中小学生健康素养水平与生活质量的关联

  目的  了解南京市中小学生健康素养与健康相关生活质量之间的关联，为促进其健康素养水平及健康相关生活质量提供参考。  方法  2018年5—6月，采用横断面研究设计，多阶段随机整群抽取南京地区小学四至六年级、初中一至三年级和高中一至三年级的4 388名在校学生为研究对象。采用儿童健康9维量表(CHU9D-CHN)测量学生的健康相关生活质量；使用线性混合效应模型，通过计算健康相关生活质量评分在不同健康素养水平组间的均数差和95%CI分析健康素养与健康相关生活质量之间的关联。  结果  研究对象中健康素养水平具备率为85.8%，健康相关生活质量的平均得分为(0.78±0.17)分。在调整了相关的混杂因素和班级水平的聚集效应后，与不具备健康素养水平的学生相比，具备健康素养水平者的健康相关生活质量评分增加0.08(95%CI=0.06~0.10)。以学生性别、学校类别和居住地进行分层分析，结果显示在每一层的研究对象中，调整了相关的混杂因素和班级水平的聚集性后，与不具备健康素养水平的学生相比，具备健康素养水平者的健康相关生活质量评分显著增加。  结论  南京地区的小学生健康素养水平与健康相关生活质量之间存在正向关联。可通过健康素养促进提高学生的健康相关生活质量。

Association between health literacy and health-related quality of life among primary and middle school students

  Objective  To investigate the association between health literacy (HL) and health-related quality of life (HRQoL) among primary and middle school students in Nanjing, and to provide a reference for improving health literacy and health-related quality of life among children.  Methods  In this cross-sectional study, by using a multi-stage rondom duster sampling method, a total of 4 388 primary (4-6), junior (grades 7-9) and senior (grades 10-12) high school students were randomly selected in Nanjing during May and June of 2018. HRQoL was measured as continuous variable with the validated Chinese version of Child Health Utility 9D (CHU9D-CHN); the relationship between health literacy level and HRQoL was examined using mixed-effect linear regression models and reported as mean difference (MD) and 95% confidence interval(CI).  Results  There were 85.8% participants who obtained adequate health literacy level, while the mean score of CHU9D-CHN was (0.78±0.17) for overall participants. After control for potential confounding factors and class-level clustering effects, participants who self-reported adequate HL recorded an increased HRQoL scores of 0.08 (95%CI=0.06-0.10) units relative to those self-reporting inadequate HL. According to the stratified analysis of students' gender, school type and place of residence, the results show that after adjusting the relevant confounding factors and the aggregation of class level, compared with the students without health literacy, the score of health-related quality of life of those with health literacy increased significantly.  Conclusion  Health literacy of primary school students in Nanjing is positively related to health-related life qualities.Therefore, there is a need to promote student's health-related quality of life through health literacy.