Social Support, Health Literacy and Depressive Symptoms among Medical Students: An Analysis of Mediating Effects

Abstract

Depressive symptoms are prevalent in university students and may impair their social, educational, and economic transition into adulthood. Identifying the factors that determine depressive symptoms is crucial for the design of effective policy interventions. This study aims to examine the associations between health literacy and depressive symptoms among medical students, and to evaluate the effect of different types of social support as a potential mediator. A cross-sectional survey of medical students was conducted through convenience sampling in East China. Associations between variables were explored using OLS and the mediation effect was estimated using the Karlson, Holm and Breen method. A total of 746 valid questionnaires were collected. The prevalence of depressive symptoms among the sample was 32.4%. Higher health literacy levels and social supports were significantly associated with lower levels of depressive symptoms. Social support partially mediated the association between health literacy and depressive symptoms, accounting for a 54.03% of the total effect size. These findings suggest that interventions for medical student mental wellbeing could improve health literacy. Whilst family support reflects greatest impact, Universities can also lead and innovate novel interventions for this critical stage of life. Future research can extend this study by exploring the dynamic interactions between health literacy, depressive symptoms, and other sources of social support. Comparisons of these findings across the different regions of China and in other university subject disciplines are also warranted.

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“…This score represents about 68% of the maximum HL score (37 points) using this scale. Other studies (49)(50)(51) that used the same instrument showed similar HL scores to those of our study. Chinese adolescents (49) , mean age of 13.4 years, had a mean HL score of 26.3, a little higher than the score obtained in our study.…”

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“…Students in the first and fifth grades accounted for 18.13, 23.35, 22.94, 19.35 and 16.23% of the sample, respectively. Reviewing the literature and referring to previous survey results, the current incidence of depressive symptoms among medical students in China is approximately 32% [ 2 ]. We set the tolerances at δ = 0.032, π = 0.32, α = 0.05, and u α/2 = 1.96.…”

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“…Los adolescentes chinos(49) , con una media de edad de 13,4 años, evidenciaron una media de 26,3 puntos, resultado ligeramente superior al de este estudio. Entre los universitarios de China, durante el período de la pandemia de COVID-19, la AeS resultó en 25,6 puntos(50) y entre los universitarios italianos fue de 27,4 puntos(51) .www.eerp.usp.br/rlae…”