积极应对方式在医学生健康素养与生活方式间的中介效应分析

Mediating effect of positive coping style on health literacy and lifestyle among medical students

目的探讨积极应对方式在医学生健康素养与生活方式间的中介效应,为开展医学生健康教育提供依据。方法于2023年4—6月,采用多阶段分层整群随机抽样方法抽取贵州省6所全日制医学高校的在校医学生为调查对象,收集性别、年龄和学历等资料,采用大学生健康生活方式评价量表调查生活方式;采用《全国居民健康素养监测调查问卷》调查健康素养水平;采用简易应对方式量表评估积极应对方式。采用Process程序分析积极应对方式在健康素养与生活方式间的中介效应,并采用Bootstrap法检验中介效应的显著性。结果调查9266人,其中男生3177人,占34.29%;女生6089人,占65.71%。年龄为(21.06±2.61)岁。专科2775人,占29.95%;本科4864人,占52.49%;硕士研究生1627人,占17.56%。生活方式得分为(118.34±19.06)分;健康素养得分为(54.57±10.81)分;积极应对方式得分为(2.81±0.68)分。中介效应分析结果显示,健康素养可直接正向影响生活方式(效应值=0.286,95%CI:0.257~0.316),也可通过积极应对方式间接正向影响生活方式(效应值=0.215,95%CI:0.193~0.236),中介效应对总效应的贡献率为42.91%。结论健康素养水平高的医学生更倾向采取积极应对方式从而间接改善生活方式。

Objective To examine the mediating effect of positive coping style on health literacy and lifestyle among medical students,so as to provide the reference for health education and health promotion among medical students in universities.Methods Medical students of six full-time medical colleges in Guizhou Province were sampled using a multi-stage stratified cluster random sampling method from April to June 2023,and their gender,age and educational level were investigated by questionnaires.The College Students'Healthy Lifestyle Scale,the Health Literacy Question⁃naire and the Simplified Coping Style Scale were used to evaluate lifestyle,health literacy and coping style of students.The Process program was used to analyze the mediating effect of positive coping style on health literacy and lifestyle,and Bootstrap method was used to examine the significance of the mediating effect.Results A total of 9266 peoples were investigated,including 3177 males(34.29%)and 6089 females(65.71%),and had a mean age of(21.06±2.61)years.There were 2775 junior college students(29.95%),4864 undergraduates(52.49%)and 1627 master students(17.56%).The scores of lifestyle,health literacy and positive coping style among medical students were 118.34±19.06,54.57±10.81 and 2.81±0.68,respectively.Health literacy had a direct positive effect on lifestyle(effect value=0.286,95%CI:0.257-0.316)and a indirect positive effect on lifestyle through positive coping style(effect value=0.215,95%CI:0.193-0.236),and the mediating effect contributed 42.91%to the total effect.Conclusion Health literacy could improve lifestyle indirectly through positive coping style among medical students.