the importance of health literacy and E-health literacy as
public health issues and factors affecting health inequalities. Health literacy abilities and
deficiencies can differ significantly between people and populations, and they frequently follow
socioeconomic gradients. People who have lower levels of health literacy, which is defined as
the capacity to comprehend, access, evaluate, recall, and use health information and services, are
more likely to have higher disease risk factors, experiences worse health outcomes, and engage
less in preventative treatment. Additionally, it is well- established that there are gaps between
intended users reading abilities and the readability of health resources, as a result of community
members increased demand for access to healthcare through digital platforms and the shift
toward the provision of health information and services exclusively through digital platforms. In
order to satisfy demands of consumers of health and social care, the next generation of health
professions students will need to be digitally literate.(Ross et al., 2016) The use of digital
technology by administrative, technical, educational, research, and health profession staff must
also spread throughout healthcare facilities. (Carey Ann, 2022)

College students should take care to conduct efficient internet searches to get health-related
information because the age. Now favours the internet as a source of knowledge. Internet health
resources are favoured by college students of the new generation. Although it is probably safe to
 11

assume that college students have easy access to web-based portals connecting E-health
information, it is crucial to remember that access alone does not guarantee that college students
are skilled at searching for locating, analysing health information. Medical practitioners are more
and more accountable for locating and assessing E-health information resources as electronic
medicals and health records, mobile medical apps, and associated health informatics
technologies proliferates. Due to this, health practitioners are now required to have E-Health
literacy as a crucial set of skills in order to get accurate and trustworthy health information in a
Web-based setting. (Michael, 2011)

The ability to use and navigate electronic platforms is a necessary skill set for nursing students if
they are to properly obtain and apply health information in their practice. To give the greatest
care possible, this entails evaluating sources critically and keeping up with trustworthy news. It’s
vital for nursing students to learn how to use technological platforms, analyse sources critically,
and keep up with current medical knowledge. These ability enable them to deliver the best care
and render wise judgement in their practice. (Rathnayake, 2019)

Many development nations, particularly those made significant investments in their E-health
system, highlighted the use of technology in healthcare settings as a top priority in their quest to
deliver high-quality healthcare services. Additionally, it has been demonstrated that E-health or
digital health technologies offer chance to improve health system. E-health deployment is
becoming more and more necessary.(Kampmeijer et al., 2016) By ensuring that medical
treatment are delivered in a secure and cost-effective way, eHealth and eHealth both support the
provision of healthcare services. One step towards the application of digital technology is the
adoption of eHealth in healthcare services. It was noted that despite the potential advantages of
eHealth, there is a lack of consistency in the definition and usage of terms linked to eHealth as a
result of the industry’s explosive growth. (Lekalakala-Mokgele, 2023)

Online resources for health information are frequently used by nursing students. They rely on the
internet is a resources for information in clinical setting and to assist their research. Nursing
students who educate the public about health, care for patients and their families, and offer
consultation to help the public find and use accurate health information online should have their
eHealth literacy levels assessed and made better.(Mauco et al., 2020) As future providers of
healthcare, nursing students are expected to be adept at locating, comprehending, evaluating, and
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using online resources connected to health in order to advance affordable, high-quality, and
secure care. (Ozlem Sinan, 2023)

The ability to evaluate health information from various electronic sources and use the learned
skills to address or solve a health problem is noted as e-Health literacy. E-Health literacy is
defined as "reading, understanding, and applying the information that individuals receive about
their health." Utilising e-Health literacy among college students is crucial for sustaining healthy
behaviour and a high standard of living. Studies demonstrate that health literacy skills help
university students build healthy habits and boost their health understanding. (Shudayfat, 2023)

People who are eHealth literate can find reliable health information using web-based search
techniques. The internet is a suitable choice for finding health information because of some
advantages like low cost, quick search times, and anonymous information access. People who are
highly literate in E-health are more likely to adopt healthy eating, exercise, and sleep habits.
(Buyl et al., 2020) And also this understanding of E-health can be a step towards improving
people’s quality of life in society. (Filabadi, 2020)

3) Methodology
3.1) Hypothesis

Null hypothesis

There is no significant relationship between E-health among nursing students.

Alternative hypothesis

There is significant relationship between E-health among nursing students.

3.1) Study design

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This research will employ a cross-sectional study design to assess the knowledge and attitude of
nursing students towards e-health

3.2) study population

The study population will consist of nursing students enrolled in IIHS Sri Lanka. This includes
students from different levels of nursing education, such as undergraduate and graduate
programs.

3.4) study sample

A random sampling method will be used to select participants from the study population. The
sample size will be determined based on the desired level of precision and statistical power. It
will be carried on a sample size of 132 students calculated by using Raosoft (www.raosoft.com).

3.5) Inclusion and exclusion criteria

●Inclusion criteria

•Students of age group of 19-25 studying in the IIHS Sri Lanka.

•Nursing students who give their consent to this research.

•.Students who have a basic understanding of E-health concept.

●Exclusion criteria

●Nursing students, who don’t like new technology

●Nursing students who refuse give their consent to this research.

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● Students who provide incomplete responses in the survey.

3.6) Data collection and Data collection methods

We will administer the online survey questionnaire to the identified sample of nursing students.
The survey will administer online, through email or in-person and responses can be analysed to
determine the level of knowledge and attitude among the nursing students. As a data collection
we will develop a questionnaire consisting of closed and open-ended questions to collect data
from nursing students. It will include sections to assess participants' demographic information,
knowledge about e-health, attitudes towards e-health, and factors influencing their knowledge
and attitude. The questionnaire will be piloted with a small group of nursing students to ensure
its clarity, reliability, and validity.

3.7) Data analysis plan

The data will analysis using SPSS version 28.0 statistical software to calculate descriptive
statistics. Descriptive statistics will be used to summarize participants' demographic
characteristics, knowledge scores, and attitude scores. Inferential statistics, such as correlation
analysis and regression analysis, will be conducted to explore relationships between variables
and identify potential factors influencing knowledge and attitude towards e-health.

3.8) Operationalization of variable

Operationalization involves defining and measuring the variables in the study. The variables in
this research include knowledge about e-health, attitude towards e-health, and factors influencing
knowledge and attitude. Each variable will be defined and operationalized in a way that allows
for consistent measurement and analysis.

Concept- To assess the Variables Question numbers

knowledge and attitude E- Demographic data 1,2,3,4,5,6,7
health among nursing student Knowledge about E-health 8,9,10,11,12,13,14
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in IIHS.
Attitude about E-health 15,16,17,18,19,20

3.9) conceptual framework

Social background

Family background Access to digital services

for health sector
Cultural status

E-heath among Education and

Technological
Culture and society nursing students knowledge
motivation

Ability to process
Socio-demographic Attitude
information and data
data analysis
Age
Dependent variable
Gender Student’s attitude on E-health
Ethnicity
Marital status
Language Positive outcome Negative outcomes

1 .Improved patient care 1. Resistance to change

Independent variable
2. Efficient electronic records 2. Reduced patient
engagement
3. Improving communication
3. Loss of privacy and
4. Innovations security

3.10) Reliability and validity

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To do this, it is necessary to evaluate the E-health literacy of such people. A quick validity
screening tool that is practical to utilise is the eHEALS (eHealth literacy scale). According to the
study’s findings, eHEALS is a viable and reliability instrument that may be utilised by students.
This eHEALS has been widespread adoption, mostly among younger group. The eHEALS score
runs from 8 to 40 on a 5 point Likert scale like 1- strongly disagree, 5-strongly agree. With a
higher score indicating more literacy. (Seon-Yoon Chung, 2015)

3.11) Ethical considerations

 Informed consent will be obtained from all participants, and their confidentiality and privacy
will be protected. We are aware of not publishing any ideas of participants without their
consent. Participants must be fully informed about the purpose, procedures, potential risks
and benefits, confidentiality measures, and their rights within the study before the consent.
They should be provided with a written consent form that clearly outlines these details and be
given sufficient time to consider participation. The principle of voluntary participation should
be upheld, ensuring that individuals can freely withdraw from the study at any time without
facing negative consequences
 Any potential risks or discomfort associated with participating in the study will be
minimized.
 Research will be conducted in accordance with ethical guidelines.

3.12) Maintenance and fate of data

The information will be store data on a secure server with proper encryption and will be only
share the data with the research community to facilitate collaboration and validation of finding.
All of the analysis- related data will be saved on a password protected personal computer in a
secure manner. All research data will be delivered to the IIHS at the conclusion of the study. All
computer data will be deleted when the final report has been submitted.
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3.13) Dissemination of data

The study’s finding will be presented to the IIHS. The study’s result will be presented in national
and international scientific forums, and abstract or full manuscript will be published in peer-
reviewed journals, conferences, or website.

3.14) Limitation

 We may not be able to gather the whole population of nursing students, due the variation in
knowledge and attitude among different years or level of nursing students.
 Additionally, we will only ask willing nursing students for their answers to the questionnaire
and gather their information with their permission.
 We are using random sampling go to International Institute of Health Sciences (IIHS)

4) References

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individuals and students and in their future career. pubmed.

Bartosiewicz, A. (2021). Polish Nurses attitude to E-health solution and self-assesment of their

IT competence. pubmed.

Carey Ann, C. T. (2022). E-health literarcy of australian undegraduate health profession

students. pubmed.

Chen Wang, X. W. (2022). A comprehensive Analysis of E-health literacy research focuses and

trends. pubmed.

Fahad Alazmi, H. M.-K. (2017). Knowledge, attitude and practice of E-health among Health care

providers in Kuwait. ResearchGate.

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Fatjona Kamberi, J. G. (2022). E-health and knowledge assessment of students and academic

staff recommendations for updating nursing cuurricula. scholar.archieve.org.

Filabadi, Z. R. (2020). Relationshipp between electronic health literacy , quality of life and self

efficacy in Tehran, Iran. pubmed.

Fonseca, M. H. (2021). E-health practices and technologies. pubmed.

Geoffrey, w. o. (2015). Knowlegde and attitude of doctors toward e-health use in healthcare

delivery in goverment and private hospitals i Nothern uganda. SPRINGER LINK.

Grood, C. d. (2016). Adoption of E-health technology by physicians. pubmed, 335-344.

Hesse, B. W. (2007). eHealth Research from the User's perspective. pubmed, 97-103.

Lekalakala-Mokgele, E. (2023). Knowledge , percepption and attitude of eHealth and health

technology among nursing students from Gauteng province, South Africa. pubmed.

Michael, B. B. (2011). E-health literacy among college students. pubmed.

Ozlem Sinan, S. A.-A. (2023). Predictors of eHealth literacy level among nursing students.

Siencedirect.

Peter, G. L. (2019). Analyzing nursing students relation to electronic health and technology as

individual and students and in their future career. pubmed, 8-10.

Rathnayake, S. (2019). Self-reported eHealth literacy skills among nursing students in Sri

Lanka . pubmed, 50-56.

Sarah, D. N. (2022). Evaluating E-health literacy, knowledge, attitude and practice regaring

covid19 prevention and self protection among iranian students. pubmed.

Seon-Yoon Chung, E.-S. N. (2015). Testing reliability and validity of the literacy

scale(eHEALS) . pubmed, 150-156.

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Shudayfat, T. (2023). Electronic health literacy andits association with lifestyle behavior among

undergraduate students. pubmed .

Srivastava, D. (2010). Knowledge of computer among healthcare professionals of India.

liebertpub, 957-962.

Sunghee Kim, J. O. (2021). The relationship between E-health literacy and health promoting

behaviors in nursing students. pubmed.

Tubaishat, A. (2016). eHealth literacy among undergraduate nursing students. ResearchGate, 47-

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Atinga, R. A., Abor, P. A., Suleman, S. J., Anaba, E. A., & Kipo, B. (2020). E-health usage and

health workers’ motivation and job satisfaction in Ghana. PLOS ONE, 15(9), e0239454.

https://doi.org/10.1371/journal.pone.0239454

Burzyńska, J., Bartosiewicz, A., & Januszewicz, P. (2023). Dr. Google: Physicians—The Web—

Patients Triangle: Digital Skills and Attitudes towards e-Health Solutions among

Physicians in South Eastern Poland—A Cross-Sectional Study in a Pre-COVID-19 Era.

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Bourbonnais, A., Giguère, A., Lechasseur, K., & Gagnon, M.-P. (2020). e-Health

interventions for healthy aging: A systematic review. Systematic Reviews, 9(1), 128.

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Jin, W., & Kim, D. H. (2018). Design and Implementation of e-Health System Based on

Semantic Sensor Network Using IETF YANG. Sensors, 18(2), 629.

https://doi.org/10.3390/s18020629

Kampmeijer, R., Pavlova, M., Tambor, M., Golinowska, S., & Groot, W. (2016). The use of e-

health and m-health tools in health promotion and primary prevention among older

adults: A systematic literature review. BMC Health Services Research, 16(S5), 290.

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5) Appendices
5.1) Gantt chart

April May June July August

1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

1.Choose a
research
area
2.Identify
main topic
3.Literature
review
4.Identify
the
objectives
of the
research
5.Develop
the
research
questions
6.Start
working on
proposal
7.Draft
proposal
submission
8.Submit
final
 22

proposal

5) Annexure
INFORMED CONSENT FORM

Knowledge and attitude on E-health among nursing students

Part I – Information sheet

1. Introduction:

We are attached to the International Institute of Health Sciences. I am doing a research ‘’

Knowledge and attitude on E-health among nursing students in IIHS Sri Lanka.’’. I wish to give
you the information about the research and invite you to participate in this research. If you do not
understand any words, you can stop me and ask for an explanation. You need not necessarily
decide now whether to participate or not. Before you decide you may talk to anyone you feel
comfortable with about the research. You are free not to participate or withdraw from the study
at any time of the study without any loss of or compromise in benefits/ other services otherwise
you are entitled. If you have any questions / doubts about the research/ procedures, you may ask
me or anyone from the research team you are comfortable with now or later.

1. Investigators details:

Name- Ms. Rebecca Desilva

Institution- International Institute of Health Sciences

Email-

Phone number- 0702018768

2. Participant selection: participants will be nursing students in IIHS Sri Lanka.

3. Duration of the study: The study will begin of April 2023 and end of August 2023

4. Nature of the benefits and potential hazards and discomforts:

 23

The benefits of ‘’KNOWLEDGE ON E-HEALTH AMONG NURSING STUDENTS IN IIHS’’

improved patient care and improved communication are just a few advantages that nursing
students may experience as a result of their understanding of and favourable attitudes towards e-
health. However potential risk could include challenges with data security, privacy, and a
technology learning curve. Resistance to change the requirement for ongoing skill improvement
could cause discomfort.

5. Procedures of study and participants responsibilities:

The process for examining nursing student’s attitude and knowledge of E-health is developing
quantitative online survey like questionnaire to gather information from nursing students. It
would be the participant’s responsibility to respond truthfully and taking part voluntarily to the
survey questions. Students may withdraw their consent to participate in this study at any time
with no effect on position or loss of benefits.

6. Confidentiality:

We are dedicated to protecting the privacy of student’s information .any information gathered for
this study will only be utilised for this study’s purpose. Student’s private and information will be
securely preserved, and only authorised researchers will have access to it. If students have any
question or issue regarding the privacy of their information, they can contact any member of
committee.

7. Members of the research team:

Yewona Rodrigo

yewona300@icloud.com

0712799710

Minoshi Peiris

Minoshipeiris28@gmail.com

0761059151
 24

Kavindi Jayasinghe

Rasangikakavindi8@gmail.com

0711269976

Ashani Kavindya

Akweerasingha1228@gmail.com

0742400077

8. Clarification and further information:

If you have further questions or require more information, please don’t hesitate to contact us.

Part II - CERTIFICATE OF CONSENT

I have read the above information / the above information has been read to me and I understand
it thoroughly. I have been allowed to ask questions regarding this study and all the questions are
being answered satisfactorily.
I voluntarily give my consent to participate in this study and understand that I have the right to
withdraw from the study at any time without loss of benefit otherwise I am entitled.
……………………………………… …………………......
Signature of the participantDate
Name of the participant: ………………………………………………
 25

I confirm that the participant was given an opportunity to ask questions about the study and all
the questions asked by the participant have been answered to the satisfaction of the participant. I
confirm that the consent has been given freely and voluntarily.
A copy of this ICF has been provided to the participant.
……………………………………………………………..
Signature of the investigator Date
…………………………………………
Name of the investigator

6) Annexure- II

SELF- ADMINISTERD QUESTIONNAIRE

Serial No: ………………………. Date: ………………….

This questionnaire is about’’ Knowledge on E-health among nursing students in IIHS Sri
Lanka”. We would like you to think carefully about each question and to answer it as honestly as
you can. Your name and address do not appear anywhere on this booklet. The information that
you give will not be used in any way that could identify you.

Knowledge and attitude on E-health among nursing students in IIHS Sri Lanka

Section 1 : Socio demographic factors

1) Age at your last birthday: (in years)

2) Ethnicity:
a) Sinhalese
b) Sri Lankan Tamil
c) Indian Tamil
 26

d) Sri Lankan Moor

e) Burgher
f) Malay
g) Others………………………

3) Religion
a) Hinduism
b) Christianise
c) Buddhism
d) Islam
e) Others……………
4) Marital status
a) Single
b) Married
c) Separate
d) Widowed
e) Divorced

5) What is your study year in IIHS?

•1st year
•2nd year
•3rd year

6) How many y members are in your family?

•Only 2
•Only 3
•More than 4

7) How many family members are working in healthcare sector?

 27

•All
•1or 2
•No one

Section 2- knowledge of E-health

8) A positive viewpoint can be found on the internet?
•Yes
•No
•Don’t know

9) How important E-health for developing new healthcare goods and services?
•Very important
•Not important
•Don’t know

10) I know how to use health information and answering about health from using internet?
•Yes
•No
•Little bit

11) Are you interest in particular E-health issue to learn or sharing experience and knowledge?
•Yes
•No

12) Are you interest in participate E-health training programs?

•Yes
•No

13) Have you any idea or previous experience about E-health?

 28

•Yes
•Not yet
•No idea

14) Do you know about fields of use of E-health?

•Yes
•No
•Not sure

Section 3- attitude about E-health

15) I have confident using internet for health sector and get information correctly?
•Yes
•No
•No idea

16) Do you agree with E-health fields and their advantages for you as a nurses?
•Strongly agree
•Strongly disagree
•Don’t know

17) How do you affected by digital technology for your healthcare education as a nurse?
•Strongly
•Normal
•Not strongly

18) I prefer to use new technology for my family healthcare

•Always
•Sometimes
 29

•Never

19) What is your level of familiarity of E-health?

•Very familiar
•Little bit familiar
•Don’t know

20) Do you feel satisfied with your technological motivation?

 No
 Of course yes
6.1) eHealth Literacy Scale (eHEALS)

1 point- strongly 5 point- strongly

disagree agree
21) I’m aware of the online health resources
that are available

22) I’m aware of where to access useful online

resources
23) I can use the internet to find the answers to
my health related questions.
24) I am aware of how to use online health
resources to my advantage
25) I feel comfortable making health decisions
using online information
26) I can differentiate between high quality and
low quality health resources on the internet
27) I possess the knowledge and abilities
required to assess the quality of the health
materials I locate online.
28) I can trust the health information on the
online websites.

6.2) Permission letter

No.137
 30

Francis Road

welihena kochchikade

Sri Lanka.

05/12/2023

Dear Sir/Madam,

REQUESTING PERMISSION FOR DATA COLLECTION FOR A RESEARCH STUDY

Yewona Rodrigo, Minoshi Peiris, Kavindi Jayasinghe and Ashani Kavindya are students who are
following Diploma in General Nursing at the International Institute of Health Sciences, Welisara.
We are hoping to conduct a research on the topic “Knowledge on E-Health among nursing
students in IIHS Sri Lanka‘’ as a part of an academic requirement. I would be grateful if you
could review my proposal (herewith) in view of granting ethical clearance for the study.

The study involves collecting data from nursing students in IIHS using self-administered
questionnaires.

Thank You,

Yours faithfully

……………………………

Minoshi Peiris

0761059151

Minoshipeiris28@gmail.com

6.3) Ethical clearance request letter

Request letter for ethical clearance

 31

Minoshi Peiris

5th December 2023

Chairperson,

Ethical Review Committee,

International Institute of Health Sciences,

No 704, Negombo Road,

Welisara,

Sri Lanka

Dear Sir/Madam,

REQUESTING ETHICAL CLEARANCE

I Miss Minoshi Peiris a student following Diploma in General Nursing at the International
Institute of Health Sciences, Welisara, I am hoping to conduct a research on the ‘’ Knowledge
and attitude on E-health among Nursing students in IIHS Sri Lanka’“ as a part of an academic
requirement. I would be grateful if you could review my proposal (herewith) in view of granting
ethical clearance for the study.

The study involves nursing students in IIHS Sri Lanka. There are no significant ethical issues.
More details are included in the completed form submitted herewith.

Thank You,

Yours faithfully

……………………………

Minoshi Peiris
 32

0761059151

Minoshipeiris28@gmail.com