Students' Scientific Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Med Educ. 2013 Oct;47(10):1001-12. doi: 10.1111/medu.12247.
The long and demanding course of medical education may be accompanied by distress with serious consequences. This study was conducted to assess the multidimensional health-related quality of life (HR-QoL) in medical students in different stages of medical education and its associations with behavioural and social factors.
A cross-sectional study was conducted in medical students at three medical schools at, respectively, Tehran University of Medical Sciences, Aja University of Medical Sciences and Baghiyatalah Medical School, in November and December 2011 using stratified sampling. Data were obtained on participants' characteristics, including gender, current education stage, living situation, smoking status, physical activity, and membership of associations or teams. Health-related QoL was measured using the Persian version of the 36-item Short Form Health Survey (SF-36), which generates a physical component score (PCS) and a mental component score (MCS). Logistic regression was applied to measure the adjusted associations between variables.
Of the 1350 students invited, 1086 individuals completed the survey to give a response rate of 80.4%. Logistic regression showed male gender (odds ratio [OR] = 2.88, p < 0.001), living with family versus in a dormitory (OR = 2.72, p < 0.001) and participation in daily physical activity (OR = 16.96, p < 0.001) to be significantly associated with a higher PCS. Being in an internship versus in the basic sciences stage of medical education showed a significant association with a lower PCS (OR = 0.12, p < 0.001). Similarly, male gender (OR = 1.67, p < 0.05), living with family rather than in a dormitory (OR = 16.91, p < 0.001), daily physical activity (OR = 25.36, p < 0.001), and membership of associations or teams (OR = 3.67, p < 0.001) were associated with a higher MCS. Likewise, studying in internship rather than in the basic sciences stage was accompanied by a lower MCS (OR = 0.12, p < 0.001).
This large, multi-institution study, despite its limitations, indicates that medical students in internships show lower scores in all domains of QoL. Social engagement is an important associate of higher HR-QoL. Further studies should address the efficacy of interventions, such as self-awareness programmes and initiatives to encourage students to be more physically and socially active, in improving students' health.
医学教育漫长而艰巨的过程可能伴随着严重后果的困扰。本研究旨在评估不同医学教育阶段医学生的多维健康相关生活质量（HR-QoL）及其与行为和社会因素的关系。
2011 年 11 月至 12 月，采用分层抽样法，在德黑兰大学医学院、阿扎大学医学院和巴格里亚塔医学院的 3 所医学院的医学生中进行了横断面研究。数据收集参与者的特征，包括性别、当前教育阶段、居住情况、吸烟状况、身体活动以及参加协会或团队的情况。使用波斯语 36 项简短健康调查问卷（SF-36）测量健康相关生活质量，该问卷产生身体成分评分（PCS）和心理成分评分（MCS）。应用逻辑回归来衡量变量之间的调整关联。
在邀请的 1350 名学生中，有 1086 人完成了调查，应答率为 80.4%。逻辑回归显示，男性（比值比[OR] = 2.88，p < 0.001）、与家人同住而不是住在宿舍（OR = 2.72，p < 0.001）以及每天进行身体活动（OR = 16.96，p < 0.001）与较高的 PCS 显著相关。与基础医学阶段相比，实习阶段与较低的 PCS 显著相关（OR = 0.12，p < 0.001）。同样，男性（OR = 1.67，p < 0.05）、与家人同住而不是住在宿舍（OR = 16.91，p < 0.001）、每天进行身体活动（OR = 25.36，p < 0.001）和参加协会或团队（OR = 3.67，p < 0.001）与较高的 MCS 相关。同样，与基础科学阶段相比，实习阶段学习与较低的 MCS 相关（OR = 0.12，p < 0.001）。
尽管存在局限性，但这项大型多机构研究表明，实习医学生在所有生活质量领域的得分都较低。社会参与是更高 HR-QoL 的重要因素。进一步的研究应该解决干预措施的效果，例如自我意识计划和鼓励学生更加积极参与身体和社会活动的举措，以改善学生的健康状况。
