Practical Digital Competence and Psychosocial Well-Being Among Adults with Severe Disabilities: Cross-Sectional Indirect Associations Through Perceived Self-Determination in Daily Life

Vollständiger Abstract

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Background/Objectives: Digital inequalities are increasingly recognized as a health-equity issue, yet self-reported practical digital competence and psychosocial well-being among adults with severe disabilities remain understudied. This study examined their cross-sectional association and indirect associations through perceived self-determination in daily life and subjective social isolation in a parallel model. Methods: Cross-sectional data from 1519 adults in a 2023 Seoul survey were analyzed. Self-reported practical digital competence was assessed with six task-ability items, perceived self-determination in daily life with one item, and subjective social isolation with two items. Adjusted product-of-coefficients models used 2000 bootstrap replications to calculate bias-corrected confidence intervals. Results: Self-reported practical digital competence was positively associated with psychosocial well-being (b = 0.085, p < 0.001). The indirect association through perceived self-determination in daily life was significant in the main analysis (estimate = 0.076, BC 95% CI [0.050, 0.106]) and remained significant across all sensitivity analyses. Self-reported practical digital competence was not significantly associated with subjective social isolation (b = −0.026, p = 0.203), and the corresponding indirect association was nonsignificant (estimate = 0.006, BC 95% CI [−0.003, 0.016]) and inconsistent across specifications. The direct association was near zero and nonsignificant after both psychosocial variables were included. Conclusions: The indirect association through perceived self-determination in daily life was consistent across analyses, but this single-item measure should be interpreted as a narrow indicator of perceived autonomy or control rather than the broader multidimensional construct of self-determination. Evidence for subjective social isolation was limited and specification-sensitive, and simultaneous measurement precludes temporal or causal interpretation. Digital inclusion efforts may benefit from combining practical digital skills with opportunities to support meaningful goals and everyday choices. Broader relational and environmental supports may also be needed for subjective social disconnection, and longitudinal and intervention research is warranted.