Background/Objectives: Effective diabetes self-management requires useful knowledge and health-related literacy based on a positive attitude toward seeking health information on the Internet. Therefore, this study aimed to determine the relationship of e-health literacy (eHL) with diabetes knowledge and attitudes toward internet health information in middle-aged patients with diabetes and to identify factors influencing patient eHL. Methods: This descriptive correlational study included 185 middle-aged patients with diabetes being followed-up with in the outpatient endocrinology department at a South Korean university hospital between 14 January and 29 February 2024. Data were collected using self-report structured questionnaires and were analyzed using IBM SPSS 27.0. Results: eHL was positively correlated with diabetes knowledge (r = 0.31, p < 0.001) and attitudes toward internet health information (r = 0.62, p < 0.001). Diabetes knowledge was also positively correlated with attitudes toward internet health information (r = 0.25, p < 0.001). Attitudes toward internet health information (β = 0.55, p = <0.001), diabetes knowledge (β = 0.13, p = 0.040), and drinking status (β = 0.12, p = 0.044) were significant variables affecting eHL. Conclusions: The most influencing factor in eHL in middle-aged patients with diabetes is the patient’s attitudes toward internet health information; diabetes knowledge was identified as a significant predictor. To improve eHL in middle-aged patients with diabetes, it is important to develop nursing intervention strategies to help promote diabetes knowledge and positive attitudes toward internet health information. Healthcare providers should continuously monitor patients to ensure they acquire and utilize correct information.
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