Health literacy and associated factors among college students in a medical university
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摘要:
目的 了解某医学专业学生健康素养现状及其影响因素,为医学院校大学生健康教育提供参考。 方法 采取随机分层整群抽样的方法,在某医学专业院校3个年级的1 428名学生进行健康素养问卷调查。资料采用率或构成比进行描述,采用χ2检验进行组间比较,采用Logistic回归分析模型分析影响因素。 结果 该校大学生具备健康素养水平的比例为57.18%,具备健康知识、健康技能和健康行为的比例分别为58.68%,65.48%,30.88%。该校大学生健康素养女生高于男生,且不同年级、不同专业、父亲受教育程度及职业不同具备健康素养的差异有统计学意义(χ2值分别为27.748、46.525、19.327、30.779,均有P < 0.01)。Logistic回归分析模型分析表明,女生健康素养高于男生(OR=1.521,95%CI:1.160~1.993,P=0.002);不同专业学生健康素养水平由高到低依次为临床医学、护理学、药学以及其他专业;母亲文化程度高的的子女健康素养高于文化程度低的子女。 结论 该校学生健康素养整体水平相对较高,医学院校应重点培养医学生健康的生活方式,从而提高大学生整体健康素养水平。 -
关键词:
- 医学生 /
- 健康素养 /
- Logistic回归分析模型
Abstract:Objective To understand the current health literacy level of students in a medical university and its influencing factors, so as to provide references for health education of medical college students. Methods By means of random stratified cluster sampling, health literacy questionnaire survey was conducted among 1 428 students in three grades of a medical university. Ratio and constituent ratio were used to describe the resuls. Chi-square test was used fot comparison among groups. Logistic regression was used to analyze the influencing factors. Results The percentage of sampled undergraduates in Hebei who had met the health literacy criteria was 57.18%.The percentages of students who had met the health literacy criteria on health concepts and the basic knowledge, and on healthy lifestyles and behaviors, and on the basic health skills were 58.68%, 30.88%, 65.48%, respectively. The health literacy of female college students was higher than that of males. There were statistically significant differences in health literacy among subjects of different grades, majors, fathers with education and fathers with different occupations (χ2=27.748, 46.525, 19.327, 30.779, all P < 0.01). Logistic regression analysis showed that girls' health literacy was higher than boys' (OR=1.521, 95% CI: 1.160-1.993). The health literacy level of students from different majors was in order of clinical medicine, nursing, pharmacy and other majors; The health literacy of the children with highly educated mothers was higher than that of the children with less educated mothers. Conclusions Overall level of health literacy of students in this school is higher than that of undergraduates nationwide. Medical colleges should focus on cultivating healthy lifestyles of medical students, so as to improve the overall health literacy of college students. -
Key words:
- Medical students /
- Health literacy /
- Logistic regression analysis
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表 1 某医学院校不同人口统计学特征大学生健康素养水平比较[n(%)]
Table 1. Comparisons of health literacy among different demographic characteristics of college students in a medical university[n(%)]
人口统计学指标 调查人数 统计值 总健康素养 健康知识理念 健康技能 健康行为 性别 男 388 176(45.36) 181(46.65) 207(53.35) 111(28.61) 女 1 011 624(61.72) 640(63.30) 709(70.13) 321(31.75) χ2值 30.652 32.076 34.917 1.297 P值 < 0.001 < 0.001 < 0.001 0.255 年龄(岁) ≤18 191 116(60.73) 106(55.50) 133(69.63) 68(35.60) 19~ 987 556(56.33) 578(58.56) 640(64.84) 306(31.00) ≥22 221 142(64.25) 142(64.25) 159(71.95) 72(32.58) χ2值 4.837 20.826 4.370 0.693 P值 0.089 0.243 0.112 0.707 年级 大一 576 299(51.91) 305(52.95) 353(61.28) 173(30.03) 大二 404 217(53.71) 229(56.68) 259(64.11) 106(26.24) 大三 419 284(67.78) 287(68.50) 304(72.55) 153(36.52) χ2值 27.748 25.113 14.095 10.507 专业 P值 < 0.001 < 0.001 0.001 0.005 临床医学 360 204(56.67) 217(60.28) 227(63.06) 116(32.22) 护理学 387 264(68.22) 278(71.83) 287(74.16) 141(36.43) 药学 357 172(48.20) 160(44.82) 216(60.50) 91(25.50) 其他专业 295 136(46.10) 152(51.53) 158(53.56) 65(22.03) χ2值 46.525 74.537 28.95 17.176 P值 < 0.001 < 0.001 < 0.001 0.002 父亲受教育程度 小学/初中 774 362(46.77) 337(43.54) 427(55.17) 223(28.81) 高中/中专 359 190(52.92) 201(55.99) 215(59.89) 121(33.70) 大专/本科 248 149(60.08) 141(56.85) 162(65.32) 80(32.26) 硕士及以上 18 11(61.11) 11(61.11) 12(66.67) 8(44.44) χ2值 19.327 25.118 7.517 10.336 P值 0.002 < 0.001 0.185 0.066 母亲受教育程度 小学/初中 868 478(55.07) 477(54.95) 520(59.91) 258(29.72) 高中/中专 339 193(56.93) 204(60.18) 211(62.24) 113(33.33) 大专/本科 176 105(59.66) 98(55.68) 116(65.91) 55(31.25) 硕士及以上 16 8(50.00) 10(62.50) 9(56.25) 6(37.50) χ2值 10.281 11.367 6.168 11.134 P值 0.068 0.045 0.290 0.049 父亲的职业 公务员/事业单位 285 150(52.63) 151(52.98) 172(60.36) 88(30.88) 教师/医务人员 155 89(57.41) 89(57.41) 97(62.58) 56(36.13) 经商/企业人员 330 188(56.96) 196(59.39) 218(66.06) 96(29.09) 农民 406 163(39.95) 165(40.44) 160(39.22) 143(35.05) 其他 223 128(57.40) 127(56.95) 142(63.68) 69(30.94) χ2值 30.779 39.492 72.477 4.705 P值 < 0.001 < 0.001 < 0.001 0.696 母亲的职业 公务员/事业单位 183 96(52.46) 92(50.27) 109(59.56) 53(28.96) 教师/医务人员 161 93(57.76) 96(59.63) 98(60.87) 52(32.30) 经商/企业人员 269 160(59.48) 169(62.83) 185(68.77) 82(30.48) 农民 498 295(59.24) 302(60.64) 344(69.08) 158(31.71) 其他 288 156(54.17) 162(56.25) 180(62.50) 567(30.21) χ2值 9.649 23.792 14.172 2.800 P值 0.209 0.001 0.048 0.903 表 2 某医学院校学生健康素养各维度相关条目回答情况[n(%)]
Table 2. Correct rates of college students for questions about three aspects of health literacy in a medical university[n(%)]
健康素养 男 女 大一 大二 大三 总正确人数 健康知识理念 骨质疏松 37(2.65) 56(4.00) 25(1.79) 29(2.07) 39(2.79) 93(6.65) 肝脏的描述 222(15.87) 425(30.38) 196(14.01) 213(15.23) 238(17.01) 647(46.25) 国家基本公共卫生服务 292(20.87) 396(28.31) 198(14.15) 205(14.65) 285(20.38) 688(49.18) 自测血压 357(25.52) 379(27.09) 236(16.87) 240(17.16) 260(18.58) 736(52.61) 健康生活方式和行为 就医方式 274(19.59) 283(20.22) 172(12.29) 185(13.22) 200(14.30) 557(39.81) 运动对健康的好处 379(27.09) 427(30.52) 254(18.16) 265(18.94) 287(20.51) 806(57.61) 健康技能 免费卫生热线号码 287(20.51) 288(20.59) 187(13.37) 191(13.65) 197(14.08) 575(41.10) 警示图 342(24.45) 359(25.66) 229(16.37) 234(16.73) 238(17.01) 701(50.11) 农药的保管 362(25.88) 387(27.66) 245(17.51) 249(17.80) 255(18.23) 749(53.54) 食品包装袋信息 382(27.31) 384(27.44) 242(17.29) 249(17.80) 275(19.66) 766(54.75) 表 3 某医学院校大学生健康素养多因素非条件Logistic分析
Table 3. Multivariate Logistic analysis of health literacy of college students in a medical university
自变量与常数 β Wald值 P值 OR(95% CI)值 性别 男 1.000 女 0.419 9.210 0.002 1.521(1.160~1.993) 年级 大一 28.797 0.001 1.000 大二 0.704 26.366 0.001 1.448(1.329~2.608) 大三 0.857 19.221 0.001 1.469(1.335~3.658) 专业 其他专业 27.385 0.007 1.000 临床医学 0.824 22.925 0.001 1.417(1.110~1.630) 护理学 0.700 19.249 0.001 1.397(1.194~2.829) 药学 0.623 7.328 0.001 1.197(1.353~2.662) 母亲文化程度 小学/初中 11.632 0.040 1.000 高中/中专 1.254 3.537 0.030 1.285(0.077~1.054) 大专/本科 0.596 0.987 0.020 1.511(1.170~2.786) 硕士及以上 0.300 0.258 0.012 1.640(1.232~3.963) 常数 -1.029 2.455 0.017 -
[1] 叶露梦, 林国建, 林丽华. 健康素养研究进展分析[J]. 中国农村卫生事业管理, 2018, 38(8): 1058-1061. DOI: 10.3969/j.issn.1005-5916.2018.08.029.Ye LM, Lin GJ, Lin LH. Research progress of health literacy[J]. Chin Rural Health Service Administration, 2018, 38(8): 1058-1061. DOI: 10.3969/j.issn.1005-5916.2018.08.029. [2] 国家卫生和计划生育委员会宣传司, 中国健康教育. 2015年中国居民健康素养检测报[R]. 北京: 国家卫生计生委, 2016.Publicity department of national health and family planning commission, China health education. 2015 Chinese residents' health literacy test report[R]. Beijing: National Health and Family Planning Commission, 2016. [3] 中华人民共和国卫生部. 健康66条-中国公民健康素养读本[M]. 北京: 人民卫生出版社, 2015.Ministry of health of the People's Republic of China. Health 66-Chinese citizens' health literacy reader[M]. Beijing: People's Medical Publishing House, 2015. [4] 高皓宇, 王刚, 袁媛媛. 健康素养的内涵及影响因素分析[J]. 中国健康教育, 2011, 27(8): 616-618. DOI: 10.16168/j.cnki.issn.1002-9982.2011.08.010.Gao HY, Wang G, Yuan YY. Analysis on the connotation and influence factor of health literacy[J]. Chin J Health Education, 2011, 27(8): 616-618. DOI: 10.16168/j.cnki.issn.1002-9982.2011.08.010. [5] 肖瓅, 程玉兰, 马昱, 等. Delphi法在筛选中国公众健康素养评价指标中的应用研究[J]. 中国健康教育, 2008, 24(2): 81-84. DOI: 10.16168/j.cnki.issn.1002-9982.2008.02.001.Xiao L, Cheng YL, Ma Y, et al. A study on applying Delphi method for screening evaluation indexes of health literacy of China adult[J]. Chin J Health Education, 2008, 24(2): 81-84. DOI: 10.16168/j.cnki.issn.1002-9982.2008.02.001. [6] 肖瓅, 陶茂萱. 健康素养研究进展与展望[J]. 中国健康教育, 2008, 24(5): 361-364. DOI: 10.16168/j.cnki.issn.1002-9982.2008.05.014.Xiao L, Tao MX. Progress and prospects of health literacy research[J]. Chin J Health Education, 2008, 24(5): 361-364. DOI: 10.16168/j.cnki.issn.1002-9982.2008.05.014. [7] 杜琳, 刘伟佳, 刘伟, 等. SPSS中的分类树模型在分析伤害影响因素中的作用[J]. 中国卫生统计, 2010, 27(5): 546-548. DOI: 10.3969/j.issn.1002-3674.2010.05.033.Du L, Liu WJ, Liu W, et al. The role of the classification tree model in analyzing the factors affecting injury in SPSS[J]. Chin J Health Statistics, 2010, 27(5): 546-548. DOI: 10.3969/j.issn.1002-3674.2010.05.033. [8] 陈晖, 卢言瑶, 马海燕, 等. 浙江省杭州市某高校大学生健康素养现状分析及对策[J]. 中国健康教育, 2011, 27(12): 911-914. DOI: 10.16168/j.cnki.issn.1002-9982.2011.12.006.Chen H, Lu YY, Ma HY, et al. Study on the health literacy status and countermeasures among undergraduate students in Hangzhou City[J]. Chin J Health Education, 2011, 27(12): 911-914. DOI: 10.16168/j.cnki.issn.1002-9982.2011.12.006. [9] 顾清, 李学军, 高皓宇, 等. 天津市居民健康素养现况研究[J]. 中国慢性病预防与控制, 2010, 18(4): 334-337. DOI: 10.16386/j.cjpccd.issn.1004-6194.2010.04.005.Gu Q, Li XJ, Gao HY, et al. Current circumstances of health literacy among the residents in Tianjin[J]. Chin J Prev Contr Chron Dis, 2010, 18(4): 334-337. DOI: 10.16386/j.cjpccd.issn.1004-6194.2010.04.005. [10] 邓韶英, 谭爱军, 李玉荣, 等. 珠海市15~69岁居民健康素养水平及影响因素分析[J]. 中华疾病控制杂志, 2011, 15(7): 598-601. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201107013Deng SY, Tan AJ, Li YR, et al. Analysis of the level and influencing factors of health literacy in Zhuhai residents aged 15-69[J]. Chin J Dis Control Prev, 2011, 15(7): 598-601. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201107013 [11] 周薇薇, 罗春花, 范存欣, 等. 广州市大学生健康素养现状及影响因素分析[J]. 中华疾病控制杂志, 2014, 18(7): 654-658. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201407021Zhou WW, Lou CH, Fan CX, et al. A study on the status and influential factors of health literacy among undergraduate students in Guangzhou City[J]. Chin J Dis Control Prev, 2014, 18(7): 654-658. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201407021 [12] 李秀兰, 张永忠, 冯长龙, 等. 石家庄市某医专学生健康素养现状及影响因素分析[J]. 中国健康教育, 2018, 34(8): 703-708. DOI: 10.16168/j.cnki.issn.1002-9982.2018.08.007.Li XL, Zhang YZ, Feng CL, et al. A study on the status and influential factors of health literacy among junior college students in a medical college in Shijiazhuang City[J]. Chin J Health Education, 2018, 34(8): 703-708. DOI: 10.16168/j.cnki.issn.1002-9982.2018.08.007. [13] 乔艳华, 李翠, 郝建章, 等. 河北省高校研究生健康素养水平及影响因素分析[J]. 中国健康教育, 2017, 33(4): 291-294. DOI: 10.16168/j.cnki.issn.1002-9982.2017.04.001.Qiao YH, Li C, Hao JZ, et al. Analysis onstatus of health literacy and its influence factors among university graduate students in Hebei Province[J]. Chin J Health Education, 2017, 33(4): 291-294. DOI: 10.16168/j.cnki.issn.1002-9982.2017.04.001. [14] 欧阳江, 牟劲松, 赵淑英. 长沙市大学生健康素养状况及相关因素分析[J]. 中国学校卫生, 2014, 35(12): 1800-1805. DOI: 10.16835/j.cnki.1000-9817.2014.12.018.Ouyang J, Mou JS, Zhao SY. Health literacy and associated factors among college students in Changsha[J]. Chin J Sch Health, 2014, 35(12): 1800-1805. DOI: 10.16835/j.cnki.1000-9817.2014.12.018.