Nursing students and health literacy: The effect of region and programme level

Health promoting resources and lifestyle factors among higher education students in healthcare and social work programmes: a survey with a longitudinal multicentre design

BACKGROUND

It has been suggested that the university environment, to improve students' health status and educational outcomes, should be based on a health promoting approach. More knowledge is needed about health promoting resources and lifestyle factors that may be of value for students in higher education and their future work-life balance. The aim of this study was to explore health-promoting resources, general health and wellbeing, and health promoting lifestyle factors among fourth and final semester students in higher education in healthcare and social work.

METHODS

This longitudinal study is based on self-reported data collected through a web-based questionnaire that included questions about general health, wellbeing, and healthy lifestyle factors and made use of instruments: the Sense of Coherence (SOC) scale, the Salutogenic Health Indicator Scale (SHIS), and five questions from the General Nordic Questionnaire (QPS Nordic). The questionnaire was distributed among students enrolled in seven different healthcare and social work programmes at six universities in Sweden. Data was collected when students were in their fourth (2019/2020) and final (2020/2021) semesters analysed with multiple linear and logistic regressions.

RESULTS

The survey included responses from students during the fourth (n = 498) and the final (n = 343) semester of higher education programmes in health and social work. Total SOC scores decreased between the fourth semester and the final semester. The prevalence of the health promoting lifestyle factor of physical exercise decreased between the fourth and final semesters. Students in their final semester reported valuing group work more highly than did students in their fourth semester. Despite this, students in both the fourth and the final semester reported high SOC, low levels of good general health and perceived wellbeing, and sleeping problems.

CONCLUSIONS

Students' report of good general health were associated with wellbeing, high-intensity physical training, and no sleeping problems A high SOC level was associated with good general health, perceived wellbeing, and no sleeping problems. A higher SHIS level was also associated with wellbeing and no sleeping problems. Therefore, we suggest further research focusing on how to prepare students in healthcare and social work during higher education for a future work-life in balance targeting effects on sleep quality.

Media Health Literacy in Spanish Nursing Students: A Multicenter Cross-Sectional Study

BACKGROUND

Amidst current misinformation, media literacy is an essential competency for nursing professionals. This study aimed to analyze the level of media health literacy among Spanish undergraduate nursing students, stratifying the results by gender, region, and other associated factors.

METHODS

A cross-sectional study was conducted at five Spanish universities (N = 416) using the Spanish version of the Media Health Literacy (MeHLit-SV) Questionnaire.

RESULTS

Students presented an average media health literacy score of 48.73 points. The media health literacy level was significantly higher among students from universities in the central and northeastern regions of Spain (ANOVA Test, p = 0.0002), those who had previously studied in a city (ANOVA Test, p = 0.001), those who combined their studies with employment (ANOVA Test, p = 0.001), and those residing in communities with fewer than 500 inhabitants (ANOVA Test, p = 0.001). No differences were found based on gender.

CONCLUSIONS

The media health literacy level of the students was deficient and varied according to socio-economic and socio-educational factors. Understanding the literacy level of future nurses and promoting the inclusion of this competency in their education will enable them to become leaders in improving the population's health self-care.

Nursing Students' Health Literacy and Strategies to Foster Patients' Health Literacy

Health literacy can be defined as an individual's competence to use knowledge and information to maintain and improve health. Research has shown the crucial importance of health literacy in everyday life. Nurses play an important role in fostering patients' health literacy. But there is a lack in research on nurses' health literacy and how it influences their work. Therefore, this study aims to determine nursing students' health literacy and find out whether this group assessed that there was a change in their health literacy before and after the COVID-19 pandemic. In addition, this study aims to find out whether there is a relation between nursing students' assessments of their health literacy and their assessments of whether and how they use strategies to foster their patients' health literary in everyday work. We conducted a longitudinal study with two points of measurement, before the COVID-19 pandemic (N = 112) and after (N = 304). Nursing students filled out an online questionnaire using validated scales. To analyze the data, we used descriptive statistics, correlation analysis, and Welch's t-test. The results show that before the COVID-19 pandemic, the nursing students assessed their health literacy as quite high, and after the COVID-19 pandemic, they found it difficult to access (t = 17.881; p < 0.001; Cohen's d = 0.46), understand (t = 16.404; p < 0.001; Cohen's d = 0.56), appraise (t = 15.429; p < 0.00; Cohen's d = 0.47), and apply health-related information (t = 13.761; p < 0.001; Cohen's d = 0.54). Implications of our study concern nurses' vocational education and training in which nurses must learn about health literacy and strategies to foster their patients' health literacy.

Health literacy profiles of medical students in an Australian Doctor of Medicine programme: A cross-sectional study using the Health Literacy Questionnaire

ISSUE ADDRESSED

With the emerging focus on designing health-literate organisations and health care systems, it is essential to understand the health literacy profiles of the medical workforce including medical students, as medical professionals play a key role in within these systems. Medical professionals contribute to good patient health outcomes through enabling access to appropriate health care, provision of quality health information and collaborative shared decision-making, which are fundamental health literacy competencies. The aim of this study is to identify health literacy strengths and weaknesses of medical students enrolled in an Australian Doctor of Medicine programme.

METHODS

Students from all 4 years of an Australian Doctor of Medicine programme were invited to complete an anonymous, online survey in January 2021. Health literacy profiles were identified using the 9-domain, 44-item multi-dimensional Health Literacy Questionnaire, a validated tool which comprehensively evaluates health literacy strengths and weaknesses from diverse perspectives. Demographic characteristics and social attributes were also recorded. The results were compared with Australian Bureau of Statistics data.

RESULTS

Eighty-six participants completed the survey. Most participants were female students (57%) who spoke English at home (88%) with tertiary-educated fathers (60%) and resided in locations associated with high socioeconomic status during adolescence (61%). Males scored significantly higher in three domains which explored health information access and appraisal, and ability to actively engage with health care providers. Students' scores were significantly lower than the Australian general population in Domain 6 (Ability to actively engage with health care providers) and Domain 7 (Navigating the health care system).

CONCLUSIONS

Medical students' health literacy profiles indicate areas of weakness in their ability to engage with health care providers and to navigate the health system. Medical educators will need to create opportunities to address these weaknesses within medical curricula. Gender differences identified in self-rated ability to access and appraise health information requires further exploration. SO WHAT?: Further understanding of health literacy profiles of medical students may influence design of medical school curricula.

Translation, cross-cultural adaptation, and validation of the Chinese version of the COVID-19 health literacy scale in nursing students

BACKGROUND

Effective communication is an essential component of high-quality nursing care. Health literacy, the ability to access, describe, evaluate and apply health information to make informed decisions, is an important component of effective communication in nursing. Nurses, including student nurses, with good levels of health literacy (HL) are well positioned to communicate reliable public health-related information effectively, at times like the COVID-19 global pandemic. At this time, many nursing students have been at the frontline of patient education, as such, it would be expected that they have high levels of HL. However, it has been suggested that there is the need to improve HL levels in nursing students.

AIMS

The aim of this study was to analyse the structure of item response of a back translated Chinese version of the COVID-HLS-Q22 questionnaire and to assess the coronavirus-related HLof Chinese speaking nursing students in Hong Kong using the COVID-HLS-Q22-CN.

METHODS

A cross-sectional study of 97 undergraduate nursing students was conducted using two self-reported questionnaires. The HLS-EU-16 scale, with face validity already established, was used to assess scale equivalence Using a cross-over study approach, student participants were randomly assigned in sequential order. The validation process was performed in five phases: direct translation, translation synthesis, back translation, consolidation with experts, and testing with the students. The intended outcome of this study will be a formally tested model of the Chinese version of the COVID-HLS-Q22-CN, that can be replicated in Chinese population.

RESULTS

Factorial equivalence was present across language versions in both questionnaires. Internal consistency was excellent for COVID-HLS-Q22-CN (coefficient alpha for Chinese version of questionnaire, 0.957 and English version, 0.953). This suggested that the four subscale are stable across the two questionnaires.

CONCLUSION

The COVID-HLS-Q22-CN has proven to be a feasible and reliable tool in the assessment of Hong Kong based Chinese speaking nursing students. The emergence of issues around COVID-related HL further highlights the need to include the teaching of critical health literacy skills within nurse education, preparing the healthcare professionals of the future for public health emergencies.

Determinants of Inadequate Health Literacy Among Faculty of Medical Technical Sciences Students in Albania: Cross-Sectional Survey

BACKGROUND

Health literacy (HL) refers to people's ability to find, understand, and use health information in order to make appropriate health decisions. Health literacy among students is important so that tomorrow's health professionals can deliver high-quality health care and enhance patient education and communication.

OBJECTIVE

In this context, the aim of this study was to assess the HL level of Faculty of Medical Technical Sciences (FMTS) students in order to shed light on this underresearched topic in Albanian settings.

METHODS

A cross-sectional study involving 193 FMTS students of various study branches (nursing, midwifery, physiotherapy, and laboratory technician) was carried out during June 22-29, 2022, on the premises of the FMTS Faculty in Tirana, Albania. The international European Health Literacy Survey Questionnaire (HLS-EU-Q) standardized questionnaire, validated in Albanian, was used to collect information about FMTS students' general HL through a face-to-face interview. Basic sociodemographic information was collected as well. Binary logistic regression was used to assess the factors associated with inadequate, problematic, or limited HL.

RESULTS

The mean level of general HL was 37.2 (on a scale from 0 [minimum HL] to 50 [maximal HL]). About one-quarter of FMTS students had inadequate (9/193, 4.7%) or problematic (38/193, 19.7%) HL, 51.3% (99/193) had sufficient HL, and 24.4% (47/193) had excellent HL. The prevalence of limited HL (inadequate and problematic HL) was higher among male than female students (6/12, 50% vs 41/181, 22.6%, respectively) and those with lower social and economic status. Upon adjusting for confounding effects, the only factor significantly increasing the likelihood of limited HL was male gender (odds ratio 8.13, 95% CI 1.68-39.39). Findings suggested that low social and economic status also increased the likelihood of limited HL, but such associations did not reach statistical significance.

CONCLUSIONS

To our knowledge, this is the first study exploring the level of HL and its associated factors among FMTS students in Albania. The prevalence of limited HL was relatively high among FMTS students. There is a need for targeted interventions to increase the HL of nursing and midwifery students, such as the inclusion of HL subjects in the nursing curriculum.

Factors related with nursing students' health literacy: a cross sectional study

Background

Nursing professionals have a crucial role in promoting health literacy in health services, so it is necessary to ensure health literacy skills in future health professionals.

Objective

The objective of the study was to examine the health literacy of nursing students and its associated factors.

Methods

A cross-sectional descriptive study was carried out on 460 nursing students. For data collection, a semi-structured questionnaire was obtained on sociodemographic characteristics, perception and health care, use of the health system and lifestyles. In addition, health literacy was assessed using the European Health Literacy Questionnaire.

Results

6.1% of the participants had an inadequate level of health literacy and 36.5% problematic. The probability of having sufficient health literacy is directly associated with age; and inversely with smoking, prolonged screen time and living alone (p < 0.05).

Conclusion

A large percentage of nursing students need to improve their health literacy skills. It is necessary to integrate a greater number of contents in health literacy in the curriculum of nursing students.

Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study

Background

Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.

Methods

This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).

Results

Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.

Conclusions

Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.

Differences in digital health literacy and future anxiety between health care and other university students in England during the COVID-19 pandemic

Background

This study investigates university students’ digital health literacy and web-based information-seeking behaviours during the early stages of the COVID-19 pandemic in England. It compares undergraduate and postgraduate students in non-health related subjects with health care students, many of whom were preparing for, or working in, frontline roles. The survey was conducted as part of a wider study by the COVID-HL research consortium.

Methods

A cross-sectional study was conducted among n = 691 university students aged ≥18 years from 25 universities across England using an adapted digital survey developed by COVID-HL. Data were collected regarding sociodemographic characteristics and specific measures drawn from the Future Anxiety Scale and the Digital Health Literacy Instrument (DHLI). These had been adapted for use in an English setting and to the specific context of the COVID-19 pandemic. Other data collected included students’ anxiety or worries about the future using the Dark Future Scale as well as behaviours in online information-seeking. Data were analysed using correlations to test for relationships between constructs and also between group comparisons to test for differences between students studying health and non-health related subjects.

Results

Across digital health literacy dimensions, there was no significant difference between students studying health-related subjects and other students. Health care students did report greater difficulties in relation to how to behave online. They also relied less on public body sources for information about the pandemic. A significant difference was found between the two student populations in relation to their anxiety about the future with health care students reporting fewer fears about the future.

Conclusions

Although digital health literacy is well developed in university students, a significant proportion of students still face difficulties with evaluating online information which may frustrate public health efforts. This could be addressed by ensuring health students’ curriculum in particular encompasses digital health literacy.

Do health literacy levels of nursing students change throughout the study programme? A cross-sectional study

OBJECTIVES

The aim of this research was to analyse if the level of health literacy (HL) of nursing students changes throughout the study programme.

DESIGN

A cross-sectional study with anonymous self-reporting was conducted.

PARTICIPANTS/SETTING

329 public university nursing students in Seville, Spain; 243 of the first year and 86 of the fourth.

INTERVENTIONS

The short Spanish version of the Health Literacy Survey Questionnaire-European Union was used to evaluate HL.

PRIMARY AND SECONDARY OUTCOME MEASURES

The proportions of the limited level of HL were compared between academic years and the crude and corrected OR were calculated with the Mantel-Haenszel test to evaluate the effect of confusion of the sex variable on the HL level and academic year relationship. A logistic regression model with step-by-step analysis was run, including the independent variables sex, age, marital status, academic year and HL level (limited/sufficient) as the dependent variable.

RESULTS

62.1% of the participants of the first year versus 47.7% of the fourth year had a limited literacy level for a crude OR of 1.5 (95% CI 1.10 to 2.21; p=0.014) and a corrected by sex OR of 1.8 (95% CI 1.10 to 2.96; p=0.026). Only the strata in women had a statistically significant relationship. The logistic regression model ratified that the HL was a function exclusive to the academic year.

CONCLUSION

The HL level of nursing students increases from the first to the fourth academic year, even when controlling for sex. Although the HL level in the fourth academic year was greater than that of the first, both groups had inadequate HL levels. It is hence recommended to implement intervention strategies, which reinforce in the curriculum the knowledge and experiences related with health communication and education to ensure that future professionals improve their HL. Achieving adequate HL is crucial to be able to provide care to patients, their families and the community.

Nursing students' understanding of health literacy and health practices: a cross-sectional study at a university in Namibia

Background

A poor understanding of health literacy and inadequate health practices among nurses can be detrimental to a population’s health. The starting point of solving this problem is through the provision of methodical health literacy and health practice education in the nursing curriculum. This study explored nursing students’ understanding of the concept of ‘health literacy’ and their health practices at a university in Namibia.

Methods

A descriptive cross-sectional study was carried out among 205 nursing students. A simple stratified sampling method was used and data were collected using a self-reporting Understanding of Health Literacy (UHL) questionnaire. Pearson correlation, independent t-test and One-way ANOVA were used to analyse the data.

Results

The overall mean Understanding of Health Literacy score was 13.04 ± 1.52. The majority (n = 157; 76.5%) of the students were found to have adequate health literacy scores, 21.5% had moderate health literacy scores, and only 2% had inadequate health literacy scores. The overall mean health practice score was 32.4 ± 5.50. Most (n = 106; 51.7%) of the students were found to have poor health practices, 44.4% had average health practices, and just 3.9% had good health practices. There was no significant relationship between the health literacy levels and health practices of the students (p = 0.63).

Conclusions

Nursing students have a good understanding of the concept of health literacy, but more effort can be made to translate this understanding into health literacy skills. There is a need to investigate the contributing factors to poor health practices, as well as develop strategies that can support good health practices among nursing students. These health literacy skills could then be transferred into the students' professional careers as nurses.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00776-z.

Is undergraduate nursing education sufficient for patient's nutrition care in today's pandemics? Assessing the nutrition knowledge of nursing students: An integrative review

AIM

To establish whether nurses are well prepared to provide nutrition care by identifying studies that evaluated undergraduate (baccalaureate) student nurses' nutrition knowledge, practices and selfcare and to identify areas for improvement.

BACKGROUND

The importance of nutrition care in health is well recognised, with poor nutrition behaviour contributing to many million deaths annually and to less resilience to COVID 19. Nurses as the largest health professional group are ideally positioned to provide basic nutrition care.

DESIGN

Integrative Review METHODS: Whittemore & Knafl's integrative review methodology guided this review. Appropriate search terms were used in seven databases (PubMed, Medline, Embase, ProQuest Nursing and Allied Health, the Royal College of Nursing Journals, Scopus) for Undergraduate nurses' nutrition knowledge during the period 2010-2020. The quality of the studies was assessed using the Mixed Methods Appraisal Tool.

RESULTS

Of the 250 studies identified, ten studies met the inclusion criteria: seven studies also investigated nurses' eating patterns and health habits. Two themes emerged from data synthesis and analysis. Nursing students lack sufficient nutrition knowledge to develop the professional capacity to provide effective nutrition care to patients; nursing students' eating patterns and health habits suggest insufficient nutrition knowledge for appropriate selfcare.

CONCLUSION

Improvements in undergraduate nutrition care are required. Consideration should be given to the inclusion of nutrition experts to guide nurse educators to develop and implement innovative nutrition care programmes.

Demographic and socio-economic differences in financial information literacy among university students

Financial information literacy helps to manage earnings, especially among those students who study non-commerce subjects. Thus, this study attempts to explore the differences in such literacy through their demographic and socioeconomic characteristics. A well-structured instrument was used to gather data from 382 non-commerce students in universities in Pakistan using a multi stage sampling technique. Analyses were conducted through percentage of correct response technique and group comparisons. The findings indicate an average level of financial knowledge among university students. The demographic differences reveal that most of the students are male, graduate, with age above 26, enrolled in a private university, residing in dormitories, and score higher in academic subjects are more financially literate. While the socioeconomic differences indicate that those students who follow family advice, study minor finance courses, maintain a bank account, and have higher parental income are more knowledgeable about finance. The study recommends arranging awareness sessions to impart financial knowledge to students.