Xiao Xueling, Xiao Jinshun, Yao Juqin, Chen Yaling, Saligan Leorey, Reynolds Nancy R, Wang Honghong
Xiangya Nursing School of Central South University, Changsha, Hunan, People's Republic of China.
School of Information Engineering, Wuhan College, Wuhan, Hubei, People's Republic of China.
Neuropsychiatr Dis Treat. 2020 Dec 8;16:3011-3021. doi: 10.2147/NDT.S277231. eCollection 2020.
Anxiety is one of the psychological problems being experienced by the general population during the current coronavirus disease 2019 (COVID-19) pandemic. Health literacy, such as infectious-disease-specific health literacy, is associated with anxiety, but the mechanism of such association is not clear. This study explored the relationship between infectious-disease-specific health literacy and anxiety.
We conducted an online survey in Hubei province, the early epicenter of the COVID-19 pandemic. A total of 1038 COVID-19-negative participants accomplished a battery of online survey tools determining their sociodemographic characteristics, perceived risk of acquiring COVID-19, infectious-disease-specific health literacy, resilience, and anxiety symptoms. We examined the moderated mediation models, in which the mediator was resilience and the moderator was gender.
Most (63%) of the study participants experienced at least mild anxiety. The indirect effect of infectious-disease-specific health literacy on anxiety through resilience was -0.282 (95% confidence interval [CI] = [-0.511, -0.083]), contributing to 32.7% of the total effect of health literacy on anxiety. Resilience fully mediated the association. The mediation effect of resilience tended to be stronger for the male participants than for the female participants as the moderation effect of gender remained until we included perceived risk of acquiring COVID-19 in the model.
Resilience was found to mediate the association between infectious-disease-specific health literacy and anxiety. Individuals with good infectious-disease-specific health literacy are more likely to acquire higher resilience, which may in turn decrease their anxiety level. Males may benefit more from the mediation effect of resilience during the current pandemic. Infectious-disease-specific health literacy programs may help reduce the anxiety of the program participants by enhancing their resilience during a pandemic.
焦虑是当前2019冠状病毒病（COVID-19）大流行期间普通人群所经历的心理问题之一。健康素养，如特定传染病的健康素养，与焦虑有关，但其关联机制尚不清楚。本研究探讨了特定传染病健康素养与焦虑之间的关系。
我们在COVID-19大流行的早期中心湖北省进行了一项在线调查。共有1038名COVID-19检测呈阴性的参与者完成了一系列在线调查工具，以确定他们的社会人口学特征、感染COVID-19的感知风险、特定传染病的健康素养、心理韧性和焦虑症状。我们检验了调节中介模型，其中中介变量是心理韧性，调节变量是性别。
大多数（63%）研究参与者至少经历了轻度焦虑。特定传染病健康素养通过心理韧性对焦虑的间接效应为-0.282（95%置信区间[CI]=[-0.511，-0.083]），占健康素养对焦虑总效应的32.7%。心理韧性完全中介了这种关联。随着性别调节效应一直存在，直到我们在模型中纳入感染COVID-19的感知风险，心理韧性的中介效应在男性参与者中往往比女性参与者更强。
发现心理韧性中介了特定传染病健康素养与焦虑之间的关联。具有良好特定传染病健康素养的个体更有可能获得更高的心理韧性，这反过来可能会降低他们的焦虑水平。在当前大流行期间，男性可能从心理韧性的中介效应中受益更多。特定传染病健康素养项目可能有助于通过增强项目参与者在大流行期间的心理韧性来减轻他们的焦虑。
