The results of this study on the readiness of chronic kidney patients to use health information technology showed that, since most chronic kidney patients are unfamiliar with how to search on the Internet, they do not trust its contents. Most of them are illiterate or unlearned, middle-aged with low income, and less likely to use technology-based resources such as the Internet. Studies [17,18,19] have shown that people often tend to seek health information. Therefore, it is necessary to remove barriers preventing patients to obtain information from electronic resources. Identifying the information needs and topics that patients are searching for on the Internet can help to develop the required content. The results of the present study showed that people are more likely to seek information about the symptoms of their disease and less likely to seek information about herbs or supplements. In this regard, the results of a study by Jafari Nodoushan et al.  also showed that most users did not use herbal medicines recommended on the Internet for their treatment.
In this study, most participants expressed that they wanted to know more about their health. Since patients with chronic renal failure undergo several treatments during their care process, to control the symptoms and complications, they should be acquainted with the causes of the disease, and various treatment methods . In this regard, a study by Green et al. showed that people could play an effective role in preventing the progression of their disease by increasing their health-related information and self-management capacity . Sometimes people express concern about the information they find on the Internet and do not trust it. In the study of Jafari Nodoushan, on thirds of people expressed that they had never trusted the knowledge and information obtained from the Internet without consulting a doctor, and often had not bought medications via the Internet .
In the present study, most people were unfamiliar with using email but liked to use the Internet. A review study by AlGhamdi et al. revealed that older people are usually not interested in the Internet, have not been properly trained to use it, and do not have the necessary self-confidence in this regard. The small font size of web pages and large amount of information on the Internet contribute to the lower use of this resource by older people. Therefore, they prefer to use traditional methods such as visiting a doctor . Distrust of the Internet may also be a barrier to its use by the elderly. In this regard, the study of Ansari et al.  also showed that dialysis patients, due to insufficient reading literacy and their older age, obtain more information from physicians than the technology-based resources such as the Internet. The reason for this finding is that more than one third of the study population in study conducted by Ansari was illiterate.
Most patients found the use of computers boring. However, when they used the Internet, they were not disappointed about the amount of information they could find about their illness and had a positive outlook. In this regard, the results of the study of Lalehzarian et al.  showed that health information-seeking behavior is a psychological phenomenon that is affected by the individual characteristics of the patient. Various studies have shown that women feel less comfortable than men working with information technologies such as computers and the Internet and are more anxious when using these technologies [22, 23]. Studies conducted by Bigdeli et al.  and Feizabadi et al.  found that women have a positive view about health information on the Internet and there is a significant relationship between using the Internet and their positive view. Both study conducted among employed women this can affect their finding regarding the Internet use. Users' positive attitude towards using the Internet often leads to using the Internet to search for health information.
In this study, most patients preferred to visit the office or make a phone call to their doctor than sending an email. They also would trust their physicians and allow them to take care of their health conditions. A study by Santana et al.  found that individuals contact their physician, or other health care professionals, via email and relevant websites to request or review prescriptions, make appointments or ask specific health questions. Wallwiener et al.  by reviewing 71 articles, introduced electronic messages as another channel of communication between patients and their physicians and acknowledged their satisfaction with these services. In general, the results of many studies have shown that patients use the Internet to consult and communicate with a physician to obtain health information [15,16,17, 25]. Therefore, patients seek to use these services due to ease of use, access at any time and place, and their cost-effectiveness.
In the present study, patients mostly use mobile phones to send text messages to people every day and less use them to search on the Internet. The results of a study by Seto et al. showed that heart failure patients can take positive behaviors to change their lifestyle using mobile phones, and these facilities improve the clinical management of patients, self-care, and clinical feedback, and reduce clinical visits and hospitalizations by providing physiological information through alerts . Therefore, mobile technology can be used in planning activities and clinical decisions, and managing signs, symptoms, and patient conditions .
Most patients in this study were concerned about invasion of their privacy if they use the Internet. Insufficient skills to identify trusted websites are among the problems that people face when searching and using the Internet to access online health information . The results of some studies [28,29,30] have shown that the use of health information technology has an important role in meeting patient information needs and now the number of users who use these services is increasing. In many cases, it is the primary resource of health-related information. Nevertheless, there are still people who have insufficient knowledge about using the Internet and cannot use these services as health information resources. Insufficient knowledge of users in addition to the lack of trustworthy websites containing health information lead to the vulnerability of patients against unauthorized disclosure of their information.
In this study, men and women were equally inclined to receive information about their health and there was a significant difference between them in other factors determining the readiness of chronic kidney patients. Koopman et al.  showed that because of the role of the women in the family, they use the Internet and information technology more. Koopman’s study was conducted among patients with chronic conditions from family medicine clinics. In the present study, single and married people had similar opinions about the mode of interaction with their physicians and there was a significant difference between them in other factors that determine the readiness of chronic kidney patients. Married people were more anxious about using the computer, more interested in knowing about their health, and more concerned about the security and confidentiality of their information on the Internet. Among postgraduate students, single people have more time and more curiosity to use the Internet, so their readiness to use information technology is higher than other people . In this study, people over the age of 60 were more anxious about computer use, more interested in knowing about their health, and more concerned about the security and confidentiality of their information on the Internet. In this regard, Powell et al. have shown that often women under the age of 45 search for online health information . The results of other studies [1, 33, 34] have also reported a direct relationship between age and seeking health information of patients. With increasing age, the rate of active search for information in patients decreases. Since in older adults the individual and physical abilities for doing daily activities including the search for health information decreases, family members should also be involved in the searching and providing information to elder patients . In the present study, a significant relationship was observed between the desire to receive health information and the education level of individuals and their history of specific diseases. In this regard, studies have shown [35, 36] people with a lower education level and those who have experienced a history of a particular disease in their lives need more health information. To encourage patients to use IT-based interventions and increase their readiness; training users, providing low-cost services and improving trust of users are possible solutions . Moreover, improving patient confidentiality and security of the data play role in accepting the IT-based intervention.
The present study had three limitations. First, most patients were unable to fill out the questionnaire personally. To solve this problem, a trained researcher read the questions for respondents and filled out the questionnaire based on their responses. Second, since this study was performed on dialysis patients in one province, the results should be used with caution to patients in other regions. However, due to the multiplicity of centers and the high number of patients, the generalizability of the results might not be affected much. Third, the validity and reliability of the questionnaire may not have enough strength as patients did not invited to participate in the face validity and the reliability was assessed with the limited number of the participants.