| BackgroundAs the World Health Organization reported, about 2 billion people have been infected with Hepatitis B virus (hereinafter referred to as HBV) worldwide, of which 350 million people have been infected with chronic HBV infection. About 1 million people died of liver failure, liver sclerosis and primary hepatocellular carcinoma induced by HBV all over the world each year. Many studies indicate that China is a high endemic area of HBV infection, with a 9.09%HBsAg rate among the population. January,28,2006, the Ministry of Health announced the implementation of the "Programs for National Hepatitis B Prevention and Control 2006-2010", which indicated that in the statutory report of infectious diseases, the incidence and morbidity of Hepatitis B has been rated high. Hepatitis B has been a great economic burden to patients, families and society, and brought great influence on the economic development in the society. It has been regarded as an important factor to make many families lapse into poverty, triggering a series of social problems, which is one of the most prominent public health problems in our country nowadays. According to the personnel from the Guangdong Preventive Medicine Association, there are 130 million carriers of hepatitis B virus and 10 million are in Guangdong Province, with the highest morbidity in the country. So the task for preventing and controlling the disease is urgent. There is a big gap between the input for the prevention for Hepatitis B and practical work and the growing public health needs. There is also a lack of reliable specific treatments for hepatitis B. Theraputic principles require adequate rest, nutrition, supplemented by appropriate medication, and avoidance of alcohol, fatigue and hepatotoxic drugs. However, the existing therapy can not eliminate HBV.Some infectors with HBV have somatic symptoms in different degree. Because the virus cannot be completely eliminated, Hepatitis B is infectious and there is social discrimination against the disease. Infectors are apt to psychological problems, which affect their personality and social support to them, bringing great mental stress and heavy economic burden to families and society and lower quality life to patients. Studies have shown that patients with chronic Hepatitis B are more easily suffered from anxiety and depressive mental disorder than healthy people. Gender, age, education and economic status are important factors for the anxiety and depressive mental disorder for those patients. Hepatitis B is also one of the serious threats to the health of college students. HBV infection in college students is worrying. There is a big regional difference in the infection. Northern and central areas are of lower infection rate than the south. From the statistics of the reasons for student's dropping out of college, Hepatitis B ranks first in the health field. Thus, Hepatitis has been a serious disease for college student's health.As an important means to improve the quality of life for HBV infector, health education has become the focus in the medical field. In the "Programs for National Hepatitis B Prevention and Control 2006-2010" implemented by the Ministry of Health, the Hepatitis B prevention strategies and main measures proposed that we should strengthen the publicity of health education and enhance people's awareness of hepatitis B prevention. The prevention and control of Hepatitis B should be publicized and popularized as an important part of popular science in local health education programs. Adhering to national health education combined with key group's education, we should carry out various forms of publicity frequently and purposefully, and publicize the dangers of Hepatitis B and preventive methods, so that people will learn the transmission path of Hepatitis B and correct preventive methods, which can enhance their self-protective awareness. Different government departments, social organizations and mass media should give full play to their advantages, actively promote the prevention and treatment of Hepatitis B, creating a good atmosphere for the control of Hepatitis B in the society. Thus, strengthening the health education for college students is imperative. Through health education, student's knowledge and awareness of the prevention of HBV infection will be enhanced, the quality of life of HBV infectors will be improved and thereby the health of students will be improved. The great number of HBV infectors and the more and more obvious health problems make the establishment of an active, systematic health education system a principal task.Purpose1. Through the survey of demographic basic information of HBV infectors, this research identify the key group of HBV infectors, providing evidence to identify the targets for health education.2. This research can effectively improve the college student's knowledge of Hepatitis B, mental health and quality of life. At the same time, the knowledge from health education can be publicized by a large amount of students so as to improve the public health.3. Through the interventional experiments in the experimental group and the control group, the effectiveness of a systemic model for health education can be proved, providing evidence for choosing an appropriate health education model. Subjects and MethodsThis research selected freshmen of 2008 in a higher vocational college. Physical examination results showed that there were 262 HBV infectors, of which male accounted for 87 while female 175, aged 19-23.243 students not infected with HBV were selected by the convenience sampling method, accounting to a total of 505 students. A survey was carried out by a self-edited questionnaire to investigate the basic information of the participants, including gender, age, living conditions and family economic status. According to the survey results, by the application of SPSS 13.0 statistical software, HBV infected and uninfected students were seperated randomly into a control group of 256 students, of which 129 were HBV infected and 127 uninfected, and an experimental group of 249 students, of which 133 were HBV infected and 116 uninfected.The two groups'knowledge of Hepatitis B was surveyed before and after the health education by a self-edited questionnaire. Two groups'levels of anxiety and depression before and after the health education were measured by the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). The average academic scores of all subjects in the first and the second semester were calculated.A systemic health education model was adopted in the experimental group, i.e. seminars, health education manual, establishing a health record of HBV infectors and a follow-up health education; while a traditional health education model was adopted in the control group, i.e. health education manual and health education bulletin board.After checking all data carefully, a database was built by the application of SPSS 13.0 to ensure the accuracy of the data input. Meanwhile, the data was statistically analyzed by SPSS13.0. Descriptive analysis, paired test, factor analysis of variance and LSD multiple comparisons between groups were adopted in the statistical methods. Test level a=0.05. Results1. HBV infection demographicsAs the HBV infection demographic information indicated, the 262 HBV infectors in the survey were Han and has a post-secondary degree, of which 175 were female, accounting for 66.8%, and 87 were male, accounting for 33.2%.14 of them aged less than 18, accounting for 5.3%while 248 of them aged 18-25, reaching a proportion of 94.7%.180 of them were from the rural areas, taking up 68.7%, while 82 of them were from the urban areas, taking up 31.3%. Annual household income was less than 5000 in 97 students' families, accounting for 37%,5000-10000 in 90 families, accounting for 34.4% and 10000-30000 in 56 families, accounting for 7.3%.2. Related knowledge of Hepatitis B in two groups before and after health educationAn obvious improvement could been seen in both groups' related knowledge of Hepatitis B. All students wanted to know more about Hepatitis B. There is a drop in the number of students who were afraid of Hepatitis B, from 82.0%to 81.3%in the control group and from 83.1% to 67.9% in the experimental group. Neither group showed obvious improvement in the HBV infected students who were deeply depressed by the disease. The number of students who had a wrong perception of the transmission path of Hepatitis B decreased from 27.0% to 23.0% in the control group and from 23.3% to 1.2% in the experimental group. The students who had a correct perception of the preventive effectiveness of a Hepatitis B Vaccine increase from 85.5% to 91.0% in the control group and from 92.4% to 98.0% in the expetimental group. The students who had received Hepatitis B Vaccine decreased from 69.9% to 59.8% in the control group, while increased from 52.6% to 72.3% in the experimental group. There was a decrease in the number of students from both groups who were unwilling to play with Hepatitis B infectors, from 16.0% to 11.3% in the control group and from 9.6% to 2.4% in the experimental group.3. Student's anxiety level before and after health educationA Paired t test was carried out to measure the anxiety level of the students in the experimental group and the control group before and after health education. The result showed that after health education,there was no obvious difference in the anxiety level of HBV uninfected and infected students from the control group, P value was more than 0.05.Significant difference was shown in the anxiety level of HBV uninfected and infected students from the experimental group, P value was less than 0.05. The anxiety was relieved after the health education. The changes of anxiety level of the HBV uninfected and infected students in the control group and experimental group before and after the health education respectively showed significant difference by factor analysis of variance (F=18.575,P=0.000). The LSD multiple comparisons between groups showed that the changes in the anxiety level of the HBV infectors in the control group and in the experimental group show significant difference, P=0.000. And the changes in the anxiety level of the HBV uninfected students in the control group and in the experimental group show significant difference, P=0.000. The changes in the anxiety level was more obvious in the experimental group than in the control group, which indicated the health education model for the experimental group could effectively improve student's anxiety.4. Student's depression level before and after health educationA Paired t test was carried out to measure the depression level of the students in the experimental group and the control group before and after health education, which showed a decrease in the depression level of HBV infected and uninfected students in both groups. The result has significant statistical difference, P values were less than 0.05. This indicated the health education could effectively relieve student's depression. The changes of depression level of the HBV uninfected and infected students in the control group and the experimental group before and after the health education respectively showed significant difference by factor analysis of variance (F=38.872,P=0.000). The LSD multiple comparisons between groups showed that the changes in the depression level of the HBV infectors in the control group and in the experimental group show significant difference, P=0.000. And the changes in the depression level of the HBV uninfected students in the control group and in the experimental group show significant difference, P=0.000. The health education model for the experimental group was proved to be more effective than that for the control group.5. Student's academic performance before and after health educationA Paired t test was carried out to measure the academic performance of the students in the experimental group and the control group before and after the health education. The result showed that after health education, there was no obvious difference in the academic performance of HBV uninfected students from the control group, the infected and uninfected students from the experimental group respectively, P value was more than 0.05. The academic performance of HBV infected students in the control group showed significant statistical difference, P value was less than 0.05. The changes in academic performance of the HBV uninfected and infected students in the control group and experimental group before and after the health education respectively showed significant difference by factor analysis of variance (F=4.376,P=0.005).The changes in academic performance was more obvious in the experimental group than in the control group. The LSD multiple comparisons between groups showed that the changes in the academic performance of the HBV infected and uninfected students from the experimental group show significant difference, P=0.000. And the changes in the academic performance of the HBV uninfected students in the control group and in the experimental group also show significant difference, P=0.017.The health education model for the experimental group could improve academic performance effectively and was even more effective for the HBV infectors.Conclusion1. HBV infection rate is as high as 11.7%in the higher vocational college in Guangdong Provice. HBV infectors are apt to have more psychological problems, such as anxiety, depression, tense interpersonal relationship ect., which have affected the personality and social support for them.2. Health education can improve all student's related knowledge of Hepatitis B, reduce the fear of Hepatitis B, improve interpersonal relationship and strenthen active defensive capability.3. Systemic health education can effectively improve student's mental health and academic performance, especially for those HBV infector's psychological state.4. The effectiveness of systemic health education is obviously better than traditional health education.
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