Attitudes Toward Digital Planetary Health Before and After a Lecture Series on Environmental Awareness and Future Visions: Repeated Cross-Sectional Survey Study Regarding Twin Transformation.

End-stage renal disease (ESRD) affects 6,708 patients in Jordan, with 97.6% receiving hemodialysis (HD) []. Patients face diminished quality of life (QoL) due to treatment complexity, comorbidities, and limited self-management skills [,]. e-Health literacy (eHL)—defined as the ability to seek, understand, and apply electronic health information []—and self-efficacy (confidence in managing health tasks) [], are critical for chronic disease management. While global studies link these factors to improved outcomes [], data in Arab HD populations remain scarce. This study examines how eHL and self-efficacy interact to influence QoL in Jordanian HD patients. A cross-sectional study (April 16–September 7, 2023) enrolled 184 adult HD patients from four Northern Jordan hospitals: King Abdullah University Hospital, Princess Bassma Hospital, Al Mafraq Government Hospital, and Northern Badia Hospital. Inclusion criteria: (1) age 18–85 years, (2) Arabic literacy, (3) ≥3 months on HD. Exclusion criteria: cognitive impairment or severe psychiatric conditions. Several validated tools were employed to assess the variables in this study, including the eHL Scale (eHEALS), the KDQOL-36, and the Self-Efficacy of Chronic Disease Scale.