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      Quality of Life of Medical Students in China: A Study Using the WHOQOL-BREF

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          The aim of this study was to assess the quality of life (QOL) of medical students during their medical education and explore the influencing factors of the QOL of students.


          A cross-sectional study was conducted in June 2011. The study population was composed of 1686 medical students in years 1 to 5 at China Medical University. The Chinese version of WHOQOL-BREF instrument was used to assess the QOL of medical students. The reliability and validity of the questionnaire were assessed by Cronbach’s α coefficient and factor analysis respectively. The relationships between QOL and the factors including gender, academic year level, and specialty were examined using t-test or one-way ANOVA followed by Student-Newman–Keuls test. Statistic analysis was performed by SPSS 13.0.


          The overall Cronbach’s α coefficient of the WHOQOL-BREF questionnaire was 0.731. The confirmatory factor analysis provided an acceptable fit to a four-factor model in the medical student sample. The scores of different academic years were significantly different in the psychological health and social relations domains (p<0.05). Third year students had the lowest scores in psychological health and social relations domains. The scores of different specialties had significant differences in psychological health and social relations domains (p<0.05). Students from clinical medicine had the highest scores. Gender, interest in the area of study, confidence in career development, hometown location, and physical exercise were significantly associated with the quality of life of students in some domains (p<0.05).


          The WHOQOL-BREF was reliable and valid in the assessment of the QOL of Chinese medical students. In order to cope with the influencing factors of the QOL, medical schools should carry out curriculum innovation and give the necessary support for medical students, especially for 3 rd year students.

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          Most cited references 30

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          Psychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns

          Objectives Few epidemiological studies have focused on the psychological health of high level athletes. This study aimed to identify the principal psychological problems encountered within French high level athletes, and the variations in their prevalence based on sex and the sport practiced. Methods Multivariate analyses were conducted on nationwide data obtained from the athletes' yearly psychological evaluations. Results A representative sample of 13% of the French athlete population was obtained. 17% of athletes have at least one ongoing or recent disorder, generalized anxiety disorder (GAD) being the most prevalent (6%), followed by non-specific eating disorders (4.2%). Overall, 20.2% of women had at least one psychopathology, against 15.1% in men. This female predominance applied to anxiety and eating disorders, depression, sleep problems and self-harming behaviors. The highest rates of GAD appeared in aesthetic sports (16.7% vs. 6.8% in other sports for men and 38.9% vs. 10.3% for women); the lowest prevalence was found in high risk sports athletes (3.0% vs. 3.5%). Eating disorders are most common among women in racing sports (14% vs. 9%), but for men were found mostly in combat sports (7% vs. 4.8%). Discussion This study highlights important differences in psychopathology between male and female athletes, demonstrating that the many sex-based differences reported in the general population apply to elite athletes. While the prevalence of psychological problems is no higher than in the general population, the variations in psychopathology in different sports suggest that specific constraints could influence the development of some disorders.
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            First year medical student stress and coping in a problem-based learning medical curriculum.

            To examine the prevalence of psychological morbidity, sources of stress and coping mechanisms in first year students in a problem-based learning undergraduate medical curriculum. Longitudinal cohort questionnaire survey. Glasgow University Medical School. All first year students (n = 275) in the 1997-98 intake. Scores on the 12-item General Health Questionnaire (GHQ-12), sources of stress and coping strategies. The prevalence of psychological morbidity and mean GHQ-12 scores increased significantly between term 1 and term 3, with no significant gender differences. Principal stressors were related to medical training rather than to personal problems, in particular uncertainty about individual study behaviour, progress and aptitude, with specific concerns about assessment and the availability of learning materials. The group learning environment, including tutor performance, and interactions with peers and patients caused little stress. Students generally used active coping strategies. Both stressor group scoring and coping strategies showed some variation with gender and GHQ caseness. Increased student feedback and guidance about progress throughout the year and the provision of adequate learning resources may reduce student stress. Educational or pastoral intervention regarding effective coping strategies may also be beneficial. Continued follow-up of this cohort could provide information to inform further curriculum development and, if appropriate, aid the design of programmes for the prevention of stress-related problems.
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              Burnout and serious thoughts of dropping out of medical school: a multi-institutional study.

              Little is known about students who seriously consider dropping out of medical school. The authors assessed the severity of thoughts of dropping out and explored the relationship of such thoughts with burnout and other indicators of distress. The authors surveyed medical students attending five medical schools in 2006 and 2007 (prospective cohort) and included two additional medical schools in 2007 (cross-sectional cohort). The survey included questions about thoughts of dropping out, life events in the previous 12 months, and validated instruments evaluating burnout, depression symptoms, and quality of life (QOL). Data were provided by 858 (65%) students in the prospective cohort and 2,248 (52%) in the cross-sectional cohort. Of 2,222 respondents, 243 (11%) indicated having serious thoughts of dropping out within the last year. Burnout (P < .0001), QOL (P < .003 each domain), and depressive symptoms (P < .0001) at baseline predicted serious thoughts of dropping out during the following year. Each one-point increase in emotional exhaustion and depersonalization score and one-point decrease in personal accomplishment score at baseline was associated with a 7% increase in the odds of serious thoughts of dropping out during the following year. On subsequent confirmatory multivariable analysis, low scores for personal accomplishment, lower mental and physical QOL, and having children were independent predictors of students having serious thoughts of dropping out during the following year. Approximately 11% of students have serious thoughts of dropping out of medical school each year. Burnout seems to be associated with increased likelihood of serious thoughts of dropping out.

                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                27 November 2012
                : 7
                : 11
                [1 ]Research Centre for Medical Education, China Medical University, Shenyang, China
                [2 ]Fourth Affiliated Hospital, China Medical University, Shenyang, China
                [3 ]Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China
                Tehran University of Medical Sciences, Iran (Republic of Islamic)
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: BQ YZ. Performed the experiments: SL YG. Analyzed the data: YZ DW. Contributed reagents/materials/analysis tools: JL. Wrote the paper: YZ.


                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Pages: 9
                This study was supported by the National Natural Science Foundation of China (Grant Number 71103200 and 81273186) and the Foundation of the Educational Department of Liaoning Province of China (Grant Number L2010577). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Research Article
                Non-Clinical Medicine
                Health Care Policy
                Quality of Life
                Academic Medicine
                Health Care Providers
                Medical Careers
                Medical Education
                Public Health
                Health Screening
                Preventive Medicine



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