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Stea TH, Bonsaksen T, Smith P, Kleppang AL, Steigen AM, Leonhardt M, Lien L, Vettore MV. Are social pressure, bullying and low social support associated with depressive symptoms, self-harm and self-directed violence among adolescents? A cross-sectional study using a structural equation modeling approach. BMC Psychiatry 2024; 24:239. [PMID: 38553669 PMCID: PMC10981317 DOI: 10.1186/s12888-024-05696-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND More in-depth evidence about the complex relationships between different risk factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing social pressure, bullying, and low social support on mental health problems in adolescence. METHODS A school-based cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13-19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, social pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts. RESULTS Poor family economy and low parental education were associated with high pressure, low parental support and depressive symptoms in males and females. Moreover, poor family economy was associated with bullying perpetration and bullying victimization among males and females, and cyberbullying victimization among females, but not males. Low parental education was associated with bullying victimization among males, but not females. Further, high social pressure was associated with depressive symptoms among males and females, whereas high social pressure was linked to self-harm and suicide thoughts among females, but not males. Bullying victimization and cyberbullying victimization were associated with depressive symptoms, self-harm, and suicide thoughts among males and females. Bullying victimization was associated with depressive symptoms among males, but not females, whereas bullying perpetration was linked to self-harm and suicide thoughts among females, but not males. Low parental support was associated with bullying perpetration, bullying victimization, depressive symptoms, self-harm and suicide thoughts among males and females, whereas low parental support was associated with high social pressure among females, but not males. Low teacher support was associated with high social pressure and depressive symptoms. Low support from friends was associated with bullying victimization, depressive symptoms and suicide thoughts among males and females, whereas low support from friends was linked to self-harm among males, but not females. Finally, results showed that depressive symptoms were associated with self-harm and suicide thoughts among males and females. CONCLUSION Low socioeconomic status, social pressure, bullying and low social support were directly and indirectly associated with depressive symptoms and self-directed violence among Norwegian adolescents.
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Affiliation(s)
- Tonje Holte Stea
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway.
| | - Tore Bonsaksen
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, VID Specialized University, Stavanger, Norway
| | - Pierre Smith
- Health information service. Epidemiology and public health. Sciensano, Brussels, Belgium
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
| | - Annette Løvheim Kleppang
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
- Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Anne Mari Steigen
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Lars Lien
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
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da Silva AN, Lucietto DA, Bastos MVDS, do Nascimento TQ, Vettore MV. The relationship of dental students’ characteristics to social support, psychosocial factors, lifestyle, and quality of life. Health Psychol Behav Med 2022; 10:596-616. [PMID: 35898595 PMCID: PMC9310912 DOI: 10.1080/21642850.2022.2102017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To examine the relationships between sociodemographic characteristics, student academic information, social support, sense of coherence, anxiety, lifestyle, and quality of life among dental students. Methods: A cross-sectional study among 233 dental students in Brazil. We captured data on sociodemographic and socioeconomic characteristics, social support through Social Support Appraisal, psychosocial factors (sense of coherence and anxiety based on SOC-13 and Depression, Anxiety and Stress Scale-21 – anxiety subscale, respectively), lifestyle as per individual Lifestyle Profile and quality of life based on VERAS-Q. Data was analysed through Structural Equation Modelling. Results: Greater social support, higher sense of coherence, lower anxiety, better lifestyle directly predicted better quality of life. Male gender, city of origin did not differ from the city of the campus, higher social support and greater sense of coherence were indirectly linked with better quality of life via better lifestyle. Lower academic semester and higher social support indirectly predicted better quality of life via lower anxiety. Conclusion: Social support, sense of coherence, anxiety, and lifestyle were relevant factors directly associated with dental student’s quality of life. Indirect pathways were observed between gender, moved home to attend dental course, academic semester, social support, sense of coherence, and quality of life.
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Affiliation(s)
- Andréa Neiva da Silva
- Department of Health and Society, Institute of Collective Health, Fluminense Federal University (UFF), Niterói, Brazil
| | - Deison Alencar Lucietto
- Department of Health and Society, Institute of Collective Health, Fluminense Federal University (UFF), Niterói, Brazil
| | | | | | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway
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Taylor CE, Scott EJ, Owen K. Physical activity, burnout and quality of life in medical students: A systematic review. CLINICAL TEACHER 2022; 19:e13525. [PMID: 36052814 PMCID: PMC9826463 DOI: 10.1111/tct.13525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/08/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Medical students are at risk of burnout and reduced quality of life (QoL). The risk of burnout doubles from third to sixth year of medical school, and medical students have an 8%-11% lower QoL than nonmedical students. It is imperative to prevent this, as burnout and reduced QoL is independently associated with errors in practice. This systematic review aims to examine whether physical activity/exercise is associated with burnout and/or QoL in medical students. METHODS Articles were identified through database searches of Embase, Medline, PsycINFO, Scopus and Web of Science. Studies were included if both physical activity/exercise and burnout or QoL were measured and limited to those focussing on medical students. Risk of bias was assessed using accredited cohort and cross-sectional checklists. A narrative synthesis was conducted due to heterogeneity in the dataset. FINDINGS Eighteen studies were included, comprising 11,500 medical students across 13 countries. Physical activity was negatively associated with burnout and positively associated with QoL. Furthermore, the findings were suggestive of a dose-response effect of physical activity on both burnout and QoL; higher intensities and frequencies precipitated greater improvements in outcomes. CONCLUSIONS This multinational review demonstrates that physical activity is associated with reduced burnout and improved QoL in medical students. It also identifies a paucity of research into the optimal intensity, frequency, volume and mode of physical activity. Further research, building on this review, is likely to inform the long overdue development of evidence-based, well-being curricula. This could involve incorporating physical activity into medical education which may improve well-being and better prepare students for the demands of medical practice.
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Affiliation(s)
| | - Emma J. Scott
- Warwick Medical SchoolUniversity of WarwickCoventryUK
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Maalouf E, Hallit S, Obeid S. Personality traits and quality of life among Lebanese medical students: any mediating effect of emotional intelligence? A path analysis approach. BMC Psychol 2022; 10:28. [PMID: 35148803 PMCID: PMC8840643 DOI: 10.1186/s40359-022-00739-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/01/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Medicine is an incredibly demanding career that appears to leave many medical students at risk of fatigue, anxiety, depression and burnout. Since adaptation and lifestyle changes are important, quality of life (QOL) of students during medical school could be impaired. Personality traits and emotional intelligence (EI) facets may be both linked to medical student's QOL. To our knowledge, no studies have been done on the concurrent and prospective relationship between QOL-related personality traits and EI in Lebanese medical students. This study aimed to investigate the role of EI as a mediator between personality traits and QOL among a sample of Lebanese medical students. METHODS This research is a descriptive cross-sectional survey study involving 293 Lebanese medical students recruited from all 7 Faculties of Medicine in Lebanon (June-December 2019). Structural equation modeling (SEM) was performed using SPSS AMOS v.24 to examine the structural relationship between each personality trait taken as independent variables, QOL as the dependent variable, and emotional intelligence as the mediator, among university students. The relative Chi-square (χ2/df), root mean square error of approximation (RMSEA) statistic, Tucker Lewis Index (TFI) and the comparative fit index (CFI) were used to evaluate the goodness-of-fit of the model. RESULTS Higher conscientiousness was significantly associated with more EI (Beta = 0.38; p < 0.001) and lower QOL (Beta = - 0.14; p = 0.025). The indirect relationships between conscientiousness, EI and QOL showed that EI mediated the association between conscientiousness and QOL (Beta = 0.17; 95% CI - 0.73 to - 0.004; p = 0.037). The fit indices of this model were adequate for χ2/df, RMSEA and CFI but not TLI. Higher openness to experience was significantly associated with more EI (Beta = 0.48; p < 0.001) and lower QOL (Beta = - 0.38; p < 0.001). The indirect relationships between openness to experience, EI and QOL showed that EI mediated the association between openness to experience and QOL (Beta = 0.30; 95% CI - 1.11 to - 0.03; p = 0.04). The fit indices were adequate for χ2/df and CFI but not RMSEA and TLI. EI did not mediate the association between the other three personality traits (extroversion, agreeableness and neuroticism) and QOL. CONCLUSION This current research has shed considerable light on the nexus of associations between EI, personality traits and well-being, nonetheless, led to the creation of more puzzling questions. On the whole, it seems that EI and its components can be used as an evaluation instrument in relates with Lebanese medical students' personality profile as a means of future training to improve quality of life during medical education.
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Affiliation(s)
- Elise Maalouf
- Department of Life and Science, University of Paris-Est, Paris, France
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
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Miguel ADQC, Tempski P, Kobayasi R, Mayer FB, Martins MA. Predictive factors of quality of life among medical students: results from a multicentric study. BMC Psychol 2021; 9:36. [PMID: 33632321 PMCID: PMC7905855 DOI: 10.1186/s40359-021-00534-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/09/2021] [Indexed: 12/23/2022] Open
Abstract
Background 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. Methods 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). Results 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%). Conclusion 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.
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Affiliation(s)
- Alice de Queiroz Constantino Miguel
- 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.
| | - Patricia Tempski
- 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
| | - Renata Kobayasi
- 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
| | | | - Milton A Martins
- 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.,Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Perotta B, Arantes-Costa FM, Enns SC, Figueiro-Filho EA, Paro H, Santos IS, Lorenzi-Filho G, Martins MA, Tempski PZ. Sleepiness, sleep deprivation, quality of life, mental symptoms and perception of academic environment in medical students. BMC MEDICAL EDUCATION 2021; 21:111. [PMID: 33596885 PMCID: PMC7890911 DOI: 10.1186/s12909-021-02544-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 02/03/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND It has been previously shown that a high percentage of medical students have sleep problems that interfere with academic performance and mental health. METHODS To study the impact of sleep quality, daytime somnolence, and sleep deprivation on medical students, we analyzed data from a multicenter study with medical students in Brazil (22 medical schools, 1350 randomized medical students). We applied questionnaires of daytime sleepiness, quality of sleep, quality of life, anxiety and depression symptoms and perception of educational environment. RESULTS 37.8% of medical students presented mild values of daytime sleepiness (Epworth Sleepiness Scale - ESS) and 8.7% presented moderate/severe values. The percentage of female medical students that presented ESS values high or very high was significantly greater than male medical students (p < 0.05). Students with lower ESS scores presented significantly greater scores of quality of life and perception of educational environment and lower scores of depression and anxiety symptoms, and these relationships showed a dose-effect pattern. Medical students reporting more sleep deprivation showed significantly greater odds ratios of presenting anxiety and depression symptoms and lower odds of good quality of life or perception of educational environment. CONCLUSIONS There is a significant association between sleep deprivation and daytime sleepiness with the perception of quality of life and educational environment in medical students.
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Affiliation(s)
- Bruno Perotta
- Mackenzie Evangelical School of Medicine - Parana, Curitiba, Brazil
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda M Arantes-Costa
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
| | - Sylvia C Enns
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
| | | | - Helena Paro
- Department of Gynecology & Obstetrics, Federal University of Uberlandia, Uberlandia, Brazil
| | - Itamar S Santos
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
| | - Geraldo Lorenzi-Filho
- Department of Cardio-Pneumology, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Milton A Martins
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil.
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil.
| | - Patricia Z Tempski
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
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Solis AC, Lotufo-Neto F. Predictors of quality of life in Brazilian medical students: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2020; 41:556-567. [PMID: 30994854 PMCID: PMC6899364 DOI: 10.1590/1516-4446-2018-0116] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/05/2018] [Indexed: 11/30/2022]
Abstract
Objective: To examine predictors associated with quality of life (QoL) in Brazilian medical students. Methods: PubMed, PsycINFO, EMBASE, LILACS, and Google Scholar were searched for research articles in English or Portuguese published through August 2018. Observational studies that measured QoL with standard instruments were selected. Three instruments were used to evaluate QoL: the World Health Organization QoL questionnaires (WHOQOL-Bref and WHOQOL-100) and 36-item Short Form Health Survey (SF-36). Hedges’ g was used to calculate effect sizes. A random-effects model was used in meta-analyses. PRISMA guidelines were followed. Results: The initial search retrieved 8,504 articles; 24 met the eligibility criteria for systematic review, and seven for meta-analyses of gender (n=3,402 students). Predictors of QoL such as gender, years of medical school(years of study), economic class, educational environment, academic efficacy, depression, burnout, resilience, empathic concern, sleep difficulties, chronic illness, body mass index, and leisure-time physical activity were identified in the systematic review. The most frequent predictors of QoL detected in Brazilian medical students were associated with gender and years of study. Conclusions: Female medical students had lower QoL scores in the physical health and psychological domains of WHOQOL-Bref compared to male students. Specific interventions should be designed for this group as appropriate. Systematic review registry number: PROSPERO CRD-42018102259.
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Affiliation(s)
- Ana C Solis
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Francisco Lotufo-Neto
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Programa de Pós-Graduação em Psicologia Clínica, Instituto de Psicologia, USP, São Paulo, SP, Brazil
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Kobayasi R, Tempski PZ, Arantes-Costa FM, Martins MA. Gender differences in the perception of quality of life during internal medicine training: a qualitative and quantitative analysis. BMC MEDICAL EDUCATION 2018; 18:281. [PMID: 30477504 PMCID: PMC6260562 DOI: 10.1186/s12909-018-1378-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 11/02/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The higher level of participation by women in medicine may impact this profession's evolution due to gender differences perceived during medical school, after graduation and during residency. Gender differences regarding quality of life are associated with higher states of anxiety and depression among female physicians. We aimed to assess gender differences in the perception of quality of life with quantitative methods and to understand further, from the female residents´ point of view, the reasons that may influence the perception of quality of life using qualitative method. Resilience, empathy and daytime sleepiness were also scored. METHODS We performed a cross-sectional study with first-year internal medicine residents to evaluate self-reported quality of life factors specific to medical residents (VERAS-Q), including empathy (Jefferson Scale of Empathy), resilience (Wagnild and Young Brief Resilience Scale) and daytime sleepiness (Epworth Scale). We explored, from the female residents´ view which factors may influence the perception of quality of life using a focus group method. RESULTS In our study, one hundred and nine residents completed the survey: 31 (28.4%) were female and 78 (71.6%) were male. Female residents exhibited significantly lower scores than those of male residents for quality of life in the domains of time management (30.3, females vs 41.1, males; p < 0.001), psychology (48.1, females vs 56.7, males; p < 0.01) and physical health (42.8, females vs 53.6, males; p < 0.05). Female residents also scored higher for daytime sleepiness (13.0, females vs 9.0, males; p < 0.001), with pathological scores for daytime sleepiness. No significant gender differences were found in the resilience or empathy scores. The focus group assessment revealed difficulty in concentration and knowledge acquisition, insecurity, feelings of loss, greater critical perception, self-doubt and difficulty in creating effective bonds to support the training period as the main factors involved in the lower perception of quality of life among the women. CONCLUSIONS In conclusion, female residents had lower scores for quality of life and higher scores for daytime sleepiness. Measures to improve quality of life among female residents during this critical period of medical training might include investing in mentoring to help them better manage their time and encouraging activities that facilitate relationship development.
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Affiliation(s)
- Renata Kobayasi
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Zen Tempski
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda Magalhâes Arantes-Costa
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Mílton Arruda Martins
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Peleias M, Tempski P, Paro HBMS, Perotta B, Mayer FB, Enns SC, Gannam S, Pereira MAD, Silveira PS, Santos IS, Carvalho CRF, Martins MA. Leisure time physical activity and quality of life in medical students: results from a multicentre study. BMJ Open Sport Exerc Med 2017; 3:e000213. [PMID: 28761706 PMCID: PMC5530174 DOI: 10.1136/bmjsem-2016-000213] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND/AIM We evaluated the association between leisure time physical activity (PA) and quality of life (QoL) in medical students. Our hypothesis was that there was a positive association between volume of PA and various domains of perception of QoL. METHODS Data were evaluated from a random sample of 1350 medical students from 22 Brazilian medical schools. Information from participants included the WHO Quality of Life questionnaire-short form (WHOQOL-BREF), a questionnaire specifically designed to evaluate QoL in medical students (VERAS-Q) and questions for both global QoL self-assessment and leisure time PA. According to the amount of metabolic equivalents (METs) spend during PA, volunteers were divided into four groups, according to the volume of PA: (a) no PA; (b) low PA, ≤540 MET min/week; (c) moderate PA, from 541 to 1260 MET min/week and (d) high PA, > 1261 MET min/week. RESULTS Forty per cent of the medical students reported no leisure time PA (46.0% of females and 32.3% of males). In contrast, 27.2% were classified in the group of high PA (21.0% of females and 34.2% of males). We found significant associations between moderate and high levels of PA and better QoL for all measurements. For low levels of PA, this association was also significant for most QoL measurements, with the exceptions of WHOQOL physical health (p=0.08) and social relationships (p=0.26) domains. CONCLUSION We observed a strong dose-effect relationship between the volume of leisure time PA and QoL in both male and female medical students.
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Affiliation(s)
- Munique Peleias
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Tempski
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Helena BMS Paro
- Department of Obstetrics and Gynecology, Federal University of Uberlandia, Uberlandia, Brazil
| | - Bruno Perotta
- Evangelical Medical School of Parana, Curitiba, Brazil
| | - Fernanda B Mayer
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Sylvia C Enns
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Silmar Gannam
- University of the City of São Paulo, Sao Paulo, Brazil
| | | | - Paulo S Silveira
- Department of Pathology, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Celso RF Carvalho
- Department of Physical Therapy, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Milton A Martins
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
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Tempski P, Santos IS, Mayer FB, Enns SC, Perotta B, Paro HBMS, Gannam S, Peleias M, Garcia VL, Baldassin S, Guimaraes KB, Silva NR, da Cruz EMTN, Tofoli LF, Silveira PSP, Martins MA. Relationship among Medical Student Resilience, Educational Environment and Quality of Life. PLoS One 2015; 10:e0131535. [PMID: 26121357 PMCID: PMC4486187 DOI: 10.1371/journal.pone.0131535] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/03/2015] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Resilience is a capacity to face and overcome adversities, with personal transformation and growth. In medical education, it is critical to understand the determinants of a positive, developmental reaction in the face of stressful, emotionally demanding situations. We studied the association among resilience, quality of life (QoL) and educational environment perceptions in medical students. METHODS We evaluated data from a random sample of 1,350 medical students from 22 Brazilian medical schools. Information from participants included the Wagnild and Young's resilience scale (RS-14), the Dundee Ready Educational Environment Measure (DREEM), the World Health Organization Quality of Life questionnaire - short form (WHOQOL-BREF), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). RESULTS Full multiple linear regression models were adjusted for sex, age, year of medical course, presence of a BDI score ≥ 14 and STAI state or anxiety scores ≥ 50. Compared to those with very high resilience levels, individuals with very low resilience had worse QoL, measured by overall (β=-0.89; 95% confidence interval =-1.21 to -0.56) and medical-school related (β=-0.85; 95%CI=-1.25 to -0.45) QoL scores, environment (β=-6.48; 95%CI=-10.01 to -2.95), psychological (β=-22.89; 95%CI=-25.70 to -20.07), social relationships (β=-14.28; 95%CI=-19.07 to -9.49), and physical health (β=-10.74; 95%CI=-14.07 to -7.42) WHOQOL-BREF domain scores. They also had a worse educational environment perception, measured by global DREEM score (β=-31.42; 95%CI=-37.86 to -24.98), learning (β=-7.32; 95%CI=-9.23 to -5.41), teachers (β=-5.37; 95%CI=-7.16 to -3.58), academic self-perception (β=-7.33; 95%CI=-8.53 to -6.12), atmosphere (β=-8.29; 95%CI=-10.13 to -6.44) and social self-perception (β=-3.12; 95%CI=-4.11 to -2.12) DREEM domain scores. We also observed a dose-response pattern across resilience level groups for most measurements. CONCLUSIONS Medical students with higher resilience levels had a better quality of life and a better perception of educational environment. Developing resilience may become an important strategy to minimize emotional distress and enhance medical training.
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Affiliation(s)
- Patricia Tempski
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
- Evangelical Medical School of Parana, Curitiba, Brazil
| | - Itamar S. Santos
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda B. Mayer
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | - Sylvia C. Enns
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | - Bruno Perotta
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Helena B. M. S. Paro
- Department of Obstetrics and Gynecology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Silmar Gannam
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | - Munique Peleias
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | | | | | | | | | | | - Luis F. Tofoli
- Department of Psychiatry, School of Medicine, State University of Campinas, Campinas, Brazil
| | - Paulo S. P. Silveira
- Department of Pathology, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Milton A. Martins
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- * E-mail:
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Tempski P, Bellodi PL, Paro HBMS, Enns SC, Martins MA, Schraiber LB. What do medical students think about their quality of life? A qualitative study. BMC MEDICAL EDUCATION 2012; 12:106. [PMID: 23126332 PMCID: PMC3527341 DOI: 10.1186/1472-6920-12-106] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 10/25/2012] [Indexed: 05/04/2023]
Abstract
BACKGROUND Medical education can affect medical students' physical and mental health as well as their quality of life. The aim of this study was to assess medical students' perceptions of their quality of life and its relationship with medical education. METHODS First- to sixth-year students from six Brazilian medical schools were interviewed using focus groups to explore what medical student's lives are like, factors related to increases and decreases of their quality of life during medical school, and how they deal with the difficulties in their training. RESULTS Students reported a variety of difficulties and crises during medical school. Factors that were reported to decrease their quality of life included competition, unprepared teachers, excessive activities, and medical school schedules that demanded exclusive dedication. Contact with pain, death and suffering and harsh social realities influence their quality of life, as well as frustrations with the program and insecurity regarding their professional future. The scarcity of time for studying, leisure activities, relationships, and rest was considered the main factor of influence. Among factors that increase quality of life are good teachers, classes with good didactic approaches, active learning methodologies, contact with patients, and efficient time management. Students also reported that meaningful relationships with family members, friends, or teachers increase their quality of life. CONCLUSION Quality of teachers, curricula, healthy lifestyles related to eating habits, sleep, and physical activity modify medical students' quality of life. Lack of time due to medical school obligations was a major impact factor. Students affirm their quality of life is influenced by their medical school experiences, but they also reframe their difficulties, herein represented by their poor quality of life, understood as necessary and inherent to the process of becoming doctors.
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Affiliation(s)
- Patricia Tempski
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Patricia L Bellodi
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Helena BMS Paro
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
- Universidade Federal de Uberlândia, Av. Pará, 1720 - Umuarama, Uberlândia, MG, 38408-144, Brazil
| | - Sylvia C Enns
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Milton A Martins
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Lilia B Schraiber
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
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Tempski P, Martins MA, Paro HBMS. Teaching and learning resilience: a new agenda in medical education. MEDICAL EDUCATION 2012; 46:345-6. [PMID: 22429168 DOI: 10.1111/j.1365-2923.2011.04207.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Patricia Tempski
- Health Sciences, Federal University of Uberlandia, Avenida Pará 1720, Uberlandia, Minas Gerais, Brazil
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Kron FW, Gjerde CL, Sen A, Fetters MD. Medical student attitudes toward video games and related new media technologies in medical education. BMC MEDICAL EDUCATION 2010; 10:50. [PMID: 20576125 PMCID: PMC2908629 DOI: 10.1186/1472-6920-10-50] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 06/24/2010] [Indexed: 05/17/2023]
Abstract
BACKGROUND Studies in K-12 and college students show that their learning preferences have been strongly shaped by new media technologies like video games, virtual reality environments, the Internet, and social networks. However, there is no known research on medical students' game experiences or attitudes towards new media technologies in medical education. This investigation seeks to elucidate medical student experiences and attitudes, to see whether they warrant the development of new media teaching methods in medicine. METHODS Medical students from two American universities participated. An anonymous, 30-item, cross-sectional survey addressed demographics, game play experience and attitudes on using new media technologies in medical education. Statistical analysis identified: 1) demographic characteristics; 2) differences between the two universities; 3) how video game play differs across gender, age, degree program and familiarity with computers; and 4) characteristics of students who play most frequently. RESULTS 217 medical students participated. About half were female (53%). Respondents liked the idea of using technology to enhance healthcare education (98%), felt that education should make better use of new media technologies (96%), and believed that video games can have educational value (80%). A majority (77%) would use a multiplayer online healthcare simulation on their own time, provided that it helped them to accomplish an important goal. Men and women agreed that they were most inclined to use multiplayer simulations if they were fun (97%), and if they helped to develop skill in patient interactions (90%). However, there was significant gender dissonance over types of favorite games, the educational value of video games, and the desire to participate in games that realistically replicated the experience of clinical practice. CONCLUSIONS Overall, medical student respondents, including many who do not play video games, held highly favorable views about the use of video games and related new media technology in medical education. Significant gender differences in game play experience and attitudes may represent male video game design bias that stresses male cognitive aptitudes; medical educators hoping to create serious games that will appeal to both men and women must avoid this.
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Affiliation(s)
- Frederick W Kron
- Medical Cyberworlds, Inc., 3895 Swoboda Road, Verona, 53590, USA
| | - Craig L Gjerde
- Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Ct., Madison, 53715-1896, USA
| | - Ananda Sen
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, 48109-1213, USA
| | - Michael D Fetters
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, 48109-1213, USA
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