Psychosocial Factors associated with Health Related Quality of Life among University Students

Abstract

Introduction: Health-related quality of life (HRQoL) is individual‘s subjective perception of his or her health condition that covers physical, psychological and social domains. HRQoL has been increasingly used as an indicator of well-being and outcome measure across various studies including randomized control trials (RCTs). Although a large body of research has explored various factors associated with HRQoL for a range of health conditions, very few investigated that for the university populations. The university groups are critical in relation to health due to their distinct psychosocial and physical characteristics. Exploring modifiable factors associated with HRQoL of this group might open a useful avenue for potential health and wellness interventions. The current research was undertaken to explore HRQoL and its associated psychosocial factors among university students. Method: The study followed a cross-sectional survey design to meet its objectives. Participants were the graduate students of a leading public university of Bangladesh. A total of 588 graduate students from randomly selected five faculties (out of 11) responded to a questionnaire survey. HRQoL was measured using revised Indian (Bengali) adapted Short Form of Health version 2 (SF-12 v 2) questionnaire. Permission was obtained from QualityMetric Inc., the copyright holders of SF-12 v 2 (License agreement # QM030016). Psychological distress and self-esteem were captured using Bangla translated 12-items General Health Questionnaire (GHQ-12) and Rosenberg Self-esteem Scale (RSE), respectively. Information on demographic (e.g., sex, age, relationship status, living status), behavioural (e.g., smoking, physical activity, physical illness), and academic (e.g., faculty, CGPA) factors were recorded in aseparated sheet. Ethical approval was obtained from the concerned university ethics committee. Results: The SF-12 v 2 questionnaire generates eight subscales score and two summary scores. The highest score was found in ‗Physical Functioning‘ subscale out of the eight sub-domains. Females were better in ‗Social Functioning‘ (mean: 67.09 vs. 60.10), ‗Role Emotional‘ (mean: 58.76 vs. 54.08) subscales than males. Males were better in ‗Physical Component Summary (PCS)‘ (mean: 44.71 vs. 43.53) than females. ‗General Health‘ and ‗Mental Health‘ were better for those who had no romantic relationship. ‗Social Functioning‘ was better for those who are in a relationship. Break up in a romantic relationship is associated with poorer scores in all dimensions. Residential students pose higher ‗Mental Component Summary (MCS)‘ than their non-residential counterparts (mean: 44.77 vs. 43.09). As for academic orientation, Arts faculty students reported significantly higher MCS followed by Fine Arts, Sciences, and Business studies. Engaging in physical activity is associated with higher PCS (mean: 45.08 vs. 43.61). Likewise, the absence of physical illness was associated with higher PCS (mean: 44.64 vs. 42.93) and MCS (mean: 44.91 vs. 40.11). The smoking cigarette was also associated with poorer mental health (mean: 41.76 vs. 44.74). Both PCS and MCS were significantly and negatively associated with psychological distress but positively with self-esteem. Multivariate analyses revealed male gender, socio-economic status (SES), non-residential status, psychological distress, and self-esteem as significant predictors of PCS [R2=0.133, F (14, 573) =6.30, p<.0001] with self-esteem (β=0.215, p<.0001) and psychological distress (β=-0.131, p<.01) being the two most crucial predictors. Similarly, non-residential status, theabsence of physical illness, psychological distress and self-esteem all emerging as significant predictors for MCS with psychological distress (β=-0.288, p<.01) and self-esteem (β=0.215, p<.0001) being the two most crucial predictors. Discussion and conclusion: The current study highlighted some key areas that might be critical for the HRQoL of the university students of Bangladesh. Attention should be paid to social-emotional aspects of male students while physical well-being for the female students. Necessary psychological support such individual and/or group counselling for the students going through relationship break-up would be useful to cope with the arisen strain and vulnerability. Specific intervention addressing the mental well-being of non-residential as well as students belonging to sciences, fine arts and business faculties is warranted. Promoting physical activity by creating plenty of games and sports would yield as higher physical and mental health of the students. In addition, extracare should be paid to students suffering from any kind of diseases as it has direct consequences on HRQoL. Furthermore, the campaign against smoking should be strengthened across the campus. Finally, adequate mental health support in the form counselling and psychotherapy, mental health workshops, and seminars, for the students in need could improve students‘ overall health status.