ABSTRACT
Abstract Objectives To compare health-related quality of life (QoL) of medical students in initial and final phases of the program, and to evaluate the association between ego defense mechanisms and specific health-related QoL domains within each group. Methods This was an observational, cross-sectional study. Quality of life was assessed according to the World Health Organization Quality of Life instrument - Abbreviated Version (WHOQOL-Bref); anxiety and depression symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS); defense mechanisms were assessed using the Defense Style Questionnaire (DSQ-40) Results A total of 139 medical students were evaluated. Students in the initial semesters of the program (1st and 3rd) presented more depressive symptoms and worse quality of life in the psychological domain of WHOQOL-Bref when compared to those in the final semesters (8th and 12th). In a later analysis, conducted to identify the variables associated with the psychological domain of the WHOQOL-Bref for each group, both depressive symptoms and defense mechanisms were independently associated with the outcome for medical students in the beginning and in the end of the graduation program. Conclusions Students in the initial phases of medical school may need more specific attention from educational managers. Understanding the role of ego defense mechanisms in the quality of life of medical students may help identify effective psychopedagogical interventions for this population. In addition, the results reinforce the impact of depressive symptoms on quality of life, an association already well evidenced in the literature.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Quality of Life/psychology , Students, Medical/psychology , Defense Mechanisms , Depression/psychology , Time Factors , Cross-Sectional StudiesABSTRACT
Introduction: Health-related quality of life (HRQOL) assessment tools have been broadly used in the medical context. These tools are used to measure the subjective impact of the disease on patients. The objective of this study was to evaluate the variables associated with HRQOL in a Brazilian sample of patients followed up in a tertiary outpatient clinic for depression and anxiety disorders. Method: Cross-sectional study. Independent variables were those included in a sociodemographic questionnaire and the Hospital Anxiety and Depression Scale (HADS) scores. Dependent variables were those included in the short version of the World Health Organization Quality of Life (WHOQOL-BREF) and the scores for its subdomains (overall quality of life and general health, physical health, psychological health, social relationships, and environment). A multiple linear regression analysis was used to find the variables independently associated with each outcome. Results: Seventy-five adult patients were evaluated. After multiple linear regression analysis, the HADS scores were associated with all outcomes, except social relationships (p = 0.08). Female gender was associated with poor total scores, as well as psychological health and environment. Unemployment was associated with poor physical health. Conclusion: Identifying the factors associated with HRQOL and recognizing that depression and anxiety are major factors are essential to improve the care of patients.
Introdução: Instrumentos para avaliar qualidade de vida relacionada à saúde têm sido amplamente utilizados no contexto médico, visando mensurar o impacto da doença de uma perspectiva subjetiva e relevante ao paciente. O objetivo desse estudo foi identificar variáveis associadas à qualidade de vida em uma amostra de pacientes acompanhados em um ambulatório terciário para transtornos de ansiedade e depressão. Métodos: Estudo transversal. As variáveis independentes incluíram dados de um questionário sociodemográfico e pontuação na Escala Hospitalar de Ansiedade e Depressão (HADS). Variáveis dependentes: pontuação total na escala breve de qualidade de vida da Organização Mundial de Saúde (WHOQOL-Bref) e cada um de seus subdomínios (geral, físico, psicológico, social e ambiental). Regressão linear múltipla foi aplicada para identificar as variáveis preditoras associadas de forma independente a cada uma das variáveis dependentes. Resultados: Setenta e cinco pacientes adultos foram avaliados. Após análise de regressão linear múltipla, pontuação na HADS esteve associada com todos os desfechos analisados, exceto para o subdomínio social (p = 0,08). Sexo feminino esteve negativamente associado com a pontuação total da WHOQOL-Bref e com os subdomínios psicológico e ambiental. Desemprego esteve associado com o subdomínio físico. Conclusão: A identificação de fatores associados à qualidade de vida relacionada à saúde e o reconhecimento de que a depressão e a ansiedade são variáveis fundamentais são essenciais para uma melhor assistência aos pacientes.