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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health Education and Promotion
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1436665

The mediating role of self-efficacy in the relationship between health literacy, health status and psychological well-being among German trainees and students in nursing

Provisionally accepted
Ramona Otto Ramona Otto 1*Ivonne-Nadine Jürgensen Ivonne-Nadine Jürgensen 2Albert Nienhaus Albert Nienhaus 1,3Peter Koch Peter Koch 1
  • 1 Competence Center for Epidemiology and Health Services Research in Nursing Professions (CVcare), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • 2 Department of Nursing and Management, Faculty of Business and Social Science, University of Applied Sciences Hamburg, Hamburg, Germany
  • 3 Department for Occupational Medicine, Hazardous Substances and Health Sciences (AGG), German Social Accident Insurance for the Health and Welfare Services (BGW), Hamburg, Germany

The final, formatted version of the article will be published soon.

    Introduction: Health literacy is considered a determinant of several health-related behaviors and outcomes. Health literacy can be seen as a particularly relevant resource for health maintenance and promotion for young adults at the beginning of their challenging vocational training in nursing. However, the underlying mechanisms and the roles of other influencing factors such as self-efficacy remain unclear and need to be understood to successfully tailor interventions.Methods: This cross-sectional study aims to examine the relationships between health literacy, selfefficacy, health behavior and health status among 556 German trainees and students in nursing. Data were collected using paper-pencil and online questionnaires between January and June 2021. Mediation models were assessed, consisting of the direct pathways between health literacy and health status; health literacy and health behavior; and indirect pathways via self-efficacy.Results: The findings showed that health literacy positively affected self-rated health status (ß = 0.05, t = 4.35, p < 0.001) and psychological well-being (ß = 0.28, t = 3.34, p < 0.001). The effect of health literacy on psychological well-being was fully mediated through self-efficacy (Z = 265 4.91, p < 0.001) while the effect of health literacy on self-rated health status was partially mediated through self-efficacy (Z = 5.06, p < 0.001). In this cohort, there was no significant association between either health literacy or self-efficacy and health behavior. Conclusion: Self-efficacy should be taken into account when investigating health literacy and its possible relationships with health-related outcomes. Furthermore, it should be considered as an objective for health literacy interventions as well as health promotion measures for nursing students and trainees.

    Keywords: Health Literacy, self-efficacy, Nursing, Vocational Education, Students, Health Status, psychological well-being

    Received: 22 May 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Otto, Jürgensen, Nienhaus and Koch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ramona Otto, Competence Center for Epidemiology and Health Services Research in Nursing Professions (CVcare), University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.