Ortaokul öğrencilerinde sağlık okuryazarlığı düzeyi ve ilişkili etmenler
Health literacy level and influential factors in secondary school students
Yazar: NAZLI ÜÇKUYU
Danışman: PROF. DR. AYLA BAYIK TEMEL
Ege Üniversitesi / Sağlık Bilimleri Enstitüsü / Halk Sağlığı Hemşireliği Ana Bilim Dalı / Halk Sağlığı Hemşireliği Bilim Dalı
Derece: Yüksek Lisans, 2020
Konu: Halk Sağlığı = Public Health ; Hemşirelik = Nursing
Dizin: Halk sağlığı = Public health ; Halk sağlığı hemşireliği = Community healt nursing ; Ortaokul öğrencileri = Secondary school students ; Sağlık okuryazarlığı = Health literacy

Özet:
Ortaokul öğrencilerinde sağlık okuryazarlığı düzeyi ve ilişkili etmenleri incelemek amacıyla yürütülen bu tanımlayıcı araştırma İzmir ilinde Buca İlçe Milli Eğitim Müdürlüğü'ne bağlı 4 ortaokulda (2 devlet ortaokulu, 2 özel ortaokul) yürütülmüştür. Toplam 431 öğrenci çalışmaya alınmıştır.
Araştırmanın verileri 2018-2019 Eğitim Öğretim döneminde 29.05.2019 – 14.06.2019 tarihleri arasında toplanmıştır.  Verilerin toplanmasında sosyodemografik form ve Okul Çağındaki Çocuklar İçin Sağlık Okuryazarlığı Ölçeği kullanılmıştır. Etik izinler alınarak toplanmıştır. Analizler IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.) paket programı kullanılarak istatistiksel olarak anlamlılık p<0,05 olarak değerlendirilmiştir.
Araştırma kapsamına alınan öğrencilerin %52,9'u kız öğrencidir, %41,3'ü düşük gelirli ailelerin çocuklarının öğrenim gördüğü okulda öğrenim görmektedir, Öğrencilerin % 85.6'sının ailesi çekirdek aile yapısındadır. Öğrencilerin kardeş sayısı ortalaması 2, ailesindeki birey sayısı ortalaması ise 4'dür. Yanlızca %4,6'sının ailesinin sosyal güvencesinin bulunmadığı belirlenmiştir.
Öğrencilerin annelerinin %72,6'sı ortaokul ve üzeri, babalarının ise %84,2'si ortaokul  ve üzeri eğitimlidir. Annelerinin %37,1'i, babaların ise büyük çoğunluğu çalışmaktadır. Katılımcıların toplam ölçek puan ortalaması 30,89±5,672'dir. Ölçek toplam madde puan ortalamasının 3.09±5.67 ve alt ölçek madde puan ortalamalarının da 1.19±1.48 ile 3.09±5.67 arasında değiştiği belirlenmiştir. Ölçekten alınacak 10-25 puan düşük, 26-35 puan orta, 36-40 puan yüksek sağlık okuryazarlığını tanımlamaktadır. Bu değerlendirmeye göre bu çalışmada öğrencilerin sağlık okuryazarlığı düzeylerinin orta düzeyin biraz üzerinde olduğu saptanmıştır. Bu değer de öğrencilerin okuryazarlık düzeyinin yeterli olmadığını göstermektedir. Ölçeğin alt boyutları ile ilgili aldıkları puanlar değerlendirildiğinde sağlık okuryazarlığı ile ilgili vatandaşlık (3.08±1.39) ve pratik bilgi (3.24±1.45) boyutlarından aldıkları puan ortalamasının en fazla ancak "biraz doğru" düzeyinde kaldığı, öz farkındalık boyut puanlarının en düşük (1.19±1.48) ve "kesinlikle doğru değil" düzeyinde, teorik bilgi (2.97±1.34) ve kritik düşünme boyut becerilerinin (2.95±1.55) de "biraz doğru" düzeyinde kaldığı ve sonuçta yeterli olmadığı söylenebilir 
Öğrencilerin sağlık okuryazarlık düzeylerinin kullanılan ilaç sayısı, sağlık algısı ve hastaneye yatış sayısı değişkenlerine göre anlamlı farklılık gösterdiği, buna karşılık öğrencilerin sağlık okuryazarlık düzeylerinin aile gelir durumu, cinsiyet, anne ve baba eğitim düzeyi, kronik hastalığa sahip olma, acil servise başvurma sayısı, okul türü (devlet okulu ya da özel okul) ve yaş grubu değişkenlerine göre anlamlı farklılık göstermediği sonucuna ulaşılmıştır. Öğrencilerde  sağlık okuryazarlığı ile hastaneye yatış sayısı arasında negatif yönde, acil servise başvuru sayısı ve kullanılan ilaç adedi ile pozitif yönde anlamlı ilişkiler belirlenmiştir.
Bu araştırma bulguları ışığında; ortaokul öğrencilerin sağlık okuryazarlığı ile ilişkili faktörlerin iyi bilinmesi ve öğrencilerin sağlık okuryazarlıklarının geliştirilmesine yönelik daha büyük örneklem grupları üzerinde sağlık okuryazarlık durumunun incelenmesi ve sağlık okuryazarlığı düzeyini artırmaya yönelik kanıta dayalı çalışmaların planlanması, ortaokul öğrencilerinde sağlık okuryazarlığı üzerinde sağlık eğitiminin etkilerine yönelik çalışmalar yapılması, sağlıklı yaşam biçimi davranışlarını ve sağlık algısını geliştirmek için ders müfredatlarına sağlık ile ilişkili dersler konulması ile ilgili düzenlemelerin yapılması önerilmiştir.

Abstract:
This descriptive study, which conducted to examine the health literacy level and related factors in secondary school students, was conducted in 4 secondary schools (two state secondary schools, two private secondary schools) affiliated to Buca District National Education Directorate in İzmir. A total of 431 students were included in the study.
The data of the research were collected between the dates of 29.05.2019 - 14.06.2019 during the 2018-2019 Academic Year. The data were collected by using the sociodemographic form and the Health Literacy Scale for School-Age Children, after obtaining ethical permissions. Analyzes were evaluated statistically at p <0.05 significance level using IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.) by using package program.
52,9% of the students included in the study are female students, 41,3% of them are studying at the school where the children of low-income families are educated, 85,6% of the students lived in nuclear families. The average number of siblings of the students is 2, and the average number of family members is 4. It was determined that only 4,6% of the families did not have social security.
72,6% of the mothers of the students have received secondary school and above education, and 84,2% of their fathers have received secondary school and above education. 37,1% of their mothers and the vast majority of the fathers are working. The total scale score average of the participants is 30.89 ± 5.672. It was determined that the mean scale item score of the participants varied between 3.09 ± 5.67 and the subscales item score averages between 1.19 ± 1.48 and 3.09 ± 5.67. 10-25 points that will be obtained from the scale define low health literacy, 26-35 points medium, and 36-40 points high health literacy. According to this evaluation, it was determined that the health literacy level of the students in this study were slightly above the medium level. This value shows that the literacy level of the students is not sufficient. When the scores of the sub-dimensions of the scale were evaluated, it can be said that the average scores they got from the dimensions of citizenship (3.08 ± 1.39) and practical knowledge (3.24 ± 1.45) related to health literacy were the most however slightly correct, and their self-awareness dimension scores were the lowest (1.19 ± 1.48). ) and "absolutely not true" level, theoretical knowledge (2.97 ± 1.34) and critical thinking dimension skills (2.95 ± 1.55) are also at the "slightly correct" level and consequently not sufficient.
It was found that the health literacy level of the students differ significantly according to the variables of the number of drugs used, health perception and the number of hospitalization, whereas the health literacy level of the students did not differ significantly according to family income, gender, mother and father education level, having chronic illness, the number of visits to the emergency service, the type of school which they attend (public school or private school) and age group variables. When the relationships between the dependent variable and the independent variables were evaluated, it was found that there was a negative relationship between the health literacy of the students and the number of hospitalizations, and a positive significant relationship with the number of admissions to the emergency department and the number of drugs used.
In the light of this research findings; knowing the factors related to the health literacy of secondary school students well and conducting studies on health literacy on larger sample groups aimed to improve students' health literacy, and planning evidence-based studies to increase the level of health literacy, conducting studies on the effects of health education on health literacy among secondary school students, so as to improve lifestyle behaviors and perception of health, It has been proposed to make regulations regarding the inclusion of health-related courses in the curriculum.
This descriptive study, which conducted to examine the health literacy level and related factors in secondary school students, was conducted in 4 secondary schools (two state secondary schools, two private secondary schools) affiliated to Buca District National Education Directorate in İzmir. A total of 431 students were included in the study.
The data of the research were collected between the dates of 29.05.2019 - 14.06.2019 during the 2018-2019 Academic Year. The data were collected by using the sociodemographic form and the Health Literacy Scale for School-Age Children, after obtaining ethical permissions. Analyzes were evaluated statistically at p <0.05 significance level using IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.) by using package program.
52,9% of the students included in the study are female students, 41,3% of them are studying at the school where the children of low-income families are educated, 85,6% of the students lived in nuclear families. The average number of siblings of the students is 2, and the average number of family members is 4. It was determined that only 4,6% of the families did not have social security.
72,6% of the mothers of the students have received secondary school and above education, and 84,2% of their fathers have received secondary school and above education. 37,1% of their mothers and the vast majority of the fathers are working. The total scale score average of the participants is 30.89 ± 5.672. It was determined that the mean scale item score of the participants varied between 3.09 ± 5.67 and the subscales item score averages between 1.19 ± 1.48 and 3.09 ± 5.67. 10-25 points that will be obtained from the scale define low health literacy, 26-35 points medium, and 36-40 points high health literacy. According to this evaluation, it was determined that the health literacy level of the students in this study were slightly above the medium level. This value shows that the literacy level of the students is not sufficient. When the scores of the sub-dimensions of the scale were evaluated, it can be said that the average scores they got from the dimensions of citizenship (3.08 ± 1.39) and practical knowledge (3.24 ± 1.45) related to health literacy were the most however slightly correct, and their self-awareness dimension scores were the lowest (1.19 ± 1.48). ) and "absolutely not true" level, theoretical knowledge (2.97 ± 1.34) and critical thinking dimension skills (2.95 ± 1.55) are also at the "slightly correct" level and consequently not sufficient.
It was found that the health literacy level of the students differ significantly according to the variables of the number of drugs used, health perception and the number of hospitalization, whereas the health literacy level of the students did not differ significantly according to family income, gender, mother and father education level, having chronic illness, the number of visits to the emergency service, the type of school which they attend (public school or private school) and age group variables. When the relationships between the dependent variable and the independent variables were evaluated, it was found that there was a negative relationship between the health literacy of the students and the number of hospitalizations, and a positive significant relationship with the number of admissions to the emergency department and the number of drugs used.
In the light of this research findings; knowing the factors related to the health literacy of secondary school students well and conducting studies on health literacy on larger sample groups aimed to improve students' health literacy, and planning evidence-based studies to increase the level of health literacy, conducting studies on the effects of health education on health literacy among secondary school students, so as to improve lifestyle behaviors and perception of health, It has been proposed to make regulations regarding the inclusion of health-related courses in the curriculum.