Skip to main content
Top
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

The association between quality of life(QOL) and health literacy among junior middle school students: a cross-sectional study

Authors: Min Ran, Linli Peng, Qin Liu, Michelle Pender, Fang He, Hong Wang

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

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.

Methods

An 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.

Results

A 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).

Conclusions

The 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.
Literature
1.
go back to reference World Health Organization. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403–9.CrossRef World Health Organization. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403–9.CrossRef
2.
go back to reference Nyman JA, Barleen NA, Dowd BE, et al. Quality-of-life weights for the US population: self-reported health status and priority health conditions, by demographic characteristics. Med Care. 2007;45(7):618–28.CrossRef Nyman JA, Barleen NA, Dowd BE, et al. Quality-of-life weights for the US population: self-reported health status and priority health conditions, by demographic characteristics. Med Care. 2007;45(7):618–28.CrossRef
3.
go back to reference Lumley S, Ward P, Roberts L, et al. Self-reported extracurricular activity, academic success, and quality of life in UK medical students. Int J Med Educ. 2015;6:111–7.CrossRef Lumley S, Ward P, Roberts L, et al. Self-reported extracurricular activity, academic success, and quality of life in UK medical students. Int J Med Educ. 2015;6:111–7.CrossRef
4.
go back to reference De Rooij AH, Luijkx KG, Declercq AG, et al. Quality of life of residents with dementia in long-term care settings in the Netherlands and Belgium: design of a longitudinal comparative study in traditional nursing homes and small-scale living facilities. BMC Geriatr. 2011;11(1):1–9.CrossRef De Rooij AH, Luijkx KG, Declercq AG, et al. Quality of life of residents with dementia in long-term care settings in the Netherlands and Belgium: design of a longitudinal comparative study in traditional nursing homes and small-scale living facilities. BMC Geriatr. 2011;11(1):1–9.CrossRef
5.
go back to reference Bingefors K, Lindberg M, Isacson D. Quality of life, use of topical medications and socio-economic data in hand eczema: a Swedish nationwide survey. Acta Derm Venereol. 2011;91(4):452–8.CrossRef Bingefors K, Lindberg M, Isacson D. Quality of life, use of topical medications and socio-economic data in hand eczema: a Swedish nationwide survey. Acta Derm Venereol. 2011;91(4):452–8.CrossRef
7.
go back to reference Hong W, Yi Z, Dawei L, et al. Analysis of quality of life and its influencing factors of junior high school students in Chongqing. Modern Preventive Medicine. 2007;34(16):3003–5. Hong W, Yi Z, Dawei L, et al. Analysis of quality of life and its influencing factors of junior high school students in Chongqing. Modern Preventive Medicine. 2007;34(16):3003–5.
8.
go back to reference Van GR, van Essen LE, Rovers MM, et al. Quality of life in children with undiagnosed and diagnosed asthma. Eur J Pediatr. 2007;166(8):843–8.CrossRef Van GR, van Essen LE, Rovers MM, et al. Quality of life in children with undiagnosed and diagnosed asthma. Eur J Pediatr. 2007;166(8):843–8.CrossRef
9.
go back to reference Gilson KM, Davis E, Reddihough D, et al. Quality of life in children with cerebral palsy: implications for practice. J Child Neurol. 2014;29(8):1134–40.CrossRef Gilson KM, Davis E, Reddihough D, et al. Quality of life in children with cerebral palsy: implications for practice. J Child Neurol. 2014;29(8):1134–40.CrossRef
10.
go back to reference Felsmann M, Futyma B, Felsmann M, et al. Quality of life in children with epilepsy, evaluated by the parents on the basis of Qolce questionnaire. Medical & Biological Sciences. 2012;26(1):99–105. Felsmann M, Futyma B, Felsmann M, et al. Quality of life in children with epilepsy, evaluated by the parents on the basis of Qolce questionnaire. Medical & Biological Sciences. 2012;26(1):99–105.
11.
go back to reference Lai JS, Nowinski C, Victorson D, et al. Quality-of-life measures in children with neurological conditions: pediatric neuro-QOL. Neurorehabil Neural Repair. 2012;26(1):36–47.CrossRef Lai JS, Nowinski C, Victorson D, et al. Quality-of-life measures in children with neurological conditions: pediatric neuro-QOL. Neurorehabil Neural Repair. 2012;26(1):36–47.CrossRef
12.
go back to reference Rosenberg AR, Orellana L, Ullrich C, et al. Quality of life in children with advanced Cancer: a report from the PediQUEST study. Journal of Pain & Symptom Management. 2016;52(2):243–53.CrossRef Rosenberg AR, Orellana L, Ullrich C, et al. Quality of life in children with advanced Cancer: a report from the PediQUEST study. Journal of Pain & Symptom Management. 2016;52(2):243–53.CrossRef
13.
go back to reference Wang H, Liu DW, Wang Y, et al. Quality of life and its influencing factors among junior middle school students of the three-gorges reservoir in Chongqing (in Chinese). Modern Preventive Medicine. 2005;32(92):102–4. Wang H, Liu DW, Wang Y, et al. Quality of life and its influencing factors among junior middle school students of the three-gorges reservoir in Chongqing (in Chinese). Modern Preventive Medicine. 2005;32(92):102–4.
14.
go back to reference Institute of Medicine. Health literacy: a prescription to end confusion. Washington DC: National Academies Press; 2004. Institute of Medicine. Health literacy: a prescription to end confusion. Washington DC: National Academies Press; 2004.
15.
go back to reference Nutbeam D. The evolving concept of health literacy. Social Science Medicine. 2008;67(12):2072–8.CrossRef Nutbeam D. The evolving concept of health literacy. Social Science Medicine. 2008;67(12):2072–8.CrossRef
16.
go back to reference Guo SJ, Yu XM, Wang L, Sun YY, et al. Factor analysis on health literacy of junior middle school students in China (in Chinese). Chinese Journal of Child Health Care. 2013;21(1):37–9. Guo SJ, Yu XM, Wang L, Sun YY, et al. Factor analysis on health literacy of junior middle school students in China (in Chinese). Chinese Journal of Child Health Care. 2013;21(1):37–9.
17.
go back to reference Zhuang RS, Li C, Zhu MZ, et al. Status of health literacy and its influencing factors among high school students in Shenzhen city (in Chinese). Chin J Public Health. 2013;29(1):130–3. Zhuang RS, Li C, Zhu MZ, et al. Status of health literacy and its influencing factors among high school students in Shenzhen city (in Chinese). Chin J Public Health. 2013;29(1):130–3.
18.
go back to reference Zhang YL, Yu H, Wei WJ, Qiu AM, Chen XL. Current situation of health knowledge and health education among junior middle school students in Xiamen (in Chinese). Chinese Journal of School Health. 2012;33(4):460–1. Zhang YL, Yu H, Wei WJ, Qiu AM, Chen XL. Current situation of health knowledge and health education among junior middle school students in Xiamen (in Chinese). Chinese Journal of School Health. 2012;33(4):460–1.
19.
go back to reference Lin PP, Chen ZJ, Zhang J, Fang MZ, Wu X, Xu WL, et al. Hangzhou junior high school students' health literacy: a survey of the status quo and possible countermeasures (in Chinese). Health Research. 2013;33(5):324–8. Lin PP, Chen ZJ, Zhang J, Fang MZ, Wu X, Xu WL, et al. Hangzhou junior high school students' health literacy: a survey of the status quo and possible countermeasures (in Chinese). Health Research. 2013;33(5):324–8.
20.
go back to reference Zhang SC, Wan YH, Tao SM, et al. Reliability and structural validity evaluation of chinese youth interactive health literacy questionnaire (in Chinese). Chinese Journal of School Health. 2014;35(3):332–6. Zhang SC, Wan YH, Tao SM, et al. Reliability and structural validity evaluation of chinese youth interactive health literacy questionnaire (in Chinese). Chinese Journal of School Health. 2014;35(3):332–6.
22.
go back to reference Burns J, Rapee R. Adolescent mental health literacy: young people's knowledge of depression and help seeking. J Adolesc. 2006;29(2):225–39.CrossRef Burns J, Rapee R. Adolescent mental health literacy: young people's knowledge of depression and help seeking. J Adolesc. 2006;29(2):225–39.CrossRef
23.
go back to reference Ghaddar S, Valerio M, Garcia C, Hansen L. Adolescent health literacy: the importance of credible sources for online health information. J Sch Health. 2011;82(1):28–36.CrossRef Ghaddar S, Valerio M, Garcia C, Hansen L. Adolescent health literacy: the importance of credible sources for online health information. J Sch Health. 2011;82(1):28–36.CrossRef
24.
go back to reference Chang LC. Health literacy, self-reported status and heal promoting behaviours for adolescents in Taiwan. J Clin Nurs. 2011;20(1–2):190–6.CrossRef Chang LC. Health literacy, self-reported status and heal promoting behaviours for adolescents in Taiwan. J Clin Nurs. 2011;20(1–2):190–6.CrossRef
25.
go back to reference Cimasi RJ, Sharamitaro AR, Seiler RL. The association between health literacy and preventable hospitalizations in Missouri: implications in an era of reform. J Health Care Finance. 2013;40(2):1–16.PubMed Cimasi RJ, Sharamitaro AR, Seiler RL. The association between health literacy and preventable hospitalizations in Missouri: implications in an era of reform. J Health Care Finance. 2013;40(2):1–16.PubMed
26.
go back to reference Herman A, Young KD, Espitia D, et al. Impact of a health literacy intervention on pediatric emergency department use. Pediatr Emerg Care. 2009;25(7):434–8.CrossRef Herman A, Young KD, Espitia D, et al. Impact of a health literacy intervention on pediatric emergency department use. Pediatr Emerg Care. 2009;25(7):434–8.CrossRef
27.
go back to reference Lee SYD, Tsai T, Tsai YW, et al. Health literacy, health status, and healthcare utilization of Taiwanese adults: results from a national survey. BMC Public Health. 2010;10(1):614.CrossRef Lee SYD, Tsai T, Tsai YW, et al. Health literacy, health status, and healthcare utilization of Taiwanese adults: results from a national survey. BMC Public Health. 2010;10(1):614.CrossRef
28.
go back to reference Yin HS, Mendelsohn AL, Wolf MS, et al. Parents' medication administration errors: role of dosing instruments and health literacy. Archives of Pediatrics & Adolescent Medicine. 2010;164(2):1816.CrossRef Yin HS, Mendelsohn AL, Wolf MS, et al. Parents' medication administration errors: role of dosing instruments and health literacy. Archives of Pediatrics & Adolescent Medicine. 2010;164(2):1816.CrossRef
29.
go back to reference Harrington KF, Zhang B, Magruder T, et al. The impact of Parent's health literacy on pediatric asthma outcomes. Pediatric Allergy Immunology & Pulmonology. 2015;28(1):20–6.CrossRef Harrington KF, Zhang B, Magruder T, et al. The impact of Parent's health literacy on pediatric asthma outcomes. Pediatric Allergy Immunology & Pulmonology. 2015;28(1):20–6.CrossRef
30.
go back to reference Hassan K, Heptulla RA. Glycemic control in pediatric type 1 diabetes:the role of caregiver literacy. Pediatrics. 2010;125(5):1104–8.CrossRef Hassan K, Heptulla RA. Glycemic control in pediatric type 1 diabetes:the role of caregiver literacy. Pediatrics. 2010;125(5):1104–8.CrossRef
31.
go back to reference Sanders LM, Thompson VT, Wilkinson JD. Caregiver health literacy and the use of child health services. Pediatrics. 2007;119(1):e86–92.CrossRef Sanders LM, Thompson VT, Wilkinson JD. Caregiver health literacy and the use of child health services. Pediatrics. 2007;119(1):e86–92.CrossRef
32.
go back to reference Morrison AK, Schapira MM, Gorelick MH, et al. Low caregiver health literacy is associated with higher pediatric emergency department use and nonurgent visits. Acad Pediatr. 2014;14(3):309–14.CrossRef Morrison AK, Schapira MM, Gorelick MH, et al. Low caregiver health literacy is associated with higher pediatric emergency department use and nonurgent visits. Acad Pediatr. 2014;14(3):309–14.CrossRef
33.
go back to reference Song L, Mishel M, Bensen JT, et al. How does health literacy affect quality of life among men with newly diagnosed clinically localized prostate cancer. Cancer. 2012;118(15):3842–51.CrossRef Song L, Mishel M, Bensen JT, et al. How does health literacy affect quality of life among men with newly diagnosed clinically localized prostate cancer. Cancer. 2012;118(15):3842–51.CrossRef
34.
go back to reference Wang C, Kane RL, Xu D, et al. Health literacy as a moderator of health-related quality of life responses to chronic disease among Chinese rural women. BMC Womens Health. 2015;15(1):15–34.CrossRef Wang C, Kane RL, Xu D, et al. Health literacy as a moderator of health-related quality of life responses to chronic disease among Chinese rural women. BMC Womens Health. 2015;15(1):15–34.CrossRef
35.
go back to reference González-Chica DA, Mnisi Z, Avery J, et al. Effect of health literacy on quality of life amongst patients with Ischaemic heart disease in Australian general practice. PLoS One. 2016;11(3):1015–79.CrossRef González-Chica DA, Mnisi Z, Avery J, et al. Effect of health literacy on quality of life amongst patients with Ischaemic heart disease in Australian general practice. PLoS One. 2016;11(3):1015–79.CrossRef
36.
go back to reference Wang LY, Wang H, Cheng XT, et al. Development of health literacy scale for middle school students and its reliability and validity analyze(in Chinese). Modern Preventive Medicine. 2016;23(43):4296–305. Wang LY, Wang H, Cheng XT, et al. Development of health literacy scale for middle school students and its reliability and validity analyze(in Chinese). Modern Preventive Medicine. 2016;23(43):4296–305.
37.
go back to reference World Health Organization. Health promotion glossary, vol. 10. Geneva, Switzerland: WHO; 1998. World Health Organization. Health promotion glossary, vol. 10. Geneva, Switzerland: WHO; 1998.
38.
go back to reference The Ministry of Education of the People's Republic of China. Notice of the ministry of education on the issuance of the outline of health education guidance in primary and secondaryschool students. Bulletin of the state council of the People's Republic of China. 2009;7(14):13–8. The Ministry of Education of the People's Republic of China. Notice of the ministry of education on the issuance of the outline of health education guidance in primary and secondaryschool students. Bulletin of the state council of the People's Republic of China. 2009;7(14):13–8.
39.
go back to reference Ministry of public health of the people's Republic of China. Chinese citizens’health literacy-basic knowledge and skills (trial). Chinese Junior of Health Education. 2016;32(1):95–6. Ministry of public health of the people's Republic of China. Chinese citizens’health literacy-basic knowledge and skills (trial). Chinese Junior of Health Education. 2016;32(1):95–6.
40.
go back to reference Cheng ZH, Gao BL. The inventory of subjective life quality for child and adolescent: development, reliability, and validity (in Chinese). Chinese Journal of Clinical Psychology. 1998;6(1):11–6. Cheng ZH, Gao BL. The inventory of subjective life quality for child and adolescent: development, reliability, and validity (in Chinese). Chinese Journal of Clinical Psychology. 1998;6(1):11–6.
41.
go back to reference Wu HR, Liu PL, Meng H, et al. Norm, reliability and validity of children and Adolescents' QOL scale(in Chinese). Chinese Journal of School Health. 2006;27(1):18–21. Wu HR, Liu PL, Meng H, et al. Norm, reliability and validity of children and Adolescents' QOL scale(in Chinese). Chinese Journal of School Health. 2006;27(1):18–21.
42.
go back to reference Lu YY, Tian Q, Hao YT, et al. Reliability and validity for Chinese version of pediatric quality of life inventory PedsQL4.0 (in Chinese). Journal of Sun Yat-sen University (Medical Sciences). 2008;29(3):328–31. Lu YY, Tian Q, Hao YT, et al. Reliability and validity for Chinese version of pediatric quality of life inventory PedsQL4.0 (in Chinese). Journal of Sun Yat-sen University (Medical Sciences). 2008;29(3):328–31.
43.
go back to reference Chang LC, Hsieh PL, Liu CH. Psychometric evaluation of the Chinese version of short-form test of functional health literacy in adolescents. J Clin Nurs. 2012;21(17):2429–37.CrossRef Chang LC, Hsieh PL, Liu CH. Psychometric evaluation of the Chinese version of short-form test of functional health literacy in adolescents. J Clin Nurs. 2012;21(17):2429–37.CrossRef
44.
go back to reference Chisolm DJ, Manganello JA, Kelleher KJ, et al. Health literacy, alcohol expectancies, and alcohol use behaviors in teens. Patient Education & Counseling. 2014;97(2):291–6.CrossRef Chisolm DJ, Manganello JA, Kelleher KJ, et al. Health literacy, alcohol expectancies, and alcohol use behaviors in teens. Patient Education & Counseling. 2014;97(2):291–6.CrossRef
45.
go back to reference Wang CL, Robert LK, Xu DJ, et al. Health literacy as a moderator of health-related quality of life responses to chronic disease among Chinese rural women. BMC Womens Health. 2015;15(1):34–41.CrossRef Wang CL, Robert LK, Xu DJ, et al. Health literacy as a moderator of health-related quality of life responses to chronic disease among Chinese rural women. BMC Womens Health. 2015;15(1):34–41.CrossRef
46.
go back to reference Ye XH, Yang Y, Gao YH, et al. Status and determinants of health literacy among adolescents in Guangdong, China. Asian Pac J Cancer Prev. 2014;15(20):8735–40.CrossRef Ye XH, Yang Y, Gao YH, et al. Status and determinants of health literacy among adolescents in Guangdong, China. Asian Pac J Cancer Prev. 2014;15(20):8735–40.CrossRef
47.
go back to reference Wolf MS, Gazmararian JA, Baker DW. Health literacy and functional health status among older adults. Arch Intern Med. 2005;165(17):1946–52.CrossRef Wolf MS, Gazmararian JA, Baker DW. Health literacy and functional health status among older adults. Arch Intern Med. 2005;165(17):1946–52.CrossRef
48.
go back to reference Bridges SM, Parthasarathy DS, Wong HM, et al. The relationship between caregiver functional oral health literacy and child oral health status. Patient Education & Counseling. 2014;94(3):411–6.CrossRef Bridges SM, Parthasarathy DS, Wong HM, et al. The relationship between caregiver functional oral health literacy and child oral health status. Patient Education & Counseling. 2014;94(3):411–6.CrossRef
49.
go back to reference Ownby RL, Acevedo A, Jacobs RJ, et al. Quality of life, health status and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS. Patient Educ Couns, 2014, 96(3): 404–10.CrossRef Ownby RL, Acevedo A, Jacobs RJ, et al. Quality of life, health status and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS. Patient Educ Couns, 2014, 96(3): 404–10.CrossRef
50.
go back to reference Sun AY, Wu YQ, Qian L, et al. Research on health literacy among junior middle school students in Chuxiong (in Chinese). Chin J Sch Health. 2014;35(5):740–2. Sun AY, Wu YQ, Qian L, et al. Research on health literacy among junior middle school students in Chuxiong (in Chinese). Chin J Sch Health. 2014;35(5):740–2.
51.
go back to reference Yao Z. Research on knowledge gap and its countermeasures in urban and rural health communication (in Chinese). Chengdu: Chengdu University of Technology; 2013. Yao Z. Research on knowledge gap and its countermeasures in urban and rural health communication (in Chinese). Chengdu: Chengdu University of Technology; 2013.
52.
go back to reference Kutner Mark, Greenburg Elizabeth, Jin Ying, Paulsen Christine. The Health Literacy of America's Adults: Results from the 2003 National Assessment of adult literacy. NCES 2006-483. National Center for Education Statistics, 2006, 39(10):685–687. Kutner Mark, Greenburg Elizabeth, Jin Ying, Paulsen Christine. The Health Literacy of America's Adults: Results from the 2003 National Assessment of adult literacy. NCES 2006-483. National Center for Education Statistics, 2006, 39(10):685–687.
53.
go back to reference Vardavas CI, Kondilis BK, Patelarou E, Akrivos PD, Falagas ME. Health literacy and sources of health education among adolescents in Greece. Int J Adolesc Med Health. 2009;21(2):179–86.CrossRef Vardavas CI, Kondilis BK, Patelarou E, Akrivos PD, Falagas ME. Health literacy and sources of health education among adolescents in Greece. Int J Adolesc Med Health. 2009;21(2):179–86.CrossRef
54.
go back to reference Wu RL, Shi HJ, Bei PL, et al. Survey on health literacy among grade seven students in Putuo District of Shanghai in 2012-2013(in Chinese). J Environ Occup Med. 2015;32(10):941–4. Wu RL, Shi HJ, Bei PL, et al. Survey on health literacy among grade seven students in Putuo District of Shanghai in 2012-2013(in Chinese). J Environ Occup Med. 2015;32(10):941–4.
55.
go back to reference Qiu SY, Zhang JQ, Feng C. Survey on health literacy of junior school students in Hefei (in Chinese). Anhui J Prev Med. 2016;22(4):225–8. Qiu SY, Zhang JQ, Feng C. Survey on health literacy of junior school students in Hefei (in Chinese). Anhui J Prev Med. 2016;22(4):225–8.
56.
go back to reference Leng Y, Sun T, Zhang SH, et al. Influence factor analysis on health literacy among city middle school students in Shandong Province (in Chinese). Chinese Journal of Health Education. 2016;32(8):681–5. Leng Y, Sun T, Zhang SH, et al. Influence factor analysis on health literacy among city middle school students in Shandong Province (in Chinese). Chinese Journal of Health Education. 2016;32(8):681–5.
Metadata
Title
The association between quality of life(QOL) and health literacy among junior middle school students: a cross-sectional study
Authors
Min Ran
Linli Peng
Qin Liu
Michelle Pender
Fang He
Hong Wang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-6082-5

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue