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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 16  |  Issue : 1  |  Page : 25-28

Health-related quality of life among medical students


Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India

Date of Submission18-Feb-2019
Date of Decision27-Nov-2020
Date of Acceptance15-Dec-2020
Date of Web Publication29-Jul-2021

Correspondence Address:
Dr. Joel Thomas
Department of Community Medicine, Datta Meghe Institute of Medical Sciences University, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_21_19

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  Abstract 


Introduction: Medical education appears to perpetuate stress through its intense academic workload, working with patients and grading systems. Various studies show that the stressful life of medical students can attribute to development of various ailments and deterioration of quality of life. The World Health Organization has defined quality of life as “individuals' perception of their position in life in the context of the culture and value systems in which they live and their relation to their goals, expectations, standards and concerns. Aim: To determine the health related quality of life of medical students and assess their mental status. Material and Methods: A descriptive cross sectional study was conducted among the undergraduate students of Jawaharlal Nehru Medical College.A total of 235 students from 2nd year MBBS and Final year part 1 MBBS participated in the survey. The study was conducted after obtaining written consent from the participants and permission from the Head of the Department to conduct the study. Results: The students who participated ranged from the age group of 17 years to 24 years, maximum being 21 years (30%), 164 of them were females. Sixty two percent of the students belonged to 2nd year. According to Beck's Depression Inventory, 23%(53) evaluated to have mild mood disturbances. Overall scores for all 8 domains ranged between 78.2 and 60.2. The maximum score was obtained in the Physical Function domain and the minimum score was obtained in the Role Limitation Due to Emotional Problems domain. Conclusions: The study shows that the quality of life ,health related as perceived by the participants is low. Various factors may be associated with this, including time constraints for social activities, heavy workload and limited contact with family and friends. Deteriorated quality of life may affect the attainment of knowledge by the students, their performances as well as their future competencies as a clinician.

Keywords: Life, medical, quality, students


How to cite this article:
Thomas J, Nair D, John P, Beeran R, Simon P. Health-related quality of life among medical students. J Datta Meghe Inst Med Sci Univ 2021;16:25-8

How to cite this URL:
Thomas J, Nair D, John P, Beeran R, Simon P. Health-related quality of life among medical students. J Datta Meghe Inst Med Sci Univ [serial online] 2021 [cited 2021 Sep 16];16:25-8. Available from: http://www.journaldmims.com/text.asp?2021/16/1/25/322611




  Introduction Top


Medical education appears to perpetuate stress through its intense academic workload, working with patients and grading systems.[1] Various studies show that the stressful life of medical students can attribute to development of various ailments and deterioration of quality of life. The World Health Organization has defined quality of life as “individuals” perception of their position in life in the context of the culture and value systems, in which they live and their relation to their goals, expectations, standards, and concerns.[2] There are different aspects that determine an individual's quality of life. Unlike conventional indicators of a person's health, the quality of life related to health attempt to assess a person's health by the person him/herself.[3] Health-related quality of life (HRQOL) regards those aspects of self-perceived well-being that are related to or affected by the presence of disease, treatment, and health policies. For better functioning and role fulfillment, medical students need to maintain an appropriate quality of life.

Depression, stress, and burnout were associated with low HRQOL among medical students.[4]

A study was conducted among the undergraduate students of Jawaharlal Nehru Medical College to assess the HRQOL and the mental status of the student.

HRQOL was assessed using the Short-Form 36 (SF-36) form and mental status using the Beck's Depression Inventory.

The SF-36 Questionnaire provides a generic, subjective measure of functional health, and well-being from the individual's point of view. It has been extensively used for monitoring the HRQOL of specific populations with a wide range of diseases and health conditions.[5] According to the SF-36 method, HRQOL comprises eight domains, considered multi-item scales: Physical Functioning (PF), Role limitations due to Physical problems (RP), Bodily Pain (BP), General Health perceptions (GH), Vitality (VT), Social Functioning (SF), Role limitations due to Emotional problems (RE), and mental health (MH). Beck's Depression Inventory is a self-scored assessment tool for the mental status of a person.


  Materials and Methods Top


A descriptive cross-sectional study was conducted among the undergraduate students of Jawaharlal Nehru Medical College, Wardha, India. All students of the 2nd and 3rd year were included in the study. A total of 235 students participated.

Ethical consideration

Permission was obtained from the Head of the Department of Community Medicine to carry out the study. Consent was obtained from the students for participation in the study. Only students who gave their consent were included in the study.

Instrument

The SE-36 questionnaire and Beck's depression inventory was distributed among the participants after briefing about the questionnaires.

The SF-36 is a generic instrument for measuring generic health concepts with 36 items covering eight domains of HRQOL namely PF, role limitations caused by physical problems (RP), BP, GH perceptions, VT, SF, role limitations caused by emotional problems (RE), and general MH. The SF-36 also provides a summary of the domains into two components: physical component score and mental component score.

The mean score of the eight domains was calculated, a high score indicating a better quality of life. The Beck's Depression inventory was scored and with total scores were associated with the level of depression, a score of 1–10 considered normal and score of >40 considered extreme depression.

Inclusion-exclusion criteria

All students who were present in the class when the forms were included in the study. Students who were absent and those who did not give their consent for participation were excluded from the study [Figure 1],[Figure 2],[Figure 3],[Figure 4].
Figure 1: Gender wise distribution

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Figure 2: Age-wise distribution

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Figure 3: Year-wise distribution

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Figure 4: Beck's depression inventory

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Ethical clearance

The Institutional Ethics Committee of DMIMSDU has approved the Research work proposed to be carried out at Jawaharlal Nehru Medical College, Sawangi(M), Wardha. Date: 27th March 2017 with Reference no DMIMS(DU)/IEC/2017-18/340.


  Results Top


A total of 235 students participated, belonging to the 2nd and 3rd year of Jawaharlal Nehru Medical College of which, 164 were female. The students who participated ranged from the age group of 17 years to 24 years, maximum being 21 years (30%). Sixty-two percent of the students belonged to the 2nd year. According to Beck's Depression Inventory, 23% (53) evaluated to have mild mood disturbances. Overall scores for all eight domains ranged between 78.2 and 60.2. The maximum score was obtained in the Physical Function domain and the minimum score was obtained in the Role Limitation Due to Emotional Problems domain [Table 1].
Table 1: Short-Form 36 Questionnaire form scores (n=235)

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  Discussion Top


Various studies have been done to assess the HRQOL of medical students over the past years. One of them indicates that medical students rate their own health as very good, with no significant differences to the general population aged 20–30,[6] but the others indicate that medical students have lower mental and physical quality of life scores than population norms[7] and that medical students perceive themselves as less healthy and more likely to become ill than general population aged 25–34 years.[8] The SF-36 scores obtained from a study conducted by Latas et al.[9] among the medical students of Belgrade University, Serbia, where the participants were evaluated in the range of 95.20 (physical function) and 55.60 (energy/fatigue) and a similar study conducted by Zainuddin et al.[10] among the medical students of Universiti Putra Malaysia showed scores ranging between 90.24 (physical function) and 53.58 (energy/fatigue). The scores obtained in our study ranged from 78.2 (physical function) and 60.2 (role limitation due to emotional problems). It can be inferred from our study that the HRQOL of the medical students who participated in the study are low, compared to their counterparts. The maximum number of students was evaluated as normal by the Beck's depression inventory. Twenty-eight percent of the participants were evaluated to have mild mood disturbances.

Heavy workload and educational content, combined with high levels of educational demands, a lack of leisure time and limited contact with family and friends could be factors that lessen the quality of life of medical students and depression. The stress put on the students by themselves as well as their parents, teachers, and peers to perform better may also be a factor for the deterioration of quality of life among the students.

The experience of poor quality of life, high levels of burnout and stress are contributing factors that adversely affect the development of students' knowledge, skills, and professionalism, and can have profound consequences, such as suicide ideation and intent to drop out of medical school.[11] A poor quality of life coupled with burnout is likely to jeopardize students' ability to reach the most optimum levels of training and have implications for their future competencies as clinicians.[12] A previous report indicates several measures that should be addressed not only to vulnerable population of medical students but also to medical schools to achieve better quality of life of medical students.[12] The measures include improvement of medical school selection criteria, support of positive social relationship and mentoring process, self-care skills training, facilitation of strategies for coping with examination stress, and modeling of self-care.

Participating in various social activities increases the quality of life, as it improves self-esteem and usefulness when the students carry out their social role. Quality of life is further improved by maintaining meaningful personal relationships.[13]

Our recommendations are that students should be encouraged to participate more in social events. Various platforms must be available for the students for discussing their emotional stress. Classes and workshops can be held to emphasize the importance of maintaining a healthy life, both physical as well as mental.[14],[15],[16],[17],[18],[19]


  Conclusion Top


The study carried out among the 2nd and 3rd year undergraduate students of Jawaharlal Nehru Medical College shows that the quality of life, health-related as perceived by the participants is low. Various factors may be associated with this, including time constraints for social activities, heavy workload, and limited contact with family and friends. Deteriorated quality of life may affect the attainment of knowledge by the students, their performances as well as their future competencies as a clinician.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Tosevski DL, Milovancevic MP, Gajic SD. Personality and psychopathology of university students. Curr Opin Psychiatry 2010;23:48-52.  Back to cited text no. 1
    
2.
The World Health Organization Quality of Life Assessment (WHOQOL): Position paper from the World Health Organization. Soc Sci Med 1995;41:1403-9.  Back to cited text no. 2
    
3.
Ebrahim S. Clinical and public health perspectives and applications of health-related quality of life measurement. Soc Sci Med 1995;41:1383-94.  Back to cited text no. 3
    
4.
Domantay JA. Health-related quality of life of future physicians at a medical school in the Philippines: A cross-sectional study. SAGE Open 2014;4:1-9. [Doi: 10.1177/2158244014545459].  Back to cited text no. 4
    
5.
Ware JE Jr. SF-36 Health Survey Update. Medical Outcomes Trust.org; 2015. Available from: https://www.researchgate.net/publication/13469786_Overview_of_the_SF-36_Health_Survey_and_the_International_Quality_of_Life_Assessment_IQOLA_Projec. [Last accessed on 2015 Oct 09].  Back to cited text no. 5
    
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Barbist MT, Renn D, Noisternig B, Rumpold G, Höfer S. How do medical students value health on the EQ-5D? Evaluation of hypothetical health states compared to the general population. Health Qual Life Outcomes 2008;6:111.  Back to cited text no. 6
    
7.
Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. And Canadian medical students. Acad Med 2006;81:354-73.  Back to cited text no. 7
    
8.
Raj SR, Simpson CS, Hopman WM, Singer MA. Health-related quality of life among final-year medical students. CMAJ 2000;162:509-10.  Back to cited text no. 8
    
9.
Latas M, Stojković T, Ralić T, Jovanović S, Spirić Z, Milovanović S. Medical students' health-related quality of life – A comparative study. Vojnosanit Pregl 2014;71:751-6.  Back to cited text no. 9
    
10.
Zainuddin H, Juni M. Health-related quality of life (hrqol) of medical students in a public university, Malaysia. Int J Public Health Clin Sci 2015;2:3.  Back to cited text no. 10
    
11.
Dyrbye LN, Power DV, Massie FS, Eacker A, Harper W, Thomas MR, et al. Factors associated with resilience to and recovery from burnout: A prospective, multi-institutional study of US medical students. Med Educ 2010;44:1016-26.  Back to cited text no. 11
    
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Henning MA, Hawken SJ, Hill AG. The quality of life of New Zealand doctors and medical students: What can be done to avoid burnout? N Z Med J 2009;122:102-10.  Back to cited text no. 12
    
13.
Tempski P, Bellodi PL, Paro HB, Enns SC, Martins MA, Schraiber LB. What do medical students think about their quality of life? A qualitative study. BMC Med Educ 2012;12:106.  Back to cited text no. 13
    
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Munjal R, Mudey G. Nasal Carriage of Staphylococcus Aureus among Undergraduate Medical Students: Prevalence and Antibiogram Including Methicillin Resistance, Inducible Clindamycin Resistance, and High-Level Mupirocin Resistance. J Datta Meghe Inst Med Sci Univ 2018;13:91-4. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_10_18. [Last accessed on 2020 Mar 18].  Back to cited text no. 14
    
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Pande G, Kute P, Chitriv YU. To Study the Relationship of Dietary Habits and Physical Activity with BMI in Medical Students. Int J Pharm Res 2019;11:1145-7. Available from: https://doi.org/10.31838/ijpr/2019.11.01.201. [Last accessed on 2020 Mar 18].  Back to cited text no. 15
    
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Rathi A, Ransing RS, Mishra KK, Narula N. Quality of Sleep among Medical Students: Relationship with Personality Traits. J Clin Diagn Res 2018;12:VC01-4. Available from: https://doi.org/10.7860/JCDR/2018/24685.12025. [Last accessed on 2020 Mar 18].  Back to cited text no. 16
    
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Bakshi S, Toshniwal V, Agrawal A, Acharya S, Shukla S. Awareness and Psychosocial Effects of Covid-19 Pandemic on Health Care Professionals and Medical Students across the State of Maharashtra. Int J Curr Res Rev 2020;12:S122-5. Available from:https://doi.org/10.31782/IJCRR.2020.SP74. [Last accessed on 2020 Mar 18].  Back to cited text no. 17
    
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Khandelwal V, Khandelwal S, Gupta N, Nayak UA, Kulshreshtha N, Baliga S. Knowledge of Hepatitis B Virus Infection and Its Control Practices among Dental Students in an Indian City. Int J Adolesc Med Health 2018;30:1-6. Available from: https://doi.org/10.1515/ijamh-2016-0103. [Last accessed on 2020 Mar 18].  Back to cited text no. 18
    
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Swapnil P, Sarika D, Alka R, Varsha P. Assessment of Knowledge, Attitude and Practices of Allied Health Care Professional Students towards Universal Precaution. Indian Journal of Forensic Medicine and Toxicology 2020;14:374-9. Available from: https://doi.org/10.37506/ijfmt.v14i4.11485. [Last accessed on 2020 Mar 18].  Back to cited text no. 19
    


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