Mirzania Marjan, Khajavi Abdoljavad, Kharazmi Akram, Moshki Mahdi
Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.
Med J Islam Repub Iran. 2020 Dec 1;34:161. doi: 10.47176/mjiri.34.161. eCollection 2020.
Main health challenge of the 21st century is improving quality of life (QoL). This study aimed to investigate the mediating role of health locus of control (HLC) between health literacy and QoL among Iranian pregnant women. In this cross sectional survey, 400 pregnant women referred to the community health centers of Gonabad, Iran, and completed the demographic, health literacy, QoL, and multidimensional HLC questionnaires during 2015-2016. Descriptive statistics and structural equation modeling were conducted using SPSS 22.0 version and AMOS 24.0 software. The findings showed that health literacy has a significant positive effect on the physical (β= 0.54, p< 0.001) and mental (β= 0.57, p< 0.001) health. Also, it has a significant positive effect on internal subscale (β= 0.42, p< 0.001) and a significant negative effect on the chance (β= -0.51, p< 0.001) and powerful others (β= -0.33, p< 0.001) subscale of HLC. From HLC subscales, internal HLC had a significant positive effect on physical (β= 0.26, p< 0.001) and mental (β= 0.12, p= 0.010) health, while the effects of chance and powerful others on QoL dimensions were not significant. The findings indicated that internal HLC is a partial mediator between health literacy and physical dimension of QoL. The results indicate that health literacy can be considered as an effective factor in HLC orientations and can improve QoL. This reflects the need for more attention on health literacy and the recognition of the type of HLC beliefs, especially the internal belief in health promotion programs for pregnant women.
21世纪主要的健康挑战是提高生活质量（QoL）。本研究旨在调查健康控制点（HLC）在伊朗孕妇的健康素养和生活质量之间的中介作用。在这项横断面调查中，400名孕妇前往伊朗戈纳巴德的社区健康中心，并在2015 - 2016年期间完成了人口统计学、健康素养、生活质量和多维HLC问卷。使用SPSS 22.0版本和AMOS 24.0软件进行描述性统计和结构方程建模。研究结果表明，健康素养对身体（β = 0.54，p < 0.001）和心理（β = 0.57，p < 0.001）健康有显著的积极影响。此外，它对HLC的内部子量表有显著的积极影响（β = 0.42，p < 0.001），对机会（β = -0.51，p < 0.001）和有势力的他人（β = -0.33，p < 0.001）子量表有显著的消极影响。在HLC子量表中，内部HLC对身体（β = 0.26，p < 0.001）和心理（β = 0.12，p = 0.010）健康有显著的积极影响，而机会和有势力的他人对生活质量维度的影响不显著。研究结果表明，内部HLC是健康素养和生活质量身体维度之间的部分中介。结果表明，健康素养可被视为HLC取向的一个有效因素，并可改善生活质量。这反映出需要更多关注健康素养，并认识到HLC信念的类型，特别是对孕妇健康促进项目的内部信念。
