ABSTRACT
Objective@#To explore the combined effect of health literacy and nonsuicidal selfinjury on suiciderelated behaviors in junior middle school students, so as to provide reference for suicide prevention.@*Methods@#During May to June 2023, a selffilling questionnaire survey was conducted among 7 367 junior middle school students selected by the methods of multistage stratified cluster sampling combined with conventient sampling in Chongqing. And a binary Logistic regression model was established to analyze the association of health literacy and NSSI with suiciderelated behaviors.@*Results@#The detection rates of suicidal ideation, suicide planning, and suicide attempt among junior middle school students were 27.99%, 9.84%, and 4.64%, and the detection rate of NSSI was 38.03%, the rates of possessing total health literacy, functional health literacy, interactive health literacy, and critical health literacy were 62.68%, 66.51%, 54.24%, and 72.65%, respectively. Binary Logistic regression analyses showed that the absence of total health literacy and the three dimensions of health literacy and NSSI were positively correlated with suicidal ideation, suicide planning, and suicide attempt in junior middle school students (OR=1.42-10.30), and there were combined effects (OR=7.43-18.71) (P<0.05).@*Conclusions@#Lack of health literacy or the presence of NSSI and their coexistence increase the risk of suiciderelated behaviors, and health literacy level should be improved in junior middle school students to reduce NSSI and thereby prevent suiciderelated behaviors.
ABSTRACT
BACKGROUND: The negative association of quality of life (QoL) and negative life evens (NLEs) among adolescents has been proved by cross-sectional studies, without exploring sex differences. This study aimed to explore the longitudinal associations between QoL and NLEs among adolescents during novel coronavirus disease 2019 (COVID-19) pandemic and whether there are sex or age differences. METHODS: A stratified cluster sampling was used to select 1421 students in primary school and middle school in Chongqing, China. From November 2020 (T0) to December 2021 (T2), the Adolescent Self-Rating Life Events Checklist and the Adolescent Quality of Life Scale were used to collect 3 waves of data. The correlations between study variables were conducted by the Pearson correlation analyses. The direction and strength of the longitudinal associations were analyzed using cross-lagged panel analyses. RESULTS: Results showed significant changes in both variables during COVID-19 pandemic (P < 0.001). Cross-sectional analyses showed stable negative correlations between NLEs and QoL stratified by sex or by age (P < 0.001). Sex and age differences in longitudinal relationships were shown by cross-lagged panel analyses. For males, NLEs had a short-term bi-directional association with QoL [ßA-D = -(0.091-0.340), P < 0.05]; for females, QoL had a short-term correlation with NLEs [ßA = -0.119), ßC = -0.109), P < 0.001]. In the youngest age group, NLEs had a short-term bi-directional correlation with QoL [ßA-D = -(0.098-0.428), P < 0.05]. There was a short-term association between total QoL and NLEs among students except the 14â¼15 year group [ßA = -(0.071-0.149), ßC = -(0.086-0.119), P < 0.05], the long-term association between total QoL and NLEs was only significant in adolescents aged 14â¼15 years (ßE = -0.132, P < 0.05). The strength of NLEs was slightly higher than that of total QoL, but lower than that of QoL in each dimension. CONCLUSION: There were negative longitudinal relationships between NLEs and QoL during COVID-19 pandemic, and the strength of the associations varied across sex or age. Strengthening QoL in different dimensions may be a promising way to reduce NLEs during the pandemic among adolescents, and interventions should be tailored according different sex and ages.