Jiang Yifan, Wang Xuan, Zhang Min, Xu Zhiyong, Wu Yibo, Chen Liang
School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, 250012, China.
Department of Emergency, Qilu Hospital of Shandong University, 107 Wenhua West Road, Jinan, Shandong Province, 250012, China.
BMC Public Health. 2025 Apr 16;25(1):1424. doi: 10.1186/s12889-025-22708-1.
Sub-health status (SHS) refers to the physical condition in which a person falls between being healthy and having a disease. The sub-health status of medical students is related to many factors. The aim of this study is to explore the current situation and related factors of sub-health of medical students from the perspective of health ecology, to provide a basis for the formulation of intervention measures and improve the health level of medical students.
The data for this study came from a nationwide cross-sectional survey conducted in June-August 2022, covering 32 provinces and autonomous regions in mainland China. Multi-stage random sampling was used to recruit. 30,505 valid questionnaires were finally collected. According to the purpose of this study, the subjects were medical students. A total of 1878 subjects were included in the study. Binary stepwise logistic regression and back propagation neural network (BPNN) were used to explore the influencing factors of sub-health.
The prevalence of sub-health among medical students in mainland China is 57.5%. Results revealed that negative life events (odds ratio [OR] = 1.64; 95%CI = 1.31-2.04), anxiety (OR = 1.97; 95%CI = 1.27-3.10), depression (OR = 1.80; 95%CI = 1.30-2.51), second-hand smoke exposure (OR = 1.32; 95%CI = 1.06-1.64), problematic Internet use (OR = 1.15; 95%CI = 1.12-1.17), and perceived stress (OR = 1.16; 95%CI = 1.10-1.22) were identified as risk factors for sub-health among medical students, and the level of health literacy was found to be a protective factor for sub-health (OR = 0.96 (95%CI = 0.94-0.98). Sub-health risk increased with increasing smartphone use 1-2 h (OR = 1.34; 95%CI = 1.03-1.73) and ≥ 2 h (OR = 1.44; 95%CI = 1.05-1.98). Four important variables were determined according to the BPNN results: perceived stress, problematic Internet use, depression, and health literacy.
Medical students in mainland China have a high rate of SHS, indicating it's a pressing public health issue for them. Factors like mental health, internet use problems, and health literacy are linked to SHS occurrence in this group. This study provides a scientific basis for early identification of high-risk groups, and provides a reference for developing personalized intervention measures based on the perspective of health ecology.
亚健康状态（SHS）是指一个人处于健康与患病之间的身体状况。医学生的亚健康状态与多种因素有关。本研究旨在从健康生态学的角度探讨医学生亚健康的现状及相关因素，为制定干预措施提供依据，提高医学生的健康水平。
本研究的数据来自于2022年6月至8月在全国范围内进行的横断面调查，覆盖中国大陆32个省和自治区。采用多阶段随机抽样进行招募。最终收集到30505份有效问卷。根据本研究目的，研究对象为医学生。共有1878名受试者纳入研究。采用二元逐步逻辑回归和反向传播神经网络（BPNN）探讨亚健康的影响因素。
中国大陆医学生亚健康患病率为57.5%。结果显示，负性生活事件（比值比[OR]=1.64；95%置信区间[CI]=1.31-2.04）、焦虑（OR=1.97；95%CI=1.27-3.10）、抑郁（OR=1.80；95%CI=1.30-2.51）、二手烟暴露（OR=1.32；95%CI=1.06-1.64）、网络使用问题（OR=1.15；95%CI=1.12-1.17）和感知压力（OR=1.16；95%CI=1.10-1.22）被确定为医学生亚健康的危险因素，健康素养水平被发现是亚健康的保护因素（OR=0.96（95%CI=0.94-0.98）。随着智能手机使用时间增加1-2小时（OR=1.34；95%CI=1.03-1.73）和≥2小时（OR=1.44；95%CI=1.05-1.98），亚健康风险增加。根据BPNN结果确定了四个重要变量：感知压力、网络使用问题、抑郁和健康素养。
中国大陆医学生亚健康发生率较高，表明这是一个紧迫的公共卫生问题。心理健康、网络使用问题和健康素养等因素与该群体亚健康的发生有关。本研究为早期识别高危人群提供了科学依据，并为从健康生态学角度制定个性化干预措施提供了参考。
