Abstract
BackgroundLower health literacy is associated with poor quality of life (QOL) among patients with chronic disease; little is known about this relationship among the general population, especially for child and adolescent. To fill this gap, this paper aimed to investigate the association between health literacy and QOL in junior middle school students, and explore how QOL varies by health literacy.MethodsAn anonymous cross-sectional survey was conducted among junior middle school students (aged 12–15) from Shapingba district, Chongqing in China, and participants were recruited using stratified cluster sampling. Health literacy and QOL were measured using two validated scales, and quantified using a five-point Likert scale with health literacy classified as low, medium, or high. We used multivariable logistic regression to test adjusted association between health literacy and QOL.ResultsA total of 1774 junior middle school students were evaluated, with the mean age was 13.8 ± 1.0 and of whom 905 (51.0%) were male. About 25.5% of the research subjects had a low health literacy. When controlling for age, grade, family structure and other covariates, highest discrimination was found among participants with low to high health literacy. Overall, Students who equipped with higher health literacy was associated with greater QOL (P < 0.01), and this discrimination remained significant in subscales: physiological well-being (P < 0.01), mental well-being (P < 0.01), social well-being (P < 0.01) and pubertal well-being (P < 0.01).ConclusionsThe prevalence of low health literacy among junior middle school students in Chongqing area was relatively high, and inadequate health literacy may contribute to poorer QOL among junior middle school students. It merits further longitudinal studies to confirm the impact of health literacy on QOL. Overall, to improve students’ QOL, public health efforts for further improving awareness and enhancing effective promotion and education are urgently needed in junior middle school students, especially for low health literacy populations.
Highlights
Lower health literacy is associated with poor quality of life (QOL) among patients with chronic disease; little is known about this relationship among the general population, especially for child and adolescent
T-tests or F tests revealed that low health literacy was more prevalent among males (Pa = 0.048), higher grade (Pa = 0.021), residents of rural areas (Pa < 0.0001), those whose father or mother were with less education (Pa < 0.001 or Pa = 0.021), those with poor family relationships (Pa = 0.017) and poor economic status (Pa = 0.010), and those who considered their school achievement as bad (Pa = 0.017)
After categorizing the health literacy into 3 levels by using quartiles as the cut-off points, we found that about one-quarter of students presented low health literacy,which is higher than other studies reported with samples from different age groups and using different previously validated evaluation instruments, such as Chang and her colleagues’ study [43] measured by the Chinese version of Test of Functional Health Literacy (TOFHL)for adolescents among Taiwanese students, and the results reported by Chisolm et al [44] assessed with the Rapid Estimate of Adult Literacy in Medicine, teen version (REALM-Teen)
Summary
Lower health literacy is associated with poor quality of life (QOL) among patients with chronic disease; little is known about this relationship among the general population, especially for child and adolescent. To fill this gap, this paper aimed to investigate the association between health literacy and QOL in junior middle school students, and explore how QOL varies by health literacy. Junior school stage is a necessary period of transition from childhood to maturity, which is critical for individual physical, psychological and social adaptation During this period, the physical and psychological health and QOL may affect their life, so it is of far-reaching significance to study the QOL of junior school students. QOL may be in the position of affecting students’ daily performance, activities, and communication
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