Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil.
Hospital Universitário da Universidade Federal de São Carlos, São Carlos, Brazil.
BMC Psychol. 2021 Feb 25;9(1):36. doi: 10.1186/s40359-021-00534-5.
Medical students have a worse perception of Quality of Life (QoL) and a high prevalence of psychosocial suffering when compared to the general population. The objective of this study was to investigate associated factors with Quality of Life of Brazilian medical students from an exploratory analysis in a cross-sectional study described in accordance with the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines.
This is a cross-sectional and multicenter study with national sample randomized by sex and year of the course. Data were collected between August 2011 and August 2012, using an electronic platform (VERAS platform). Our outcomes included: personal quality of life (QoLp) and quality of life related to medical course activities (QoLmc), both measured using a score ranging from 0 (worst) to 10 (best). Variables as predictors: the World Health Organization Quality of Life Assessment abbreviated version (WHOQOL-BREF); VERAS-Q (a questionnaire created to evaluate the QoL of students in health professions); Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maslach Burnout Inventory (MBI), Resilience Scale (RS-14), Interpersonal Reactivity Multidimensional Scale (IRMS) and Dundee Ready Education Environment Measure (DREEM).
Our sample is comprised of 1350 (81.8%) medical students. When comparing predictors and both quality of life outcome measures, we found a negative correlation between QoL and the BDI, PSQI and ESS scores. Through a multiple linear regression mode we identified the median of significant predictors to higher QoL. We then run a tree regression model that demonstrated that the VERAS-Q-physical health domain (a domain assessing self-care, self-perception of health, sleep, leisure, physical activity and appearance) was the most important factor predicting QoL. Students with a VERAS-Q-physical health score ≥ 60.9 and a VERAS-Q-time management (address the management of the student's time, free time and whether he can dedicate himself to other activities besides the course) score ≥ 55.7 presented the best QoLmc (score: 8.08-9.63%). Students with a VERAS-Q-physical health score ≥ 79.7 presented the highest QoLp (score 8.93-8.74%).
Physical symptoms, self-perception of health and self-care assessed by the VERAS-Q physical domain had association with both final outcomes. Time management seems to have a protective role for better Quality of Life. These variables should be taken in consideration when designing interventions to improve Quality of Life among medical students.
与普通人群相比，医学生对生活质量（QoL）的感知更差，且更易遭受心理社会痛苦。本研究旨在通过横断面研究中的探索性分析，调查与巴西医学生生活质量相关的因素。本研究符合 STROBE（加强观察性研究的报告）指南的要求。
这是一项全国性样本的、按性别和课程年份随机的、具有探索性的、多中心的横断面研究。数据收集于 2011 年 8 月至 2012 年 8 月之间，使用电子平台（VERAS 平台）。我们的结局包括：个人生活质量（QoLp）和与医学课程活动相关的生活质量（QoLmc），两者均通过评分（范围为 0 分[最差]至 10 分[最佳]）进行测量。作为预测因素的变量有：世界卫生组织生活质量评估简表（WHOQOL-BREF）；VERAS-Q（一个为评估健康专业学生生活质量而创建的问卷）；Epworth 嗜睡量表（ESS）、匹兹堡睡眠质量指数（PSQI）、贝克抑郁量表（BDI）、状态特质焦虑量表（STAI）、马斯拉赫职业倦怠量表（MBI）、韧性量表（RS-14）、人际反应多维量表（IRMS）和邓迪准备教育环境量表（DREEM）。
我们的样本包括 1350 名（81.8%）医学生。在比较预测因素和两种生活质量结局测量时，我们发现 QoL 与 BDI、PSQI 和 ESS 评分呈负相关。通过多元线性回归模型，我们确定了与较高 QoL 相关的中位数显著预测因素。然后，我们进行了树回归模型分析，结果表明，VERAS-Q-身体健康领域（评估自我护理、自我健康感知、睡眠、休闲、身体活动和外表的领域）是预测 QoL 的最重要因素。VERAS-Q-身体健康评分≥60.9 和 VERAS-Q-时间管理评分（评估学生时间管理、空闲时间以及他是否可以将时间用于课程以外的其他活动）≥55.7 的学生具有最佳的 QoLmc（评分：8.08-9.63%）。VERAS-Q-身体健康评分≥79.7 的学生具有最高的 QoLp（评分：8.93-8.74%）。
由 VERAS-Q 身体领域评估的躯体症状、自我健康感知和自我护理与两个最终结局均相关。时间管理似乎对提高生活质量具有保护作用。在设计改善医学生生活质量的干预措施时，应考虑这些变量。
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