Health literacy, health status and health behavior among students and trainees in nursing: a longitudinal cohort study
Abstract
Nursing trainees and students are exposed to considerable physical and psychological demands early in their careers, which may affect their health status and health behavior. Health literacy has been suggested as a potential resource for maintaining health; however, longitudinal evidence in this population remains scarce. This longitudinal cohort study aimed to assess health literacy, health status, and health behavior among 128 nursing trainees and 43 nursing students over one year and to examine their development and potential group differences. Data were collected using paper-pencil and online questionnaires between January 2021 and July 2022. Health literacy (HLS-EU-Q16), psychological wellbeing (WHO-5), self-rated health status, BMI, and health behaviors (smoking, alcohol consumption, physical activity, and nutrition) were assessed. While average health literacy scores remained stable over time, individual-level changes were heterogeneous. BMI increased significantly over time. Self-rated health status deteriorated significantly among trainees. In the total sample, both self-rated health status and psychological wellbeing showed slight, non-significant decreases. Smoking prevalence increased significantly, whereas other health behaviors remained largely unchanged. No significant associations were found between baseline health literacy and health outcomes or health behaviors at follow-up. Differences between trainees and students were generally small, with BMI being the only outcome consistently higher among trainees. During the first year of training, nursing trainees and students showed a decline in aspects of health status, while health literacy remained stable. No statistically significant associations were detected between health literacy at baseline and health outcomes or behaviors at follow-up. These findings highlight the need for targeted health promotion strategies in early nursing education. Further research is needed to better understand the development of health literacy throughout nursing job training.