Qualidade de vida dos alunos do curso de medicina da Escola Paulista de Medicina - Universidade Federal de São Paulo
Data
2015-08-12
Autores
Cunha, Deyse Helena Fernandes da 
Orientadores
Santos, Amelia Miyashiro Nunes dos
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Analisar as propriedades psicométricas do questionário WHOQOL-100, avaliar a qualidade de vida e os fatores associados ao menor escore de qualidade de vida de estudantes de medicina da Escola Paulista de Medicina - Universidade Federal de São Paulo em 2011. Métodos: Estudo transversal realizado de agosto a dezembro de 2011 com aplicação do questionário WHOQOL-100 com inclusão de todos os alunos matriculados em 2011 do 1o ao 6o ano no curso de medicina da instituição. Foram coletados dados sobre ano do curso, sexo, idade, estado civil, número de filhos, nível socioeconômico e com quem o aluno morava. A confiabilidade do questionário foi avaliada pelo coeficiente de Cronbach e a validade por análise fatorial. Calculou-se o coeficiente de Kaiser-Meyer-Olkin e o nível de significância do teste de esfericidade de Bartlett. Na análise fatorial, determinou-se o número de fatores que explicassem pelo menos 60% da variância das respostas. A seguir, analisou-se a carga fatorial das variáveis em relação aos componentes extraídos, seguida de rotação da matriz. Os escores obtidos foram convertidos para uma escala de zero a 100. Na análise dos grupos, foram considerados o escore global e escores dos domínios físico, psicológico, independência, relações sociais, ambiente e aspectos espirituais. As comparações entre as variáveis numéricas foram feitas por teste t ou ANOVA e as categóricas por ?2. Os fatores associados ao menor escore global foram analisados por regressão linear. Utilizou-se o programa SPSS for Win/v.17.0 (IBM, Somers, NY, EUA), considerando-se significante p < 0,05. O projeto foi aprovado pelo Comitê de Ética da Instituição e os participantes assinaram o Termo de Consentimento. Resultados: Dos 736 alunos matriculados, 607 (82,5%) responderam ao questionário. A idade média dos alunos incluídos foi 22,9 ± 2,9 anos, sendo 57,4% do sexo masculino,99,0% solteiros e 14,5% moravam sozinhos. A distribuição segundo classe socioeconômica foi: A1 (7,2%), A2 (21,1%), B1 (21,6%), B2 (25,4%), C1 (17,0%), C2 (4,8%) e D (1,2%). O coeficiente de Cronbach foi 0,956. O coeficiente de Kaiser-Meyer-Olkin foi 0,916 e o teste de esfericidade de Bartlett foi significante (p<0,001). A análise fatorial identificou 23 itens que explicaram 69,3% da variância das respostas. Os alunos apresentaram em conjunto um escore global de 72,1 ± 7,7 pontos. A somatória dos escores de todos os domínios foi semelhante do 1o ao 5o ano e entre os alunos do 3o e 6o anos. Entretanto, os alunos do 6o ano (69,2 ± 8,5) apresentaram menor escore global que os do 1o (72,9 ± 7,3), 2o (72,5 ± 7,6), 4o (72,4 ± 7,2) e 5o (73,8 ± 7,8) anos. Nas questões específicas sobre a qualidade de vida, o escore foi maior: no ciclo básico que nos ciclos profissionalizante e internato; do 1o ao 4o ano que no internato; no 1o, 2o e 4o anos que no 3o ano; no 3o ano que no 6o ano; e no 1o em comparação ao 6o ano. Os alunos do 6o apresentaram menores escores que o 1o ano em todos os domínios, exceto na espiritualidade. O sexo masculino apresentou maior escore global e nos domínios físico, psicológico, independência e qualidade de vida, comparado ao feminino. Os que moravam sozinhos, comparados àqueles que tinham companhia, apresentaram menores escores no domínio físico. Os alunos da classe socioeconômica C/D apresentaram menor escore global e no domínio ambiente, comparados àqueles das classes A e B (p <0,001). Os fatores associados a menor escore global foram: sexto ano (OR: -3,5, p<0,001), sexo feminino (OR: -2,1, p=0,001) e classe C/D (OR: -1,8, p=0,017). Conclusões: O WHOQUOL-100 apresentou confiabilidade e validade adequadas para avaliar a qualidade de vida dos alunos de medicina. O escore global de qualidade de vida foi de 72 pontos, com maiores escores entre alunos do 1o, 2o 4o e 5o anos e menores nos alunos do 3o e 6o anos. Estar no sexto ano, ser do sexo feminino e pertencer a classe C/D se associaram a menor escore global de qualidade de vida.
Objectives: To analyze the psychometric properties of the WHOQOL-100 questionnaire, assess the quality of life and the factors associated with lower scores of quality of life among medical students of the Escola Paulista de Medicina - Universidade Federal de São Paulo, in 2011. Methods: A cross-sectional study was conducted from August to December 2011 using the WHOQOL-100 questionnaire with inclusion of all students enrolled in 2011 from first to sixth year of the medical course at the institution. Data related to year of the course, sex, age, marital status, number of children, socioeconomic level and who lives with the student were collected. The reliability of the questionnaire was assessed by the Cronbach's coefficient and the validity by factor analysis. We calculated the coefficient of Kaiser-Meyer-Olkin and the level of significance of Bartlett's test of sphericity. In the factor analysis, it was determined the number of factors that explained at least 60% of the variance of the responses. Next, we analyzed the factor loadings of the variables in relation to the extracted components, followed by rotation of the array. The scores were converted to a scale of zero to 100. In the analysis of the groups, we considered the overall score and scores of physical, psychological, independence, social relationships, environment and spiritual aspects. Comparisons between numerical variables were made by t test or ANOVA and categorical variables by qui-square. Factors associated with lower overall scores were analyzed by linear regression. For statistical analysis, SPSS for Win / v.17.0 (IBM, Somers, NY) was applied, considering significant p <0.05. The project was approved by the Institutional Ethics Committee and all participants signed a consent form. Results: Of the 736 students enrolled, 607 (82.5%) answered the questionnaire. The mean age of the included students was 22.9 ± 2.9 years, 57.4% male, 99.0% were single and 14.5% were living alone. The distribution according to the socioeconomic class was: A1 (7.2%), A2 (21.1%), B1 (21.6%), B2 (25.4%), C1 (17.0%), C2 (4 , 8%) and D (1.2%). Cronbach's coefficient was 0.956. The coefficient of Kaiser-Meyer-Olkin was 0.916 and Bartlett's test of sphericity was significant (p <0.001). Factor analysis identified 23 items that explained 69.3% of the variance of the responses. The students presented together an overall score of 72.1 ± 7.7 points. The global score was similar among students of the 1st to 5th year and between students of 3rd and 6th years. However, students of the 6th year (69.2 ± 8.5) had lower overall scores than the 1st (72.9 ± 7.3), 2nd (72.5 ± 7.6), 4th (72.4 ± 7.2) and 5th (73.8 ± 7.8) years. The perception of quality of life was greater in 1st-2nd years students compare to 3rd-4th year and 5th-6th years; the 1st, 2nd and 4th years comparede to the 3rd year; the 3rd year compered to the 6th year; and 1st against the 6th year. Students from 6th year had lower scores than the 1st year in all areas except in spirituality. Males had higher overall score, in the physical, psychological, independence and quality of life, compared with females. Those who were living alone, compared to those who had company, had lower scores in the physical domain. Students of the C/D socioeconomic status had a lower overall and environment domain score in compared to those of class A and B (p <0.001). Factors associated with lower overall scores were: 6th year (OR: -3.5, p <0.001), female sex (OR: -2.1, p = 0.001) and class C / D (OR: -1.8 , p = 0.017). Conclusions: WHOQUOL-100 showed adequate reliability and validity for assessing the quality of life of medical students. The overall score for quality of life was 72 points, with higher scores among students of 1st, 2nd, 4th and 5th years and lower in students of 3th and 6th years. Being in the 6th year, being female and belong to class C / D were associated with lower overall score for quality of life.
Objectives: To analyze the psychometric properties of the WHOQOL-100 questionnaire, assess the quality of life and the factors associated with lower scores of quality of life among medical students of the Escola Paulista de Medicina - Universidade Federal de São Paulo, in 2011. Methods: A cross-sectional study was conducted from August to December 2011 using the WHOQOL-100 questionnaire with inclusion of all students enrolled in 2011 from first to sixth year of the medical course at the institution. Data related to year of the course, sex, age, marital status, number of children, socioeconomic level and who lives with the student were collected. The reliability of the questionnaire was assessed by the Cronbach's coefficient and the validity by factor analysis. We calculated the coefficient of Kaiser-Meyer-Olkin and the level of significance of Bartlett's test of sphericity. In the factor analysis, it was determined the number of factors that explained at least 60% of the variance of the responses. Next, we analyzed the factor loadings of the variables in relation to the extracted components, followed by rotation of the array. The scores were converted to a scale of zero to 100. In the analysis of the groups, we considered the overall score and scores of physical, psychological, independence, social relationships, environment and spiritual aspects. Comparisons between numerical variables were made by t test or ANOVA and categorical variables by qui-square. Factors associated with lower overall scores were analyzed by linear regression. For statistical analysis, SPSS for Win / v.17.0 (IBM, Somers, NY) was applied, considering significant p <0.05. The project was approved by the Institutional Ethics Committee and all participants signed a consent form. Results: Of the 736 students enrolled, 607 (82.5%) answered the questionnaire. The mean age of the included students was 22.9 ± 2.9 years, 57.4% male, 99.0% were single and 14.5% were living alone. The distribution according to the socioeconomic class was: A1 (7.2%), A2 (21.1%), B1 (21.6%), B2 (25.4%), C1 (17.0%), C2 (4 , 8%) and D (1.2%). Cronbach's coefficient was 0.956. The coefficient of Kaiser-Meyer-Olkin was 0.916 and Bartlett's test of sphericity was significant (p <0.001). Factor analysis identified 23 items that explained 69.3% of the variance of the responses. The students presented together an overall score of 72.1 ± 7.7 points. The global score was similar among students of the 1st to 5th year and between students of 3rd and 6th years. However, students of the 6th year (69.2 ± 8.5) had lower overall scores than the 1st (72.9 ± 7.3), 2nd (72.5 ± 7.6), 4th (72.4 ± 7.2) and 5th (73.8 ± 7.8) years. The perception of quality of life was greater in 1st-2nd years students compare to 3rd-4th year and 5th-6th years; the 1st, 2nd and 4th years comparede to the 3rd year; the 3rd year compered to the 6th year; and 1st against the 6th year. Students from 6th year had lower scores than the 1st year in all areas except in spirituality. Males had higher overall score, in the physical, psychological, independence and quality of life, compared with females. Those who were living alone, compared to those who had company, had lower scores in the physical domain. Students of the C/D socioeconomic status had a lower overall and environment domain score in compared to those of class A and B (p <0.001). Factors associated with lower overall scores were: 6th year (OR: -3.5, p <0.001), female sex (OR: -2.1, p = 0.001) and class C / D (OR: -1.8 , p = 0.017). Conclusions: WHOQUOL-100 showed adequate reliability and validity for assessing the quality of life of medical students. The overall score for quality of life was 72 points, with higher scores among students of 1st, 2nd, 4th and 5th years and lower in students of 3th and 6th years. Being in the 6th year, being female and belong to class C / D were associated with lower overall score for quality of life.
Descrição
Citação
CUNHA, Deyse Helena Fernandes da. Qualidade de vida dos alunos do curso de medicina da Escola Paulista de Medicina - Universidade Federal de São Paulo. 2015. 128 f. Tese (Doutorado em Pediatria e Ciências Aplicadas à Pediatria) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.