Association of Knowledge and Health Habits with Physiological Hydration Status

Psychometric Properties of the Knowledge of Hydration among Foreign Students of Óbuda University, Hungary

It is known that the quantity, makeup, and distribution of bodily fluids have a significant impact on the cognitive health, physiological health, and cell activity of human beings. This narrative could be influenced by the level of knowledge about hydration, dehydration, and the practice of Adequate Water Intake (AWI) of an individual based on the recommended daily Total Water Intake (TWI) by either the World Health Organization (WHO) or the European Food Safety Authority (EFSA). In this study, we have developed and validated a scale to adequately measure knowledge of the recommended daily Total Water Intake (TWI) practices among foreign students at Óbuda University, Hungary. Hence, we implemented an 11-item scale to measure the Knowledge of Hydration (KH-11) and evaluate its psychometric properties among students. This study is an online cross-sectional study assessing water intake knowledge with the use of the KH-11 tool among 323 students with ages ranging from 18 to 35 years, who have enrolled for at least two semesters at the University. The statistical analysis performed was reliability (using Cronbach alpha ≥ 70%) and factor analysis. Knowledge levels were categorized as poor (<50%), intermediate (50-70%), or adequate (71-100%). The intraclass correlation, chi-square, and rotated component matrix were also estimated and reported. Data were analyzed using SPSS version 25. Cronbach's alpha analysis revealed that the KH-11 had an overall good reliability with a value of 0.80, where the survey items had an acceptable level of consistency ranging from 0.75 to 0.81 and demonstrated sufficient independence from each other as Pearson's R within factors was positive and ranged from 0.02 to 0.74. In evaluating the participants' knowledge of hydration, the total possible score for the scale is 72, while the mean score for the KH-11 was 55.2 ± 11.61 SD, and the factor analysis model yielded an acceptable fit (χ2 = 3259.4, p = 0.000). We recorded a high-level positive concordance of 0.770 with an average intraclass correlation of 0.80 at a 95% CI, where p-value = 0.000. Our findings show that the majority (66.3%) of the students have a good knowledge of hydration. However, the skewed distribution of the knowledge scores suggests that some may have lower levels of knowledge, which may warrant further study to improve knowledge in those students.