Quality of life of postgraduate students stricto sensu in dentistry and sociodemographic factors

Qualidade de vida dos alunos de pós-graduação stricto sensu em odontologia e fatores sociodemográficos

Abstract

Introduction

Quality of life (QL) is subjective and must be based on a multidimensional construct and on positive and negative factors in the individual’s life.

Objective

The objective of this study was to evaluate the QL of the students of the Postgraduate Program in Dentistry (PPGO) of the Federal University of Ceará.

Material and method

Cross-sectional study with a quantitative approach, conducted with 88 students regularly enrolled in PPGO. The QL was measured by the World Health Organization Questionnaire for Quality of Life-bref (WHOQOL-bref). For a better analysis of the QL scores, they were categorized into three levels: dissatisfaction, uncertainty and satisfaction. A multinomial logistic regression model was used.

Result

The majority of the respondents (55.7%) was classified in the area of satisfaction with QL, with 14,05 total average scores, corresponding to 62.8% of the total. By associating the socio-demographic data with the categories of analysis of QL, it was observed relevant in single students (p=0.005), those who considered themselves religious (p=0.041) and those who did not have a postgraduate scholarship (p=0.025), being evaluated in the area of dissatisfaction/uncertainty about the QL.

Conclusion

It was concluded that marital status, religion and scholarship in postgraduate school were relevant in the QL of stricto sensu postgraduate students in Dentistry.

Descriptors:
Quality of life; students, dental; education

Resumo

Introdução

A qualidade de vida (QV) é subjetiva e deve ser baseada num constructo multidimensional e em fatores positivos e negativos da vida do indivíduo.

Objetivo

O objetivo desse estudo foi avaliar a QV dos estudantes do Programa de Pós-graduação em Odontologia (PPGO) da Universidade Federal do Ceará.

Material e método

Estudo transversal, com abordagem quantitativa, realizado com 88 discentes regulamente matriculados no PPGO. A QV foi mensurada pelo World Health Organization Questionnaire for Quality of Life-bref (WHOQOL-bref). Para uma melhor análise dos escores de QV, eles foram categorizados em três níveis: insatisfação, indefinição e satisfação. Modelo de regressão logística multinomial foi utilizado.

Resultado

A maioria dos entrevistados (55,7%) foi classificada na região de satisfação quanto a QV, sendo 14,05 a média total dos escores, correspondendo a 62,8% do total. Ao associar os dados sociodemográficos com as categorias de análise da QV, observou-se relevância nos estudantes solteiros (p=0,005), os que se consideraram religiosos (p=0,041) e aqueles que não possuíam bolsa na pós-graduação (p=0,025), sendo avaliados na região de insatisfação/indefinição quanto à QV.

Conclusão

Concluiu-se que o estado civil, religiosidade e bolsa na pós-graduação foram relevantes na QV dos alunos da pós-graduação stricto sensu em Odontologia.

Descritores:
Qualidade de vida; estudantes de odontologia; educação

INTRODUCTION

Considering the history of Dentistry in the state of Ceará, on March 12, 1916, the Free Faculty of Pharmacy and Dentistry of the Federal University of Ceará was founded. This was regulated by Law nº 1391, on October 2, 1916, with the denomination “Faculty of Pharmacy and Dentistry and Births of Ceará”, being 2016 the centennial of its foundation and regulation¹.

However, only in 2005, the Postgraduate Program in Dentistry (PPGO) was founded, inserted in the Faculty of Pharmacy, Dentistry and Nursing (FFOE) of the Federal University of Ceará, having completed, in 2015, its ten years of existence. The PPGO offers to the community stricto sensu academic courses of master, doctoral and post-doctoral, inserted in the line of research “Dental Clinic”², contributing to the formation and qualification of professionals for the labor market and for the teaching in the state of Ceará.

According to the Coordination for the Improvement of Higher Education Personnel (CAPES)³, stricto sensu courses in the academic modality prepare a researcher, and the student, after the master’s degree, should continue his or her career with the doctorate. These courses include students in various activities, such as participation in research groups, assistance with graduation activities and publication of articles, for example. The accumulation of these activities, allied to personal and professional life, can affect the quality of life (QL) of these students.

The reference for this study was the definition of the World Health Organization (WHO) that the QL is “[...] the individual’s perception of their position in life, in the context of the culture and system of values in which they live and in relation to their goals, expectations, standards and concerns [...]”⁴ p. 1405. It was used the World Health Organization Questionnaire for Quality of Life-bref (WHOQOL-bref), a cross-cultural instrument, already translated and validated in our midst⁵.

The accomplishment of this work was justified by the importance of evaluating the QL of the students that make up the Graduate Program in Dentistry, given the need for hours of dedication required by the stricto sensu courses; for the possibility of verifying the influence of sociodemographic factors on the QL of these students and the lack of publications in the literature relating the quality of life (QL) with the students of the post-graduation stricto sensu in Dentistry.

The objective of this study was to evaluate the QL of the students of the Post-Graduation Program stricto sensu in Dentistry of the Federal University of Ceará using the WHOQOL-bref and to verify the association of sociodemographic factors with the obtained scores.

MATERIAL AND METHOD

88 students enrolled in the master’s, doctorate and post-doctoral programs of the Postgraduate Program in Dentistry of the Federal University of Ceará, composed of 100% of the researched universe participated in this study. The data collection took place in the classrooms, laboratories and clinics of the program, between June and August 2015.

The research paper consisted of two parts: the first one was composed of socio-demographic information, such as gender, marital status, children, work, monthly income, three questions about religiosity, if he/she was a scholarship holder of the said program, course and year in which he/she was in post-graduation; the second was formed by the WHOQOL-bref questionnaire.

The WHOQOL-bref is an abbreviated version of the WHOQOL-100, consisting of 26 questions. The first two are general, for self-evaluation of QL, and the other two represent each of the facets of the original instrument, being distributed in four domains: Physical, Psychological, Social Relations and Environment. All questions have five Likert type response options. The respondent should consider the previous fifteen days for self-filling of the instrument⁵. This instrument demonstrated good internal consistency, discriminant validity, concurrent validity, content validity and test-retest reliability⁵ and has already been used in different samples of undergraduate students in Brazil^6,7 and abroad^8,9.

Three researchers applied the research paper, being discarded the training of these because the WHOQOL-bref is considered an instrument of easy understanding, allied to the high intellectual level of the researched ones. Reading and signing of the Free and Informed Consent Form were done by all the participants.

The study was approved by the Ethics and Research Committee of the Federal University of Ceará, under the Certificate of Presentation for Ethical Assessment (CAAE) 45227015.7.0000.5054 and Opinion nº 1.113.226, in June 2015.

Data analysis included the tabulation of these in Microsoft Excel and export to the Statistical Package for the Social Sciences (SPSS) software, in which the analyzes were performed considering a 95% confidence level and significance at p<0,05. The obtained scores were transformed into a linear scale that ranged from 0-100, being these, respectively, the less and more favorable values of QL, according to the syntax proposed by the WHOQOL group¹⁰. For the analysis of the QL scores, an adapted scale was used⁶, being categorized as follows: values between 0 and 40 were considered a region of dissatisfaction; from 41 to 69, corresponded to the region of uncertainty; and above 70, as the region of satisfaction.

The values of the quality of life scores were submitted to the Kolmogorov-Smirnov test and analyzed using the ANOVA test, for repeated measures, followed by the Bonferronni post-test (parametric data) to evaluate the difference between the measured domains. The categorical data were expressed in absolute and percentage frequency and analyzed using the chi-square test, and the multinomial logistic regression model was also used. For the statistical analysis, the variables were grouped into dissatisfaction/uncertainty and satisfaction.

RESULT

More than half (55.7%) of the students of the Postgraduate Program in Dentistry of the Federal University of Ceará were classified in the region of satisfaction regarding QL. The majority were female (61.4%), half were married and 73.9% had no children. Thirty students (34.1%) reported dedicating themselves exclusively to postgraduate activities. The majority (59.1%) claimed to have a monthly income of more than four minimum wages. Religious practice was affirmed by 89.8%, however 36.4% reported that the frequency of this practice always occurred and 75.0% considered themselves religious. 68.2% had a postgraduate scholarship. 53.4% were in the doctorate or post-doctorate and 46.6% of the students were in the second year of the postgraduate course (Table 1).

Table 1
Profile of quality of life and socio-demographic of the students of the PPGO/UFC. Fortaleza-CE, 2015

	n	%
Quality of life
Dissatisfaction	1	1.1
Uncertainty	38	43.2
Satisfaction	49	55.7
Gender
Male	34	38.6
Female	54	61.4
Marital Status
Single	43	48.9
Married	44	50.0
Divorced	1	1.1
Children
Yes	23	26.1
No	65	73.9
Work-Exclusive dedication	30	34.1
Work- Dentist surgeon	47	53.4
Monthly Income
Up to 2 MW	15	17.0
2 to 4 MW	21	23.9
> 4 MW	52	59.1
Practice of religion	79	89.8
Frequency of religious practice
Never	7	8.0
Rarely	10	11.4
Sometimes	39	44.3
Always	32	36.4
Are considered religious	66	75.0
Scholarship holder	60	68.2
Course in the Postgraduation
Master	41	46.6
Doctorate/Post-doctorate	47	53.4
Year in the Post
First	29	33.0
Second	41	46.6
Third	12	13.6
Fourth	6	6.8

• Data expressed as absolute and percentage frequency.

The Social Relations domain presented the highest average (15.23 ± 2.72). The Physical domain had a lower average (12.82 ± 1.56), when compared to the other domains and to the questions of self-evaluation of QL, in which they were called Domain 5, presenting a statistically significant relation (p<0.001). The Domain 5, when compared to the Physical (95% CI = 1.7-2.9), Psychological (95% CI = 0.4-1.5) and Environment (95% CI = 0.2-1.3), presented statistical relevance (p<0.001) (Table 2).

Table 2
Individual and general average of the 5 WHOQOL-bref domains. Fortaleza-CE, 2015

	Average	SD	Medium	Minimum	Maximum	p-Value
Physical Domain*	12.82	1.56	13.14	8.57	16.57	<0.001
Psychological Domain	14.12	1.48	14.00	11.33	18.00
Social Relationships Domain	15.23	2.72	15.33	8.00	20.00
Environment Domain	14.35	1.64	14.50	10.50	18.00
Domain Five†	15.11	2.92	16.00	4.00	20.00
General Domain	14.05	1.37	13.92	11.23	17.8
Sum Domain	71.64	7.69	71.45	53.93	90.07

• ^*
  p<0,05 versus all groups;
• ^†
  p<0,05 versus all groups except group 3. ANOVA test/Bonferronni (Average ± SD).

The association between the sociodemographic profile and the analysis of the QL of the students was expressed in Table 3. There was statistical significance when single individuals were associated (p=0.005) (95% CI = 2.0-62.5), the ones who considered themselves religious (p=0.041) (95% CI = 1.1-142.8) and those who did not have scholarship in the PPGO (p=0.025) (95% CI = 1.2-26.9) and QL categories, being classified in the region of dissatisfaction/indefinition.

Table 3
Influence of the sociodemographic profile in the analysis of the quality of life of the students of the Post-graduation in Dentistry/UFC. Fortaleza-CE, 2015

	Category of QL analysis		p-Value a	p-Value b	95% CI
	Dissatisfaction/ Uncertainty	Satisfaction
Gender
Male	13(33.3%)	21(42.9%)	0.362	-
Female	26(66.7%)	28(57.1%)
Marital Status
Single	25*†(64.1%)	18(36.7%)	0.011	0.005	2.0;62.5
Married/Divorced	14(35.9%)	31(63.3%)
Children
Yes	9(23.1%)	14(28.6%)	0.560	-
No	30(76.9%)	35(71.4%)
Work-Exclusive dedication
No	25(64.1%)	33(67.3%)	0.750	-
Yes	14(35.9%)	16(32.7%)
Work-Dentist Surgeon
No	20(51.3%)	21(42.9%)	0.431	-
Yes	19(48.7%)	28(57.1%)
Monthly Income
Up to 2 MW	10(25.6%)	5(10.2%)	0.158	-
2 to 4 MW	8(20.5%)	13(26.5%)
> 4 MW	21(53.9%)	31(63.3%)
Practice of religion
Yes	36(92.3%)	43(87.8%)	0.484	-
No	3(7.7%)	6(12.2%)
Frequency of religious practice
Never	2(5.1%)	5(10.2%)	0.587	-
Rarely	6(15.4%)	4(8.1%)
Sometimes	18(46.2%)	21(42.9%)
Always	13(33.3%)	19(38.8%)
Are considered religious
Yes	32†(82.1%)	34(69.4%)	0.173	0.041	1.1;142.8
No	7(17.9%)	15(30.6%)
Scholarship holder in the PPGO
Yes	23(59%)	37(75.5%)	0.098	0.025	1.2;26.9
No	16†(41%)	12(24.5%)
Course in the Post
Master	18(46.2%)	23(46.9%)	0.942	-
Doctorate/Post-doctorate	21(53.8%)	26(53.1%)
Year in the Post
First	15(38.4%)	14(28.5%)	0.283	-
Second	17(43.6%)	24(49%)
Third	3(7.7%)	9(18.4%)
Fourth	4(10.3%)	2(4.1%)

• ^a
  Chi-square test (*p<0,05);
• ^b
  Multinomial logistic regression;
• (†p<0,05). Blank boxes indicate non-significance. CI – Confidence Interval.

DISCUSSION

The quality of life evaluation through the WHOQOL-bref has already been measured in undergraduate students in the health area, such as Dentistry⁶, Nursing^11,12 and Medicine^13-15. However, studies in which this instrument has been applied in stricto sensu postgraduate students were not found in the national and international literature, making this work significant and original, being limited, however, the comparison of the results.

Another aspect that makes this study relevant is the representation of 100% of the researched universe of students in all postgraduate years and the use of a cross-cultural instrument validated in our environment for the measurement of QL in its subjective and cross-cultural aspects.

The students of the Postgraduate Program in Dentistry of the Federal University of Ceará were classified in the region of satisfaction regarding QL, approaching a study carried out with undergraduate students in Dentistry in Ceará⁶, corroborating with that found in a study carried out with an adult population of the Federal District¹⁶.

The results of a study of 3121 master’s and doctoral students in the United States indicated that 44.7% of the students felt stressed at some point, in relation to the year prior to the survey. In addition, 46.3% of the postgraduate students said they felt burdened and 39.6% said they felt exhausted “often” or “all the time”. The consequences reported by students, such as perceptions of stress, burden and exhaustion, were caused by the pressure to research and teach, the need to publish and concern with financial conditions, as well as having to deal with the frequent ambiguity of the expectations of the advisor¹⁷.

The average of the scores of the four domains in this study was lower for the Physical, like the one found in a study carried out to synthesize the contributions of the WHOQOL-bref to instrumentalize health promotion actions in the Family Health Strategy¹⁸. Different scores were found in a study that examined the performance of the WHOQOL-bref as an integrated instrument, with the highest score being found in Brazil in the Physical domain and the lowest in the Environment¹⁹.

The result of the association between marital status and QL was similar to that found in the study where single men had a lower QL score when compared to married men²⁰. This may be justified because marriage may be a condition of financial and emotional stability, which allows the married graduate student greater peace of mind in pursuing postgraduate activities.

Research has shown that the religious, spiritual and personal belief dimensions are more related to QL in people with compromised health situations^21,22, a factor not measured in our study, although the item considered to be religious presents statistical relevance when compared to QL. The result found in this study can be explained by the fact that religious belief is a subjective item, in which it is often referred to it in a disease situation²².

The study found that scholarships seem to encourage undergraduate students in the pursuit of stricto sensu postgraduate programs²³ and that students who received scholarships for scientific initiation presented a prevalence twice as high in the pursuit of academic postgraduate studies²⁴. Autonomous professionals, such as dental surgeons, and with partial dedication in educational institutions represent an expressive category in some university courses. The university career, for many dentists, is more a source of status than of income. In these cases, the income sacrificed to the achievement of a master’s or doctorate degree is significant, discouraging investment by the teacher, compromising the qualification plans of educational institutions²⁵. This factor may justify the relationship found in this study between the postgraduate scholarship and the QL.

Despite being a pioneering research, some limitations guided this study, since it was performed in a localized population, not establishing temporal precedence over the evaluated conclusions.

Future investigations involving other aspects relating to stricto sensu postgraduate students and quality of life, such as longitudinal study, so that investigations in different postgraduate periods, such as the beginning and the end of the course can be compared, are necessary, being important this constant investigation to know better these future teachers, researchers and scientists that are being formed.

CONCLUSION

The results obtained in this study suggest that aspects such as marital status, religiosity and the postgraduate scholarship were relevant in the QL of students of the stricto sensu postgraduate course in Dentistry.

ACKNOWLEDGEMENTS

The authors are grateful to the Pro-teaching in Health of CAPES for granting a master’s degree scholarship to the authors CNGT and MMAF.

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Publication Dates

• Publication in this collection
  19 Oct 2017
• Date of issue
  2017

History

• Received
  04 Feb 2017
• Accepted
  17 Aug 2017