Predictors of quality of life in Brazilian medical students: a systematic review and meta-analysis

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.

Figure 1. Flow diagram of study selection. QoL = quality of life; SF-36 = 36-item Short Form Health Survey.

Figure 2. Forest plot of between-group analyses – WHOQOL-Bref domains. 95%CI = 95% confidence interval; WHOQOL-100 = World Health Organization Quality of Life instrument; WHOQOL-Bref = World Health Organization Quality of Life instrument-Abbreviated version.