Nurses' health education competence and health literacy: A cross-sectional survey in Chinese county hospitals

Aim: This study aims to assess the health education competence of nurses in China's county hospitals, examining its relationship with health literacy and other influencing factors, such as receipt of health education training, and acquisition of health knowledge. Background: Nurses are pivotal in delivering health education, which is crucial for improving health outcomes. In rural China, the prevalent low health literacy, stemming from limited access to health guidance, necessitates an evaluation of nurses' health education competence in county hospitals. Understanding these competencies and their influencing factors is essential to enhance the health literacy of the Chinese population. Design: A cross-sectional study. Methods: The study surveyed 692 nurses from nine county hospitals in Shanxi Province, China, using convenience sampling. The analysis employed descriptive statistics, t-tests, ANOVA, Pearson's correlation, and hierarchical multiple linear regression. Results: The study revealed a low level of health education competence among the surveyed nurses, with total health education scores averaging 3.77+0.60, +0.60, and mean scores for knowledge, skills, and attitudes being 3.73 +0.67, 3.77+0.64, +0.64, and 3.89+0.64, +0.64, respectively. The multiple regression models were significant (P<0.001), with R2 2 values ranging from 0.143 to 0.197. Key predictors included the incentive mechanism for health education, receipt of health education training, acquisition of health knowledge, and literacies in infectious disease prevention, scientific health concepts, and chronic disease prevention. Conclusions: This study assessed the health education competence of nurses in county hospitals in China and investigated the impact of various dimensions of health literacy on this competence. The findings indicate that the health education competence of nurses in these settings remains relatively low. Additionally, health education training and incentive mechanisms were found to significantly enhance nurses' health education competence in areas lacking medical resources.