健康素养和非自杀性自伤行为对初中生自杀相关行为的联合作用

Combined effect of health literacy and non-suicidal self-injurious behaviors on suicide-related behaviors of junior middle school students

目的探讨初中生健康素养和非自杀性自伤行为(NSSI)对自杀相关行为的联合作用,为初中生自杀预防提供参考依据。方法2023年5—6月采用多阶段分层整群抽样与方便抽样相结合的方法,抽取重庆市7367名初中生进行自填式问卷调查。建立二元Logistic回归模型,分析健康素养和NSSI与自杀相关行为的关联。结果初中生自杀意念、自杀计划、自杀未遂的检出率分别为27.99%,9.84%,4.64%,NSSI的检出率为38.03%,总健康素养、功能性健康素养、互动性健康素养、批判性健康素养的具备率分别为62.68%,66.51%,54.24%,72.65%。二元Logistic回归分析显示,不具备总健康素养、不具备3个维度健康素养、有NSSI与初中生自杀意念、自杀计划、自杀未遂均呈正相关(OR=1.42~10.30),且存在联合作用(OR=7.43~18.71)(P值均<0.05)。结论不具备健康素养或存在NSSI以及两者共存会增加自杀相关行为的发生风险。应提高初中生健康素养水平,减少NSSI进而预防自杀相关行为的发生。

Objective To explore the combined effect of health literacy and non-suicidal self-injury on suicide-related behaviors in junior middle school students,so as to provide reference for suicide prevention.Methods During May to June 2023,a self-filling questionnaire survey was conducted among 7367 junior middle school students selected by the methods of multi-stage stratified cluster sampling combined with conventient sampling in Chongqing.And a binary Logistic regression model was established to analyze the association of health literacy and NSSI with suicide-related behaviors.Results The detection rates of suicidal ideation,suicide planning,and suicide attempt among junior middle school students were 27.99%,9.84%,and 4.64%,and the detection rate of NSSI was 38.03%,the rates of possessing total health literacy,functional health literacy,interactive health literacy,and critical health literacy were 62.68%,66.51%,54.24%,and 72.65%,respectively.Binary Logistic regression analyses showed that the absence of total health literacy and the three dimensions of health literacy and NSSI were positively correlated with suicidal ideation,suicide planning,and suicide attempt in junior middle school students(OR=1.42-10.30),and there were combined effects(OR=7.43-18.71)(P<0.05).Conclusions Lack of health literacy or the presence of NSSI and their co-existence increase the risk of suicide-related behaviors,and health literacy level should be improved in junior middle school students to reduce NSSI and thereby prevent suicide-related behaviors.