Fatores associados à qualidade de vida dos estudantes de medicina no interior do Nordeste brasileiro

Santos, Heloísa Alves dos; Segundo, Jair Matos; Barreto, Maria Luiza Lins; Santos, Victor Régis dos; Azevedo, George Dantas de; Sousa, Ana Carolina Patrício de Albuquerque

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Revista Brasileira de Educação Médica

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ORIGINAL ARTICLE • Rev. bras. educ. med. 45 (03) • 2021 • https://doi.org/10.1590/1981-5271v45.3-20210042.ING copiar

Fatores associados à qualidade de vida dos estudantes de medicina no interior do Nordeste brasileiro

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo:

Introdução:

A atual política de interiorização da educação médica mundial e a aplicação de métodos ativos, bem como a falta de consenso sobre os fatores associados à qualidade de vida dos estudantes de Medicina, são conhecidos temas de discussão na literatura médica.

Objetivo:

Tendo em vista a escassez de análise sobre o assunto, este estudo teve como objetivo avaliar a qualidade de vida entre os estudantes de Medicina de uma universidade do interior do Nordeste brasileiro.

Método:

Trata-se de um estudo transversal, desenvolvido de março a maio de 2018. Utilizou-se o questionário WHOQOL-bref para avaliar a qualidade de vida, e os dados foram relacionados a características sociodemográficas, dados antropométricos e estilo de vida. Analisaram-se os dados por meio de estatística descritiva, e, em seguida, fez-se a análise bivariada com teste para comparação das médias dos escores, a fim de identificar possíveis variáveis associadas aos domínios investigados. Realizou-se regressão logística binária para identificar possíveis fatores associados à pior qualidade de vida nos domínios investigados. A análise estatística estimou IC 95% e valor de p < 0,05.

Resultado:

O presente estudo caracterizou a qualidade de vida dos estudantes de Medicina e identificou como principais fatores associados à má qualidade de vida: ser do sexo feminino, cursar anos pré-clínicos, ser fumante, ter peso normal classificado pelo índice de massa corporal e apresentar uma avaliação negativa da própria saúde e da qualidade de vida. Os resultados também evidenciaram que a maioria dos estudantes apresentou uma avaliação negativa nos domínios físico, psicológico e meio ambiente, em contraste com o domínio relações sociais, ao qual a maioria atribuiu uma avaliação positiva.

Conclusão:

Os achados permitem discutir acerca de medidas voltadas a lidar com fatores que prejudicam a qualidade de vida de alunos de escolas de Medicina em regiões remotas e rurais.

Palavras-chave:
Qualidade de Vida; Estudantes de Medicina; Saúde Mental; Educação Médica; Zona Rural

Sociodemographic Variables		Absolute Frequency (n)	Absolute Frequency (%)
GENDER	Male	80	55.2%
GENDER	Female	65	44.8%
MARITAL STATUS	Single	136	93.8%
	Married/Common-law marriage	8	5.5%
	Separated/divorced	1	0.7%
SKIN COLOR/ETHNICITY	White	63	44.4%
	Black	6	4.2%
	Brown	73	51.4%
MEDICAL SCHOOL YEAR	4th year	29	20%
	3rd year	38	26.2%
	2nd year	39	26.9%
	1st year	39	26.9%
PAID WORK	No	133	91.7%
PAID WORK	Yes	12	8.3%
ACADEMIC SCHOLARSHIP	No	117	80.7%
ACADEMIC SCHOLARSHIP	Yes	28	19.3%
Anthropometric measurements
WHR	Low risk	130	90.9%
	Moderate risk	7	4.9%
	High risk	6	4.2%
BMI	Low weight	7	4.9%
	Normal weight	91	64.1%
	Overweight	34	23.9%
	Obesity	10	7%
Lifestyle habits
RELIGIOUS PRACTICE	No	58	41.4%
RELIGIOUS PRACTICE	Yes	82	58.6%
ALCOHOL CONSUMPTION	No	65	44.8%
ALCOHOL CONSUMPTION	Yes	80	55.2%
SMOKER	No	136	94.4%
SMOKER	Yes	8	5.6%
PRACTICES PHYSICAL ACTIVITY	No	38	26.4%
PRACTICES PHYSICAL ACTIVITY	Yes	106	73.6%

WHOQOL-Bref		Absolute Frequency (n)	Relative Frequency (%)
QUALITY OF LIFE PERCEPTION	Needs improvement	11	7.6%
	Regular	24	16.6%
	Good	93	64.1%
	Very good	17	11.7%
HEALTH SATISFACTION	Needs improvement	27	18.6%
	Regular	33	22.8%
	Good	66	45.5%
	Very good	19	13.1%
PHYSICAL DOMAIN	Needs improvement	14	9.8%
	Regular	78	54.5%
	Good	51	35.7%
	Very good	0	0%
PSYCHOLOGICAL DOMAIN	Needs improvement	20	14%
	Regular	73	51%
	Good	49	34.3%
	Very good	1	0.7%
SOCIAL RELATIONSHIPS	Needs improvement	16	11.3%
	Regular	47	33.1%
	Good	70	49.3%
	Very good	9	6.3%
ENVIRONMENTAL	Needs improvement	15	10.4%
	Regular	91	63.2%
	Good	38	26.4%
	Very good	0	0

VARIABLES		PHYSICAL DOMAIN		PSYCHOLOGICAL DOMAIN		SOCIAL RELATIONSHIPS		ENVIRONMENTAL DOMAIN
		TOTAL SCORE 67.09 ± 16.06 [Min.: 21.43; Max.: 96.43]		TOTAL SCORE 65.40 ± 16.90 [Min.: 8.33; Max.: 100.00]		TOTAL SCORE 70.25 ± 18.54 [Min.: 16.67; Max.: 100.00]		TOTAL SCORE 64.64 ± 13.36 [Min.: 21.80; Max.: 96.80]
		MEAN	p-value	MEAN	p-value	MEAN	p-value	MEAN	p-value
SEX	Male	70.09	0.012	68.03	0.038	69.32	0.502	65.70	0.291
SEX	Female	63.39		62.17		71.41		63.33	0.291
YEAR AT MEDICAL SCHOOL	1st year	66.68	0.158	65.38	0.139	70.72	0.08	65.17	0.570
	2nd year	65.29		63.88		67.09		62.98
	3rd year	64.84		62.28		67.43		63.73
	4th year	73.01		71.58		77.58		67.34
ACADEMIC SCHOLARSHIP	Yes	69.00	0.485	64.88	0.855	67.70	0.420	64.06	0.799
ACADEMIC SCHOLARSHIP	No	66.63		65.53		70.86		64.78	0.799
RELIGIOUS PRACTICE	Yes	68.51	0.271	68.09	0.022	73.11	0.034	66.36	0.093
RELIGIOUS PRACTICE	No	65.51		61.42		66.37		62.60	0.093
PHYSICAL ACTIVITY	Yes	68.12	0.306	65.72	0.653	69.53	0.498	64.87	0.727
PHYSICAL ACTIVITY	No	65.03		64.27		71.92		63.98	0.727
BMI	Low weight	66.32	0.421	69.04	0.031	70.23	0.181	67.41	0.262
	Normal weight	66.00		63.14*		68.40		63.57
	Overweight/Obesity	69.89		70.85*		74.71		67.40
WHR	Low risk	67.82	0.162	66.25	0.290	70.28	0.939	65.15	0.354
WHR	Moderate/ high risk	61.26		61.21		69.87		61.53	0.354
ALCOHOL CONSUMPTION	Yes	67.85	0.527	67.04	0.198	70.93	0.627	65.82	0.241
ALCOHOL CONSUMPTION	No	66.15		63.39		69.42		63.19	0.241
SMOKER	Yes	55.35	0.034	47.39	0.002	55.20	0.019	48.82	<0.001
SMOKER	No	67.77		66.42		71.04		65.58	<0.001
QUALITY OF LIFE PERCEPTION	Good/ very good	70.45	<0.001	70.45	<0.001	72.68	0.005	68.27	<0.001
QUALITY OF LIFE PERCEPTION	Regular/needs improvement	56.53		56.53		62.61		53.21	<0.001
HEALTH SATISFACTION	Good/very good	74.11	<0.001	74.11	<0.001	72.10	0.154	68.25	<0.001
HEALTH SATISFACTION	Regular/needs improvement	57.15		57.15		67.63		59.53	<0.001

Variables	Physical Domain		Psychological Domain		Social Relationships Domain		Environmental Domain
Variables	Odds Ratio [IC95%]	p-value	Odds Ratio [IC95%]	p-value	Odds Ratio [IC95%]	p-value	Odds Ratio [IC95%]	p-value
Block1: Sociodemographic Variables
Gender
Male	1.00	0.01	1.00	0.10	1.00	0.39	1.00	0.40
Female	3.05 [1.24 - 7.52]	0.01	2.21 [0.85 - 5.73]	0.10	0.70 [0.31 -1.57]	0.39	1.42 [0.61 - 3.28]	0.40
Medical School Period
Clinical Period	1.00	0.29	1.00	<0.01	1.00	0.05	1.00	0.33
Preclinical Period	1.55 [0.68 - 3.52]	0.29	5.01 [1.95 -12.87]	<0.01	2.10 [0.99 - 4.46]	0.05	1.48 [0.66 - 3.32]	0.33
Religious practice
Yes	1.00	0.59	1.00	0.60	1.00	0.88	1.00	0.46
No	0.79 [0.33 - 1.85]	0.59	1.28 [0.50 - 3.29]	0.60	1.05 [0.49 - 2.28]	0.88	1.36 [0.59 - 3.17]	0.46
Block 2: Health Variables
BMI
Normal Weight	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		1.00	0.02	1.00	0.06	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.
Low Weight/ Overweight/Obesity	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		0.30 [0.10 - 0.85]	0.02	0.45 [0.20 - 1.04]	0.06	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.
WHR
Low Risk	1.00	0.65	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.
Moderate/high risk	0.65 [0.10 - 4.20]	0.65	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.
Alcohol consumption
No	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		1.00	0.55	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.
Yes	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		0.75 [0.30 -1.89]	0.55	^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.		^# # The variables did not enter the model because they showed a p-value>0.20 in the bivariate analysis in relation to the investigated domain.
Smoker
No	1.00	0.34	1.00	0.47	0.34 [0.05 - 2.02]	0.23	^## ## The variable entered the regression mode;, however, the value could not be computed since 100% of those who smoke showed a regular/needs improvement quality of life for the environmental domain, making comparative analysis impossible.
Yes	0.30 [0.02 - 3.58]	0.34	2.63 [0.18 - 37.85]	0.47			^## ## The variable entered the regression mode;, however, the value could not be computed since 100% of those who smoke showed a regular/needs improvement quality of life for the environmental domain, making comparative analysis impossible.
Block 3: General QoL Variables
Quality of Life Perception
Good/very good	1.00	0.81	1.00	<0.01	1.00	0.01	1.00	0.03
Regular/ Needs improvement	1.15 [0.34 - 3.88]	0.81	10.45 [1.91 -57.10]	<0.01	3.70 [1.36 - 10.07]	0.01	5.30 [1.12 -25.15]	0.03
Satisfaction with one’s health
Good/very good	1.00	<0.01	1.00	<0.01	1.00	0.36	1.00	0.08
Regular/Needs improvement	7.99 [2.81-22.67]	<0.01	5.77 [1.98 - 16.83]	<0.01	0.67 [0.28 - 1.57]	0.36	2.27 [0.89 - 5.79]	0.08

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