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Psychometric properties of the Portuguese version of the European Health Literacy Survey Questionnaire (HLS-EU-PT-Q16) in nursing students: Ahead of Print

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Resumo:Context: Health literacy is a social determinant of health and a public health priority, requiring credible, rigorous, and context-appropriate measurement. Objective: To examine the psychometric properties — structural validity, reliability, convergent validity, and discriminant validity — of the Portuguese version of the European Health Literacy Survey Questionnaire (HLS-EU-PT-Q16) in a sample of nursing students. Method: A methodological study was conducted with 476 undergraduate nursing students from a higher education institution in the central region of mainland Portugal. Data were collected in person in classrooms using Google Forms, with electronic informed consent. Results: Exploratory factor analysis yielded a three-factor solution that diverged from the original theoretical structure, suggesting an empirical reconfiguration of the health literacy domains in this sample. Confirmatory factor analyses indicated that the correlated three-factor models (both theoretically and empirically derived) provided a superior fit to the data relative to the unifactorial model. All models displayed highly satisfactory reliability. Convergent validity emerged as the main psychometric weakness, whereas discriminant validity, assessed through the HTMT criterion, was satisfactory in both three-factor models. Conclusions: The findings support the multidimensionality of health literacy, with the three-factor models outperforming the unifactorial model. In the Portuguese higher education context, the dimensions of health literacy appear to display strong functional and conceptual integration without compromising the empirical independence of the underlying constructs.
Autores principais:Monteiro, Patrícia
Outros Autores:Rodrigues, Mariana; Rosa, Amorim; Loureiro, Luís Manuel
Assunto:Confirmatory factor analysis Health literacy Nursing students Psychometric properties Validation Análise fatorial confirmatória Literacia em saúde Estudantes de Enfermagem Propriedades psicométricas Validação
Ano:2026
País:Portugal
Tipo de documento:artigo
Tipo de acesso:unknown
Instituição associada:Instituto Superior Miguel Torga
Idioma:português
Origem:Revista Portuguesa de Investigação Comportamental e Social
Descrição
Resumo:Context: Health literacy is a social determinant of health and a public health priority, requiring credible, rigorous, and context-appropriate measurement. Objective: To examine the psychometric properties — structural validity, reliability, convergent validity, and discriminant validity — of the Portuguese version of the European Health Literacy Survey Questionnaire (HLS-EU-PT-Q16) in a sample of nursing students. Method: A methodological study was conducted with 476 undergraduate nursing students from a higher education institution in the central region of mainland Portugal. Data were collected in person in classrooms using Google Forms, with electronic informed consent. Results: Exploratory factor analysis yielded a three-factor solution that diverged from the original theoretical structure, suggesting an empirical reconfiguration of the health literacy domains in this sample. Confirmatory factor analyses indicated that the correlated three-factor models (both theoretically and empirically derived) provided a superior fit to the data relative to the unifactorial model. All models displayed highly satisfactory reliability. Convergent validity emerged as the main psychometric weakness, whereas discriminant validity, assessed through the HTMT criterion, was satisfactory in both three-factor models. Conclusions: The findings support the multidimensionality of health literacy, with the three-factor models outperforming the unifactorial model. In the Portuguese higher education context, the dimensions of health literacy appear to display strong functional and conceptual integration without compromising the empirical independence of the underlying constructs.