{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:00:28Z","timestamp":1790834428721,"version":"4.1.0"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>First-aid education has been widely implemented in universities, with first-aid literacy serving as key evaluation indicators. Meaning in life (MIL) positively influences health awareness and prosocial behavior; however, its relationship with first-aid literacy remains insufficiently explored. This study investigated the association between meaning in life and safety and first-aid literacy among first-year undergraduate students and examined the mediating role of prior first-aid training times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 4,723 first-year undergraduate students from a comprehensive university completed a social-factor questionnaire, the Meaning in Life Questionnaire, and the First-aid Literacy Questionnaire based on the Knowledge-Attitude-Practice model. After data cleaning, 4,708 valid responses were analyzed. Correlation and mediation analyses were conducted to assess relationships among variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Knowledge scores followed a left-skewed distribution, whereas skill scores were concentrated at moderate levels. MIL scores presented an overall upward distribution. Correlation analysis revealed significant associations among most variables (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). No significant correlations were observed between first-aid skills and the two dimensions of meaning in life, nor between knowledge and prior training times. Mediation analysis suggested a statistically significant indirect association between MIL and first-aid skills through training times, whereas no significant indirect association was observed for first-aid knowledge. The association between MIL and attitude was mainly dominated by the direct effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Integrating MIL into first-aid education may enhance students\u2019 first-aid literacy. Promoting a balanced life-meaning orientation can improve training effectiveness, particularly with increased training exposure, supporting integrated psychological\u2013health education models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1915728","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:41:10Z","timestamp":1790833270000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association among first-aid literacy, training and life meaning: a KAP study of first-year undergraduates at a comprehensive university in China"],"prefix":"10.3389","volume":"17","author":[{"given":"Yan","family":"Xu","sequence":"first","affiliation":[{"name":"Research Center for Medical and Health Emergency Rescue, School of Public Health, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Jiang","sequence":"additional","affiliation":[{"name":"The First Clinical Medical School, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichen","family":"Li","sequence":"additional","affiliation":[{"name":"Research Center for Medical and Health Emergency Rescue, School of Public Health, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tie","family":"Xu","sequence":"additional","affiliation":[{"name":"Research Center for Medical and Health Emergency Rescue, School of Public Health, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijia","family":"Zhu","sequence":"additional","affiliation":[{"name":"The First Clinical Medical School, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Lin","sequence":"additional","affiliation":[{"name":"The First Clinical Medical School, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianya","family":"Zhang","sequence":"additional","affiliation":[{"name":"The First Clinical Medical School, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Qin","sequence":"additional","affiliation":[{"name":"Research Center for Medical and Health Emergency Rescue, School of Public Health, Xuzhou Medical University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"64","DOI":"10.4088\/JCP.19m13064","article-title":"Meaning in life and its relationship with physical, mental, and cognitive functioning: a study of 1,042 community-dwelling adults across the lifespan","volume":"81","author":"Aftab","year":"2019","journal-title":"J. Clin. Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1757-7241-19-11","article-title":"First aid skill retention of first responders within the workplace","volume":"19","author":"Anderson","year":"2011","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s13049-022-01056-8","article-title":"Preparing medical first responders for crises: a systematic literature review of disaster training programs and their effectiveness","volume":"30","author":"Baetzner","year":"2022","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/j.jad.2020.12.156","article-title":"The relationship between search for meaning in life and symptoms of depression and anxiety","volume":"282","author":"Chen","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref5","volume-title":"Report on the Surveillance of Health Literacy among Chinese Residents","year":"2022"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"17449871261419724","DOI":"10.1177\/17449871261419724","article-title":"Predictive effect of psychological first aid practice self-efficacy on disaster response self-efficacy in nursing students: a cross sectional study","author":"Cinar Ozbay","year":"2026","journal-title":"J. Res. Nurs."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e0258769","DOI":"10.1371\/journal.pone.0258769","article-title":"Searching for meaning is associated with costly prosociality","volume":"16","author":"Dakin","year":"2021","journal-title":"PLoS One"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1080\/10888691.2018.1537791","article-title":"Implications for educational practice of the science of learning and development","volume":"24","author":"Darling-Hammond","year":"2020","journal-title":"Appl. Dev. Sci."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"146","DOI":"10.33808\/clinexphealthsci.1669866","article-title":"Exploring the association between disaster preparedness literacy and psychological first aid practice self-efficacy in nursing students: a descriptive cross-sectional study","volume":"16","author":"Durmu\u015f Sar\u0131kahya","year":"2026","journal-title":"Clin. Exp. Health Sci."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1749-6632.2011.06230.x","article-title":"Neuromodulation of reward-based learning and decision making in human aging","volume":"1235","author":"Eppinger","year":"2011","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1186\/s40359-025-02859-x","article-title":"The relationship between meaning in life and self-regulated learning among college students","volume":"13","author":"Feng","year":"2025","journal-title":"BMC Psychol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"105732","DOI":"10.1016\/j.nedt.2023.105732","article-title":"Effectiveness of an intervention to enhance first aid knowledge","volume":"125","author":"Fern\u00e1ndez-Garc\u00eda","year":"2023","journal-title":"Nurse Educ. Today"},{"key":"ref13","first-page":"671","article-title":"Man's search for meaning: an introduction to logotherapy","volume":"67","author":"Frankl","year":"1962","journal-title":"Ther. Recreat. J."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"6466","DOI":"10.3390\/ijerph19116466","article-title":"Awe and prosocial behavior","volume":"19","author":"Fu","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"14935","DOI":"10.1007\/s12144-022-04020-y","article-title":"Meaning in life and health behavior habits during the COVID-19 pandemic: mediating role of health values and moderating role of conscientiousness","volume":"43","author":"Hu","year":"2022","journal-title":"Curr. Psychol."},{"key":"ref16","volume-title":"Introduction to Health Research Methods","author":"Jacobsen","year":"2016"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"CD015538","DOI":"10.1002\/14651858.CD015538.pub2","article-title":"First aid training for laypeople","volume":"2025","author":"Kendall","year":"2025","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1080\/14330237.2014.904095","article-title":"Presence of meaning and search for meaning","volume":"24","author":"Khumalo","year":"2014","journal-title":"J. Psychol. Afr."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1080\/17439760.2016.1209541","article-title":"Prosocial behavior increases perceptions of meaning in life","volume":"12","author":"Klein","year":"2017","journal-title":"J. Posit. Psychol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1037\/0022-3514.77.6.1121","article-title":"Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments","volume":"77","author":"Kruger","year":"1999","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref21","first-page":"81","article-title":"Actual survey of college students' knowledge of first aid","volume":"7","author":"Kwon","year":"2003","journal-title":"Korean J. Emerg. Med. Serv."},{"key":"ref22","first-page":"1","article-title":"Analysis of health literacy level and influencing factors among residents in Chongqing","volume":"16","author":"Lai","year":"2019","journal-title":"Health Med. Res. Pract."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"100","DOI":"10.16835\/j.cnki.1000-9817.2015.01.030","article-title":"Epidemiological characteristics of public health emergencies in schools","volume":"36","author":"Li","year":"2015","journal-title":"Chin. J. Sch. Health."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"12255","DOI":"10.3390\/ijerph191912255","article-title":"The effect of boredom on college students' meaning in life: a longitudinal mediation model","volume":"19","author":"Li","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1002\/pchj.733","article-title":"The unique role of meaning in life in the relationships between trait awe, subjective well-being, and prosocial tendency: a network analysis","volume":"13","author":"Lv","year":"2024","journal-title":"Psych J."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"739","DOI":"10.3969\/j.issn.1672-5166.2020.06.010","article-title":"Thoughts on building and improving the public health emergency management information system","volume":"17","author":"Ma","year":"2020","journal-title":"Chin. J. Health Inf. Manag."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/j.resuscitation.2007.08.017","article-title":"Retention of knowledge and skills in first aid and resuscitation by airline cabin crew","volume":"76","author":"Mahony","year":"2008","journal-title":"Resuscitation"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"100043","DOI":"10.1016\/j.resplu.2020.100043","article-title":"Willingness to perform bystander cardiopulmonary resuscitation: a scoping review","volume":"4","author":"Matsuyama","year":"2020","journal-title":"Resusc Plus."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"8910448","DOI":"10.25163\/angiotherapy.8910448","article-title":"Integrating first aid education in higher learning: advancing health literacy, preparedness, and campus safety","volume":"8","author":"Mohamed","year":"2024","journal-title":"J. Angiotherapy."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1017\/dmp.2022.27","article-title":"The impact of psychological first aid training on the providers: a systematic review","volume":"17","author":"Movahed","year":"2022","journal-title":"Disaster Med. Public Health Prep."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/8361602","article-title":"The psychometric properties of the meaning in life questionnaire (MLQ) in patients with life-threatening illnesses","volume":"2020","author":"Naghiyaee","year":"2020","journal-title":"ScientificWorldJournal"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1111\/jopy.12321","article-title":"The dynamics of searching for meaning and presence of meaning in daily life","volume":"86","author":"Newman","year":"2018","journal-title":"J. Pers."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1177\/10249079211050148","article-title":"Knowledge and training preference of standard first aid among undergraduates in Hong Kong: a cross-sectional survey","volume":"30","author":"Ng","year":"2021","journal-title":"Hong Kong J. Emerg. Med."},{"key":"ref34","article-title":"Basic knowledge and skills of Chinese citizens' health literacy (2015 edition)","year":"2016"},{"key":"ref35","article-title":"Basic knowledge and skills of Chinese citizens' health literacy","year":"2024"},{"key":"ref36","volume-title":"Notice on Implementing the Public Health Emergency Response Law of the People\u2019s Republic of China","year":"2025"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1037\/a0018301","article-title":"Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events","volume":"136","author":"Park","year":"2010","journal-title":"Psychol. Bull."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1111\/josh.12373","article-title":"School-based first aid training programs: a systematic review","volume":"86","author":"Reveruzzi","year":"2016","journal-title":"J. Sch. Health"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1080\/02673843.2015.1124791","article-title":"Psychometric properties of the meaning in life questionnaire (MLQ) in a sample of Australian adolescents","volume":"22","author":"Rose","year":"2016","journal-title":"Int. J. Adolesc. Youth"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1006\/ceps.1999.1020","article-title":"Intrinsic and extrinsic motivations: classic definitions and new directions","volume":"25","author":"Ryan","year":"2000","journal-title":"Contemp. Educ. Psychol."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s10869-011-9217-6","article-title":"Energy management of people in organizations: a review and research agenda","volume":"26","author":"Schippers","year":"2011","journal-title":"J. Bus. Psychol."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1007\/s11482-023-10150-7","article-title":"Measurement invariance of the meaning in life questionnaire across 17 countries","volume":"18","author":"Schutte","year":"2023","journal-title":"Appl. Res. Qual. Life"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1037\/0022-0167.53.1.80","article-title":"The meaning in life questionnaire: assessing the presence of and search for meaning in life","volume":"53","author":"Steger","year":"2006","journal-title":"J. Couns. Psychol."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/j.1467-6494.2007.00484.x","article-title":"Understanding the search for meaning in life: personality, cognitive style, and the dynamic between seeking and experiencing meaning","volume":"76","author":"Steger","year":"2008","journal-title":"J. Pers."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"734461","DOI":"10.3389\/fpsyg.2021.734461","article-title":"The contribution of basic psychological need satisfaction to psychological well-being via autonomous motivation among older adults: a cross-cultural study in China and France","volume":"12","author":"Tang","year":"2021","journal-title":"Front. Psychol."},{"key":"ref46","volume-title":"Existential Counseling and Psychotherapy in Practice","author":"Van Deurzen","year":"2001"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1080\/17439760.2015.1048814","article-title":"Prosociality enhances meaning in life","volume":"11","author":"Van Tongeren","year":"2016","journal-title":"J. Posit. Psychol."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"764","DOI":"10.16128\/j.cnki.1005-3611.2013.05.008","article-title":"Reliability and validity of the Chinese revised version of the meaning in life questionnaire among middle school students","volume":"21","author":"Wang","year":"2013","journal-title":"Chin. J. Clin. Psychol."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"579","DOI":"10.16187\/j.cnki.issn1001-4918.2016.05.08","article-title":"The influence of proactive personality on academic achievement in college students: the mediating roles of academic self-efficacy and learning adaptation","volume":"32","author":"Wang","year":"2016","journal-title":"Psychol. Dev. Educ."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"112","DOI":"10.16187\/j.cnki.issn1001-4918.2018.01.14","article-title":"Mediating roles of meaning in life in the relationship between posttraumatic stress disorder, posttraumatic growth and prosocial behavior among adolescents after the Wenchuan earthquake","volume":"34","author":"Wang","year":"2018","journal-title":"Psychol. Dev. Educ."},{"key":"ref51","volume-title":"The Human Quest for Meaning: A Handbook of Psychological Research and Clinical Application","author":"Wong","year":"1998"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1186\/s12877-024-05153-4","article-title":"Evaluation of a knowledge-attitude-practice model based narrative life education program for community-dwelling older adults: a mixed-methods feasibility study","volume":"24","author":"Xie","year":"2024","journal-title":"BMC Geriatr."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1007\/s10902-014-9540-5","article-title":"The relationship between meaning in life and subjective well-being: forgiveness and hope as mediators","volume":"16","author":"Yal\u00e7\u0131n","year":"2015","journal-title":"J. Happiness Stud."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"842","DOI":"10.11847\/zgggws2015-31-06-44","article-title":"Analysis on safety cognition and first-aid self-rescue abilities of urban and rural residents in China","volume":"31","author":"Yan","year":"2015","journal-title":"China Public Health."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"420","DOI":"10.3969\/j.issn.1004-4663.2009.06.025","article-title":"Investigation on the status of first-aid knowledge among different populations in Hubei Province","volume":"26","author":"Yang","year":"2009","journal-title":"Chin. Health Serv. Manage."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1177\/0033294117697084","article-title":"Presence of meaning in life and search for meaning in life and relationship to health anxiety","volume":"120","author":"Yek","year":"2017","journal-title":"Psychol. Rep."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1349726","DOI":"10.3389\/fpsyg.2024.1349726","article-title":"Mediating roles of meaning in life and psychological flexibility in the relationships between occupational stress and job satisfaction, job performance, and psychological distress in teachers","volume":"15","author":"Yildirim","year":"2024","journal-title":"Front. Psychol."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/curationis.v45i1.2325","article-title":"Effectiveness of school-based CPR training among adolescents to enhance knowledge and skills in CPR: a systematic review","volume":"45","author":"Zenani","year":"2022","journal-title":"Curationis"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"700","DOI":"10.3969\/j.issn.1004-4663.2012.09.021","article-title":"On the significance and implementation of life view education for college students","volume":"29","author":"Zhang","year":"2012","journal-title":"Chin. 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