中小学生健康素养水平与生活质量的关联

赵萍; 秦真真; 汪娜; 徐斐

doi:10.16835/j.cnki.1000-9817.2021.11.008

中小学生健康素养水平与生活质量的关联

doi: 10.16835/j.cnki.1000-9817.2021.11.008

赵萍¹,
秦真真²,
汪娜²,
徐斐^2, ,

1.
南京卫生高等职业技术学校护理学院, 江苏 210038
2.
南京市疾病预防控制中心

基金项目:

南京市2017年第十五批科技发展计划项目 201715058

详细信息

作者简介:
赵萍(1966-), 女, 江苏宝应人, 硕士, 副教授, 主要研究方向为护理学

通讯作者:
徐斐, E-mail: frankxufei@163.com

中图分类号: R179 G479
计量
- 文章访问数: 859
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- 被引次数: 0
出版历程
- 收稿日期: 2021-01-28
- 修回日期: 2021-06-30
- 网络出版日期: 2021-12-01
- 刊出日期: 2021-11-25

Association between health literacy and health-related quality of life among primary and middle school students

1.
Department of Nursing, Nanjing Vocational Health College, Nanjing(210038), China

摘要

摘要: 目的了解南京市中小学生健康素养与健康相关生活质量之间的关联，为促进其健康素养水平及健康相关生活质量提供参考。方法 2018年5—6月，采用横断面研究设计，多阶段随机整群抽取南京地区小学四至六年级、初中一至三年级和高中一至三年级的4 388名在校学生为研究对象。采用儿童健康9维量表(CHU9D-CHN)测量学生的健康相关生活质量；使用线性混合效应模型，通过计算健康相关生活质量评分在不同健康素养水平组间的均数差和95%CI分析健康素养与健康相关生活质量之间的关联。结果研究对象中健康素养水平具备率为85.8%，健康相关生活质量的平均得分为(0.78±0.17)分。在调整了相关的混杂因素和班级水平的聚集效应后，与不具备健康素养水平的学生相比，具备健康素养水平者的健康相关生活质量评分增加0.08(95%CI=0.06~0.10)。以学生性别、学校类别和居住地进行分层分析，结果显示在每一层的研究对象中，调整了相关的混杂因素和班级水平的聚集性后，与不具备健康素养水平的学生相比，具备健康素养水平者的健康相关生活质量评分显著增加。结论南京地区的小学生健康素养水平与健康相关生活质量之间存在正向关联。可通过健康素养促进提高学生的健康相关生活质量。
- 健康教育 /
- 生活质量 /
- 线性模型 /
- 学生
Abstract: Objective To investigate the association between health literacy (HL) and health-related quality of life (HRQoL) among primary and middle school students in Nanjing, and to provide a reference for improving health literacy and health-related quality of life among children. Methods In this cross-sectional study, by using a multi-stage rondom duster sampling method, a total of 4 388 primary (4-6), junior (grades 7-9) and senior (grades 10-12) high school students were randomly selected in Nanjing during May and June of 2018. HRQoL was measured as continuous variable with the validated Chinese version of Child Health Utility 9D (CHU9D-CHN); the relationship between health literacy level and HRQoL was examined using mixed-effect linear regression models and reported as mean difference (MD) and 95% confidence interval(CI). Results There were 85.8% participants who obtained adequate health literacy level, while the mean score of CHU9D-CHN was (0.78±0.17) for overall participants. After control for potential confounding factors and class-level clustering effects, participants who self-reported adequate HL recorded an increased HRQoL scores of 0.08 (95%CI=0.06-0.10) units relative to those self-reporting inadequate HL. According to the stratified analysis of students' gender, school type and place of residence, the results show that after adjusting the relevant confounding factors and the aggregation of class level, compared with the students without health literacy, the score of health-related quality of life of those with health literacy increased significantly. Conclusion Health literacy of primary school students in Nanjing is positively related to health-related life qualities.Therefore, there is a need to promote student's health-related quality of life through health literacy.
- Health education /
- Quality of life /
- Linear models /
- Students

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表 1 不同组别学生健康素养具备率比较

Table 1. Comparison of the proportion of students with adequate health literacy between sub-groups

组别	选项	人数	具备健康素养人数	χ²值	P值
性别	男	2 204	1 818(82.5)	39.37	< 0.01
	女	2 184	1 946(89.1)
学校类别	小学	1 602	1 182(73.8)	310.89	< 0.01
	初中	1 455	1 315(90.4)
	高中	1 331	1 267(95.2)
居住地类别	农村	2 030	1 778(87.6)	11.75	< 0.01
	郊区	997	848(85.1)
	城区	1 361	1 136(83.5)
父母最高教育程度	初中及以下	1 264	1 029(81.4)	34.86	< 0.01
	高中	1 415	1 213(85.7)
	专科及以上	1 709	1 523(89.1)
注： ()内数字为具备率/%。

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表 2 不同组别学生健康相关生活质量评分比较(x±s)

Table 2. Comparison of HRQoL scores between sub-groups of students(x±s)

组别	选项	人数	生活质量评分	t/F值	P值
性别	男	2 204	0.79±0.18	2.39	0.02
	女	2 184	0.78±0.17
学校类别	小学	1 602	0.84±0.16	159.46	< 0.01
	初中	1 455	0.78±0.16
	高中	1 331	0.73±0.18
居住地类别	农村	2 030	0.79±0.17	0.90	0.41
	郊区	997	0.78±0.18
	城区	1 361	0.78±0.18
父母最高教育程度	初中及以下	1 264	0.76±0.17	12.94	< 0.01
	高中	1 415	0.78±0.16
	专科及以上	1 709	0.80±0.18

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表 3 不同组别学生具备健康素养与健康相关生活质量评分的关系[MD值(MD值 95%CI)]

Table 3. The association of health literacy and HRQoL score among sub-groups of students[MD值(MD值 95%CI)]

组别	选项	人数	模型1	模型2
性别	男	1 818	0.07(0.03~0.10)^*	0.08(0.06~0.10)^*
	女	1 946	0.06(-0.03~0.15)	0.08(0.01~0.16)^*
学校类别	小学	1 182	0.06(-0.19~0.31)	0.07(0.01~0.12)^*
	初中	1 315	0.11(0.02~0.20)^*	0.10(0.02~0.18)^*
	高中	1 267	0.10(-0.01~0.21)	0.12(0.04~0.19)^*
居住地	农村	1 779	0.07(0.02~0.11)^*	0.08(0.05~0.11)^*
	郊区	848	0.06(-0.01~0.12)	0.06(0.02~0.09)^*
	城区	1 137	0.07(0.00~0.14)^*	0.08(0.05~0.11)^*
注：模型1指单因素混合效应模型，仅调整了班级水平的聚集性效应；模型2指多因素混合效应模型模型，各分层根据模型需要相应调整年龄、性别、学校类别、居住地、体重、父母文化程度、体力活动、视屏时间、睡眠时间、快餐和软饮料食用情况以及班级水平的聚集性效应。*P < 0.05。

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参考文献(21)

[1]	US Department of Health and Human Services. Measuring Healthy Days. Population assessment of health-related quality of life. (2020-12-11). http://www.cdc.gov/hrgol.concept.html.
[2]	REVICKI D A, KLEINMAN L, CELLA D. A history of health-related quality of life outcomes in psychiatry. Dialog Clin Neurosci, 2014, 16(2): 127-135. doi: 10.31887/DCNS.2014.16.2/drevicki
[3]	LEHNERT T, SONNTAG D, KONNOPKA A, et al. The long-term cost-effectiveness of obesity prevention interventions: systematic literature review. Obes Rev, 2012, 13(6): 537-553. doi: 10.1111/j.1467-789X.2011.00980.x
[4]	VARNI J, BURWINKLE T, LANE M. Health-related quality of life measurement in pediatric clinical practice: an appraisal and precept for future research and application. Health Qual Life Outcomes, 2005, 3: 34. doi: 10.1186/1477-7525-3-34
[5]	郭欣, 王克安. 健康素养研究进展. 中国健康教育, 2005, 21(8): 590-590. doi: 10.3969/j.issn.1002-9982.2005.08.008 GUO X, WANG K A. Progress of health literacy research. Chin J Health Educ, 2005, 21(8): 590-590. doi: 10.3969/j.issn.1002-9982.2005.08.008
[6]	MELAS P A, TARTANI E, FORSNER T, et al. Mental health literacy about depression and schizophrenia among adolescents in Sweden. Eur Psychiatry, 2013, 28(7): 404-411. doi: 10.1016/j.eurpsy.2013.02.002
[7]	LOUREIRO L M, JORM A F, OLIVEIRA R A, et al. Mental health literacy about schizophrenia: a survey of Portuguese youth. Early Interv Psychiatry, 2015, 9(3): 234-241. doi: 10.1111/eip.12123
[8]	ZHANG S C, LI D L, YANG R, et al. The association between health literacy and psychosomatic symptoms of adolescents in China: a cross-sectional study. BMC Public Health, 2019, 19(1): 1259. doi: 10.1186/s12889-019-7589-0
[9]	顾璇, 李红影, 汤建军, 等. 安徽省蚌埠市中学生健康素养与心理亚健康症状相关因素分析. 中国健康教育, 2017, 33(1): 8-11, 28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201701003.htm GU X, LI H Y, TANG J J, et al. Analysis on health literacy and psychological sub-health symptoms and their related factors among middle school students in Bengbu, Anhui. Chin J Health Educ, 2017, 33(1): 8-11, 28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201701003.htm
[10]	XU F, CHEN G, STEVENS K, et al. Measuring and valuing health-related quality of life among children and adolescents in mainland China a pilot study. PLoS One, 2014, 9(2): e89222. doi: 10.1371/journal.pone.0089222
[11]	STEVENS K. Developing a descriptive system for a new preference-based measure of health-related quality of life for children. Q Life Res, 2009, 18(8): 1105-1113. doi: 10.1007/s11136-009-9524-9
[12]	康玫, 高俊岭, 顾沈兵, 等. 中学生健康素养量表的编制及其信度效度评价. 中国健康教育, 2015, 31(10): 5-8, 14. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201510002.htm KANG M, GAO J L, GU S B, et al. Development and Validation of Health Literacy Scale for middle school students. Chin J Health Educ, 2015, 31(10): 5-8, 14. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201510002.htm
[13]	储文杰, 王志勇, 周海茸, 等. 儿童青少年体力活动量表的信度和效度分析. 中华疾病控制杂志, 2014, 18(11): 1079-1082. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201411018.htm CHU W J, WANG Z Y, ZHOU H R, et al. The reliability and validity of a Physical Activity Questionnaire in Chinese children. Chin J Dis Control Prev, 2014, 18(11): 1079-1082. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201411018.htm
[14]	AINSWORTH B E, HASKELL W L, HERMANN S D, et al. 2011 compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc, 2011, 43(8): 1575-1581. doi: 10.1249/MSS.0b013e31821ece12
[15]	张云婷, 马生霞, 陈畅, 等. 中国儿童青少年身体活动指南. 中华循证儿科杂志, 2017, 12(6): 401-408. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK201706001.htm ZHANG Y T, MA S X, CHEN C, et al. Physical activity guide for Chinese children and adolescents. Chin J Evid Based Pediatr, 2017, 12(6): 401-408. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK201706001.htm
[16]	中华人民共和国中央人民政府. 中共中央国务院关于加强青少年体育增强青少年体质的意见. (2007-05-07). http://www.gov.cn/gongbao/content/2007/content_663655.html. The Central Committee of the Communist Party of China and the State Council. Opinions on strengthening youth sports and improving youth physical fitness. (2007-05-07). http://www.gov.cn/gongbao/content/2007/content_663655.html.
[17]	王文鹏, 程红, 赵小元, 等. 北京市儿童青少年食物频率问卷的信度和效度研究. 中国儿童保健杂志, 2016, 24(1): 8-11. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201601003.htm WANG W P, CHENG H, ZHAO X Y, et al. Reproducibility and validity of a Food Frequency Questionnaire developed for children and adolescent in Beijing. Chin J Child Health Care, 2016, 24(1): 8-11. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201601003.htm
[18]	国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018.2018-08-01. National Health and Family Planning Commission of the PRC. Screening for overweight and obesity among school-age children and adolescents: WS/T 586-2018.2018-08-01.
[19]	刘舒萍, 任正中, 刘维波, 等. 重庆市某区初中生健康素养与生活质量的相关性分析. 重庆医学, 2018, 47(21): 2828-2830. doi: 10.3969/j.issn.1671-8348.2018.21.017 LIU S P, REN Z Z, LIU W B, et al. Association between quality of life and health literacy among junior school student in one district in Chongqing. Chongqing Med, 2018, 47(21): 2828-2830. doi: 10.3969/j.issn.1671-8348.2018.21.017
[20]	杜国平, 颜文娟, 李小杉, 等. 江苏籍大学新生健康素养现况及影响因素分析. 中华疾病控制杂志, 2017, 21(7): 710-713. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201707015.htm DU G P, YAN W J, LI X S, et al. The status of health literacy and its influencing factors among freshmen from Jiangsu Province. Chin J Dis Control Prev, 2017, 21(7): 710-713. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201707015.htm
[21]	ROCHA P C, ROCHA D C, LEMOS S M A. Functional health literacy and quality of life of high-school adolescents in state schools in Belo Horizonte. Codas, 2017, 29(4): e20160208. http://www.scielo.br/scielo.php?script=sci_abstract&pid=S2317-17822017000400307&lng=pt&nrm=iso&tlng=pt