CC BY
32
РАЗДЕЛ 3 МОДЕЛИ, СИСТЕМЫ, СЕТИ В ПРИРОДЕ И ОБЩЕСТВЕ
УДК 614.1
STUDENTS HEALTH, HEALTH BEHAVOUR AND QUALITY OF LIFE
N. S. Juraeva
ЗДОРОВЬЕ, ЗДОРОВЬЕСБЕРЕГАЮЩЕЕ ПОВЕДЕНИЕ И КАЧЕСТВО ЖИЗНИ СТУДЕНТОВ
Н. С. Джураева
Abstract. The results of the literature review of publications devoted to the health of healthy behavior and quality of life of students. It was noted that the relationship of these determinants with each other and with the different social, economic and cultural factors.
Key words: students, healthy behavior, quality of life, value system.
Аннотация. Показаны результаты обзора литературы, посвященной здоровью студентов, их здоровьесберегающему поведению и качеству жизни. Отмечена взаимосвязь этих детерминант друг с другом и с различными социальными, экономическими и культурными факторами.
Ключевые слова: студенты, здоровьесберегающее поведение, качество жизни, система ценностей.
QoL is a multi-level and amorphous concept which reflects both macro societal and socio-demographic influences and also micro concerns, such as individuals' experiences, circumstances, health, social well-being, values, perceptions, and psychology. It is thereby a collection of interacting objective and subjective dimensions [1]. It is dependent on the perceptions of individuals, and is likely to be mediated by cognitive factors. However, models of QoL are not consistent. Some incorporate a needs-based satisfaction model, based on Maslow's (1954) hierarchy of human needs for maintenance and existence (physiological, safety and security, social and belonging, ego, status and self-esteem, and self-actualization). Scales used to measure the QoL of people with mental health problems, for example, are based on a satisfaction of human needs model, coupled with assessments of global well-being [2]. In contrast, traditional social science models of QoL have been based primarily on the overlapping concepts of "the good life," "life satisfaction," "social well-being," "morale," "the social temperature," or "happiness" [3-5].
The World Health Organization Quality of Life assessment Group, at the World Health Organization, has included in their definition of QoL the individual's
perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectation, standards and concerns (1993).
Students - it is young generation - country future and the guarantee of its development. Orientation of the students to the healthy behaviour, psychological and social satisfaction may aid to forecast the health of population in the future. Young adults may evaluate qualitative aspects of their live differently than older adults due to variation in developmental task, social and role setting, age-related expectations, and health status [6, 7].
There are a lot of published articles which are dedicated to evaluation of quality of life (QoL), health and the health behavior of young people and students [8-24].
The major determinants of health are socioeconomics determinants, lifestyle and physical environment [10]. Life style related risk factors, acknowledged in the report, are unhealthy nutrition, physical inactivity, tobacco use and use of alcohol and illicit drugs [10].
As Chen et al [6] noted lower socioeconomic status was associated with poor child health in US. Interaction effects revealed that for injury and acute respiratory illness had a reverse socioeconomic status gradient (low socioeconomic status with poor outcome) were evident during adolescence.
We have found interesting relation between health risk behavior and socioeconomic factors among university student by gender in Turkey. Health risk behaviors in university students were in general related to low socioeconomic status, except for alcohol use, which was related to high socioeconomic status. Among female students whose mothers had completed high school, 81,9 % used alcohol, compared with less than 68 % of female students whose mothers had not completed high school or had completed university. Also, 4,0 % of female students whose mothers had completed high school had attempted suicide, compared with less than 1,5 % of female students whose mothers had not completed high school or had completed university. In male students, important variables were parental education level and paternal employment status. Among male students who had unemployed fathers, 66,7 % used cigarettes, 26,7 % engaged in substance use, and 4,4 % attempted suicide in comparison with 11,9 and 0,7 %, respectively, of male students whose fathers were employed. Logistic regression showed male gender to be associated with an increase in all risk behaviors [11].
Gender differences have received much attention from researchers. The gender differences in health according to Denton et al are attributable to differing structural (socioeconomic, age, social support, family arrangement) context and to different exposure to lifestyle (smoking, drinking, exercise and diet) and psychological (critical level events, stress, psychological recourses) factors [12].Denton et al showed that women's health was more influenced by structural and psychological determinants, while men's health was more affected by health behaviour such as smoking, drinking and physical activity [12]. The mean smoking rate among Sweden university students was 22 % (20 % for female students, 24 % for male students) [13, 15].
29,5 % of the first year male and 18,8 % of females students of Kaunas universities (p < 0,001) smoked daily, and one-fifth (24,2 % males and 24,5 % females) of students smoked occasionally. Almost every fifth male student (18,7 %) and every
tenth (8,5 %) female students tried drugs at least once in life (p < 0,001) [16]. Every third female and every fifth male declared themselves of non drinkers of any alcohol [15].
Logistic regression analysis have shown high sense of coherence, low stress, high health awareness of Kaunas universities students were associated with low prevalence of smoking and alcohol consumption and higher physical activity. Smoking was related with alcohol and drugs use. Physically passive students more often consumed wine and beer compared with physically active ones [9]. Results of the surveys have suggested that many students at Lithuania universities engage in health-risk behavior, which contribute to morbidity and mortality among adults [8, 9, 16].
Psychological well-being pertains to affective states such as feeling happy, optimistic, satisfied, and interested in life, in contrast to feeling negative, anxious, or depressed, is an important indicator of QoL. As rule female students have more healthy habits related to alcohol consumption, nutrition, smoking, than male students [8, 17, 18], but symptoms related to psychological problems were more frequent in female than male students [10, 17-19]. The study of Adamiak G [20] revealed that 28,8 % of the 2nd year students and 14 % of the 4th year medical students were diagnosed with depressive symptoms. A negative correlation between the depressive symptom intensity and a feeling of satisfaction with life was shown [20]. Although there was a definite by Parkerson et al [21] trend of worsening along all parameters of health and satisfaction during the year for both women and men, the most marked change was the increase in depressive symptoms. Dyrbye L N et al [19] literature review identified 40 articles on medical students psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) in US and Canada. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. 50,6 % of the students in Kaunas universities have a tendency a suicide [8]. No statistical significant difference was observed between males and females (4,7 % and 5,7 %; p > 0,05). Results showed positive view to suicide: with the statement about freedom to choose suicide agreed 51,4 % students. One third of students (32,1 %) worried about suicide of their relatives and friends [8].
Life satisfaction it is important issue in daily living. The students who were very satisfied with life had fewer symptoms of depression and anxiety; higher self-esteem, better physical, mental, and social health; stronger social relations; more physical activity; more sleep; and fewer stressful life events. A strong social relation was the factor most positively related to better health and life satisfaction [21]. McCabe MP et al demonstrated the importance of relationships and sexual experience to satisfaction with life [22].
Most Sweden students rated their psychological and physical health as "good" or "very good", and restrictions on life activities - when experienced -were found to be considerably more common for physical than for psychological problems. Country of birth of student was the strongest predictor of self-rated physical health, and the second strongest predictor of psychological and overall health (following sex of student) [19]. A majority of the respondents rated their physical and psychological health as very good or good, but male students' ratings were higher than those of female students, whereas the males' average scores on self-perceived QOL were lower than those of females. Both male and female stu-
dents' self-perceived QOL was more strongly associated with self-rated psychological than with physical health [17]. Also Lithuanian students who assessed their QoL as "very good" or "good" scored their QoL significantly higher than those who answered "poor" for all domains at the 5 % significance level [8, 14].
More than 50 % last year medical students and interns in University Hospital in Caracas read about QoL in newspaper, journals and fiction literature. Only 68 % had heard in sort of academicals institution the term "quality of life" such as the school of medicine, high school or in some discussion groups. Although everybody considered that the quality of life was an important element in medical actions such as diagnostic or therapeutics, its importance was reduced for diagnosis compared to treatment. All the elements that were considered as part of the concept were also considered as important, regardless of the group and were statistically significant. Among the elements included in the definition was the social in 27,65 %, psychological in 23,53 % and, the economical in 12,35 % of the questionnaires [23].
According Haase A et al physical inactivity has been linked with chronic disease and obesity on most western population in Europe [24]. Insufficiently active students scored lower on psychological well-being and were twice as likely to have consulted a physician regarding an illness compared with sufficiently active students [25].The study conducted among medical students in Tajikistan shown that the quality of life of students depends on health behavior factors such as physical activity and the regularity of nourishment. Students, who are physically inactive and eat not regularly their quality of life score is lower than those who are physically active and eat regularly. Quality of life among working students was less than among not working ones in psychological, social relations and environmental domain (p < 0.05).
Thus, according to the WHO «Health for All in the 21st Century» program, quality of life for the population depend on various factors and can be improved if the monitoring of health potential and QoL is started; active participation of individuals in community activities and formulation of health policy in particular are encouraged; access to health prerequisites, especially education, is improved; healthy lifestyles are accepted as a social norm; greater emphasis is imposed on the QoL at primary, secondary and tertiary levels of health care system [26].
List of reference links
1. Lawton, M. P. A multidimensional view of quality of life in frail elders / M. P. Law-ton // The concept and measurement of quality of life / J. E. Birren, J. Lubben, J. Rowe, D. Deutchman (eds). - New York : New Academic Press, 1991.
2. Bowling, A. Measuring disease. A review of disease specific quality of life measurement scales / A. Bowling. - Buckingham : Open University Press, 2001.
3. Andrews, F. M. Research on the quality of life / F. M. Andrews. - Michigan : University if Michigan. Institute for Social Research, 1986.
4. Andrews, F. M. Social indicators of well-being: American's perception of life quality / F. M. Andrews, S. B. Withley. - New York : Plenum Press, 1976.
5. Let's ask them: a national survey of definitions of quality of life and its enhancement among people aged 65 and over / A. Bowling, Z. Gabriel, J. Dykes, L. M. Dowding, O. Evans, A. Fleissig et al. // Aging and human development. - 2003. - Vol. 56 (4). -P. 269-306.
6. Costruction and validation of a quality of life instrument for young adults / H. Chen, P. Cohen, S. Kasen, K. Gordan, R. Dufur, E. Smiles // Qual Life Res. - 2004. -№ 13. - P. 747-759.
7. Ducinskiene, D. Quality of life among Lithuanian university students and factors influencing it. Summary of the Doctoral Diss / D. Ducinskiene // Biomedical sciences, Public health. - Kaunas, 2004. - 29 p.
8. Petrauskas, D. Assessment of links between perceived health, emotional status, and health behavior among students of Kaunas Universities / D. Petrauskas // Summary of the Doctoral Diss. Biomedical sciences, Public health. - Kaunas 2004. - 35 p.
9. Ducinskiene, D. Quality of life among Lithuanian University Students / D. Ducin-skiene, R. Kalediene, J. Petrauskiene // Acta Medica Lithuanica. - 2003. - T. 10, № 2. - P. 76-81.
10. Trends in smoking, diet, physical exercise, and attitudes toward health in European university students from 13 countries, 1990-2000 / A. Steptoe, J. Wardle, W. Cui, F. Bellisle, A. M. Zotti, R. Baranyai, R. Sanderman // Prev Med. - 2002. - Aug. -V. 35 (2). - Р. 97-104.
11. Oksuz, E. Socioeconomic factors and health risk behaviours among university students in Turkey / E. Oksuz, S. Malhan // Croat Med J. - 2005. - Feb. - V. 46 (1). -Р. 66-73.
12. Denton, M. Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health / M. Denton, S. Prus, V. Walters // Soc. Sci. Med. - 2004. - V. 58. - Р. 2585-2600.
13. Vaez, M. Health - related determinants of perceived quality of life: a comparison between first year university students and their working peers / M. Vaez, A. Ponce de Leon, L. Laflamme // Work. - 2006. - V. 26 (2). - Р. 167-177.
14. Ducinskiene, D. Quality of life among students: view from qualitative perspective / D. Ducinskiene // Abst issue 2nd conf on PH research in the Baltic count. - Kaunas, 2000. - Р. 21.
15. Vaez, M. Health behaviors, self-rated health, and quality of life: a study among first-year Swedish university students / M. Vaez, L. Laflamme // J Am Coll Health. -2003. - Jan. - V. 51 (4). - Р. 156-162.
16. Janusauskas, A. Smoking and alcohol consumption habits among the students of Kaunas Police Faculty of Lithuanian Academy of Low / A. Janusauskas, A. Butavicius // Abst issue 2nd conf on PH research in the Baltic count. - Kaunas, 2000. - Р. 24.
17. Von Bothmer, M. I. Gender differences in health habits and in motivation for healthy lifestyle among Swedish university students / M. I. von Bothmer, B. Fridlund // Nurs Health Sci. - 2005. - Jun. - V. 7 (2). - Р. 107-118.
18. Dyrbye, L. N. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students / L. N. Dyrbye, M. R. Thomas, T. D. Shanafelt // Acad Med. - 2006. - Apr. - V. 81 (4). - Р. 354-373.
19. Vaez, M. First-year university students' health status and socio-demographic determinants of self-rated health / M. Vaez, L. Laflamme // Work. - 2002. - V. 19 (1). -Р. 71-80.
20. Assessment of quality of life of medical students relative to the number and intensity of depressive symptoms / G. Adamiak, E. Swiatnicka, L. Wolodzko-Makarska, M. J. Switalska // Psychiatr Pol. - 2004. - Jul-Aug. - V. 38 (4). - Р. 631-638. [Pub-Med Summary].
21. Parkerson, G. R. Jr. The health status and life satisfaction of first-year medical students / G. R. Jr. Parkerson, W. E. Broadhead, C. K. Tse // Acad Med. - 1990. - Sep. -V. 65 (9). - Р. 586-588.
22. McCabe, M. P. Sexuality and quality of life among young people / M. P. McCabe, R. A. Cummins // Adolescence. - 1998. - Winter. - V. 33 (132). - Р. 761-773.
23. The «quality of life» concept in medical students and postgraduate residents in a university hospital / N. Gonzalez, J. Padilla, E. Rodriguez, M. Esteva, M. Ruiz, R. Tomarelli et al. // Invest Clin. - 2000. - Dec. - V. 41 (4). - Р. 219-235. [PubMed Summary].
24. Leisure-time physical activity in university students from 23 countries: associations with health beliefs, risk awareness, and national economic development / A. Haase, A. Steptoe, J. F. Sallis, J. Wardle // Prev Med. - 2004. - Jul. - V. 39 (1). -P. 182-190.
25. Bray, S. R. Physical activity is associated with better health and psychological well-being during transition to university life / S. R. Bray, M. Y. Kwan // J Am Coll Health. - 2006. - Sep-Oct. - V. 55 (2). - P. 77-82.
26. Health for All policy and strategy for Europe in the 21st Century. - Copenhagen, WHO regional office for Europe, 1998.
Джураева Наргис Сарабековна
кандидат медицинских наук, кафедра общественного здоровья и медицинской статистики, Таджикский государственный медицинский университет имени Абуали ибни Сино (Авиценны) E-mail: [email protected]
Juraeva Nargis Sarabekovna
candidate of medical science,
sub-department of public health
and medical statistics,
Avicenna Tajik State Medical University
УДК 614.1 Juraeva, N. S.
Students health, health behavour and quality of life / N. S. Juraeva // Модели, системы, сети в экономике, технике, природе и обществе. - 2014. - № 3 (11). - C. 155-160.
