Propriedades psicométricas da versão portuguesa do European Health Literacy Survey Questionnaire (HLS-EU-PT-Q16) em estudantes de Enfermagem: Publicação Antecipada

Patrícia Monteiro; Mariana Rodrigues; Amorim Rosa; Luís Manuel Loureiro

doi:10.31211/rpics.2026.12.1.415

Authors

Patrícia Monteiro Escola Superior de Enfermagem da Universidade de Coimbra (ESEUC), Coimbra, Portugal https://orcid.org/0009-0000-6656-1327
Mariana Rodrigues Escola Superior de Enfermagem da Universidade de Coimbra (ESEUC); Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA: E), Coimbra, Portugal https://orcid.org/0009-0007-3967-7560
Amorim Rosa Escola Superior de Enfermagem da Universidade de Coimbra (ESEUC); Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA: E), Coimbra, Portugal https://orcid.org/0000-0002-4847-637X
Luís Manuel Loureiro Escola Superior de Enfermagem da Universidade de Coimbra (ESEUC); Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA: E), Coimbra, Portugal https://orcid.org/0000-0002-2384-6266

DOI:

https://doi.org/10.31211/rpics.2026.12.1.415

Keywords:

Confirmatory factor analysis, Health literacy, Nursing students, Psychometric properties, Validation

Abstract

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.

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Author Biography

Luís Manuel Loureiro, Escola Superior de Enfermagem da Universidade de Coimbra (ESEUC); Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA: E), Coimbra, Portugal

Professor Adjunto

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