Association among first-aid literacy, training and life meaning: a KAP study of first-year undergraduates at a comprehensive university in China

Background 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. Methods 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. Results 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 ( p < 0.05). 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. Conclusion Integrating MIL into first-aid education may enhance students’ first-aid literacy. Promoting a balanced life-meaning orientation can improve training effectiveness, particularly with increased training exposure, supporting integrated psychological–health education models.