Study On Influencing Factors And Intervention Of Health Literacy And Lifestyle Of Nursing Students In Higher Vocational Colleges

ObjectiveTo understand the status of health literacy and lifestyle of nursing students in higher vocational colleges,and analyze the influencing factors.Based on the preliminary investigation,the study also aims to design and implement interventions to improve health literacy and lifestyle of nursing students in higher vocational colleges.Through evaluation of the intervention effects,the study will provide implications for conducting related interventions about health literacy and lifestyle among nursing students in higher vocational colleges.Methods1.In the first stage,survey method was employed.Using stratified cluster sampling method,684 nursing students was recruited from a medical colleges in Shandong Province between January and March 2019.The students were investigated by using general data questionnaire,2015 Chinese citizens health literacy survey,college students' healthy lifestyle evaluation scale revised edition,general self-efficacy scale and peer influence resistance questionnaire to understand their current status of health literacy and lifestyle,as well as the influencing factors.2.In the second stage,a pre-post quasi-experimental design was adopted.A total of117 subjects were selected from the survey sample to receive the health education intervention based on the Pender health promotion model.The intervention lasted 6months and took a variety of methods including lectures(4 times),video presenting,WeChat group,and peer education(1-2 times/month),etc.In this stage,the same questionnaires that were used in the first stage were distributed to compare the changes in health literacy and lifestyle level of nursing students before and after the intervention.SPSS23.0 software was used for data management and analysis,which included descriptive statistical analysis,rank sum test,independent sample t test,one-way analysis of variance,Pearson correlation analysis,multiple linear regression analysis,and pairedsample t test.Results1.The status of health literacy of nursing students in higher vocational collegesThe total score of health literacy of 684 nursing students in higher vocational colleges was 56.00(52.00,60.00).The score of fundamental knowledge and concept,healthy lifestyle and behavior,and health skills dimensions were 24.00(22.00,26.00),19.00(17.00,21.00),and 13(11.00,14.00),respectively.2.Influencing factors of health literacy of nursing students in higher vocational collegesThe results of multivariate analysis showed that the main influencing factors of the total score of health literacy included grade,peer influence resistance,gender,mother's level of education and attention to health knowledge.They accounted for 11.2 percent of the variation in health literacy.The total score of health literacy of senior students is higher than that of junior students.Students with higher scores of peer influence resistance showed a higher total score of health literacy.The female students' total score of health literacy was higher than their male counterparts.The total score of health literacy of students whose mothers' education levels were primary school and below was higher than that of other students.The health literacy scores of students who regularly paid attention to health knowledge were higher than those who occasionally paid attention to health knowledge and those who paid no attention to health knowledge at all.3.The status of lifestyle of nursing students in higher vocational collegesThe score of lifestyle of 684 nursing students in higher vocational colleges was120.26±16.11.The score of exercise behavior,regular behavior,nutrition behavior,health risk behavior,health responsibility behavior,interpersonal supporting behavior,stress management behavior,and life appreciation behavior dimensions were 6.83±2.38,10.00±2.51,13.86±3.09,9.31±1.29,20.06±3.22,23.48±4.19,17.78±3.23,and 18.95±3.77,respectively.4.Influencing factors of lifestyle of nursing students in higher vocational collegesThe results of multivariate analysis showed that the main influencing factors of the total score of lifestyle included self-efficacy,self-measured health,attention to health knowledge,peer influence resistance,health literacy score and gender.They accounted for 32.9 percent of the variation in lifestyle.Students who had higher level of the self-efficacy and better self-rated health status reported higher total score of lifestyle.Thetotal lifestyle score of those who always pay attention to health knowledge was higher than that of those who occasionally paid attention to health knowledge and those paying no attention to health at all.Students who had stronger resistance of peer influence and higher score of health literacy reported higher total score of lifestyle.The total lifestyle score of female students was higher than that of male counterparts.5.The intervention effect of health literacy and lifestyle among nursing students in higher vocational collegesAfter intervention,the total score of health literacy(Z=9950.500,P<0.05),fundamental knowledge and concept(Z=10703.500,P<0.05),healthy lifestyle and behavior(Z=9106.500,P<0.05),and health skills(Z=8277.000,P<0.05)dimensions showed some improvement with statistically significant differences.The total score of lifestyle(t=-2.649,P<0.05),regular behavior(t=-5.099,P<0.05),nutrition behavior(t=-3.993,P<0.05),health responsibility behavior(t=-2.401,P<0.05),and life appreciation behavior(t=-2.029,P<0.05)dimensions showed some improvement with the differences statistically significant.There was no statistically significant difference in scores of exercise behavior,health risk behavior,interpersonal supporting behavior,and stress management behavior dimensions before and after intervention(P>0.05).Conclusion1.The health literacy and lifestyle of nursing students in higher vocational colleges are at a moderate level.2.The health literacy and lifestyle of nursing students in higher vocational colleges are influenced by a variety of factors.3.The levels of each dimension on the health literacy and lifestyle of nursing students in higher vocational colleges are not changed homogeneously before and after the intervention,and they are influenced by a variety of factors.