Document Type : Original Article


1 Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences

2 Faculty of Medicine, Tabriz University of Medical Sciences

3 Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran


BACKGROUND: Medical students face a variety of challenges during their years of medical education
that can affect their quality of life (QOL). This study aimed to investigate the association of QOL
with physical activity (PA), depression, and demographic characteristics, as well as to determine its
predictors among medical students in different stages of education.
METHODS: A cross‑sectional descriptive‑correlational study was conducted on 186 medical students
of Tabriz University of Medical Sciences in different educational stages including basic sciences,
physiopathology, externship, and internship using stratified random sampling method. Data were
collected using demographic questionnaire, International PA Questionnaire, World Health Organization
QOL Questionnaire, and Beck depression inventory‑2. Data analysis was performed using SPSS/Ver 23
through descriptive and analytic statistics including one‑way analysis of variance, independent t‑test,
Pearson and Spearman correlation coefficient, and multivariate linear regression model.
RESULTS: There were significant differences in total score of QOL among students in different
stages (P < 0.05). There were indirect significant correlations between total score of QOL (β [confidence
interval 95%]:−0.85 [−1.11–−0.59]) and its all subdomains with Beck depression score but direct
significant correlations with total PA (P < 0.05) except for social relationship. Educational stage,
employment status, family income, inhabitant, moderate PA, and depression were the predictors of
QOL and altogether explained 63% of its variance.
CONCLUSIONS: To pay attention to the predictors of QOL, life among medical students seems
necessary for increasing their QOL to provide high‑quality care for people with disabilities as well
as for the whole community.


1. Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress:
Causes, consequences, and proposed solutions. Mayo Clin Proc
2. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review
of depression, anxiety, and other indicators of psychological
distress among U.S. and Canadian medical students. Acad Med
3. Peleias M, Tempski P, Paro HB, Perotta B, Mayer FB, Enns SC,
et al. Leisure time physical activity and quality of life in medical
students: Results from a multicentre study. BMJ Open Sport Exerc
Med 2017;3:e000213.
4. Jamali A, Tofangchiha S, Jamali R, Nedjat S, Jan D, Narimani A,
et al. Medical students’ health‑related quality of life: Roles of social
and behavioural factors. Med Educ 2013;47:1001‑12.
5. Theofilou P. Quality of life: Definition and measurement. Eur J
Psychol 2013;9:150‑62.
6. Messina G, Quercioli C, Troiano G, Russo C, Barbini E, Nisticò F,
et al. Italian medical students quality of life: Years 2005‑2015. Ann
Ig 2016;28:245‑51.
7. Serinolli MI, Novaretti MC. A cross‑sectional study of
sociodemographic factors and their influence on quality of life in
medical students at Sao Paulo, Brazil. PLoS One 2017;12:e0180009.
8. Zhang Y, Qu B, Lun S, Wang D, Guo Y, Liu J. Quality of life of
medical students in China: A study using the WHOQOL‑BREF.
PLoS One 2012;7:e49714.
9. Kebede MA, Anbessie B, Ayano G. Prevalence and predictors of
depression and anxiety among medical students in Addis Ababa,
Ethiopia. Int J Ment Health Syst 2019;13:30.
10. Moutinho IL, Lucchetti AL, Ezequiel OD, Lucchetti G. Mental
health and quality of life of Brazilian medical students: Incidence,
prevalence, and associated factors within two years of follow‑up.
Psychiatry Res 2019;274:306‑12.
11. WHO. 10 Facts on Physical Activity; 2017. Available from: http:// [Last
accessed on 2019 Sep 12].
12. Stanford FC, Durkin MW, Stallworth JR, Blair SN. Comparison of
physical activity levels in physicians and medical students with
the general adult population of the United States. Phys Sportsmed
13. Stanford FC, Durkin MW, Blair SN, Powell CK, Poston MB,
Stallworth JR. Determining levels of physical activity in attending
physicians, resident and fellow physicians and medical students
in the USA. Br J Sports Med 2012;46:360‑4.
14. Joseph RP, Royse KE, Benitez TJ, Pekmezi DW. Physical activity
and quality of life among university students: Exploring
self‑efficacy, self‑esteem, and affect as potential mediators. Qual
Life Res 2014;23:659‑67.
15. Dyrbye LN, Satele D, Shanafelt TD. Healthy exercise habits are
associated with lower risk of burnout and higher quality of life
among U.S. medical students. Acad Med 2017;92:1006‑11.
16. Tofighi A, Babaei R, Eloon Kashkuli F, Babaei S. The relationship
between the amount of physical activity and general health in
Urmia Medical University students. J Urmia Nurs Midwifery Fac
17. Bashiri Moosavi F, Farmanbar R, Taghdisi M, Atrkar Roshan Z.
Level of physical activity among girl high school students in Tarom county and relevant factors. Iran J Health Educ Health
Promot 2015;3:133‑40.
18. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML,
Ainsworth BE, et al. International physical activity questionnaire:
12‑country reliability and validity. Med Sci Sports Exerc
19. Silva WR, Campos JA, Marôco J. Impact of inherent aspects of
body image, eating behavior and perceived health competence on
quality of life of university students. PLoS One 2018;13:e0199480.
20. Nejat S, Montazeri A, Holakouie Naieni K, Mohammad K,
Majdzadeh S. The World Health Organization quality of
Life (WHOQOL‑BREF) questionnaire: Translation and validation
study of the Iranian version. J Sch Public Health Inst Public Health
Res 2006;4:1‑12.
21. de Sá Junior AR, de Andrade AG, Andrade LH, Gorenstein C,
Wang YP. Response pattern of depressive symptoms among
college students: What lies behind items of the Beck Depression
Inventory‑II? J Affect Disord 2018;234:124‑30.
22. Taheri Tanjani P, Hamidi R, Fekrizadeh Z, Azadbakht M,
Garmaroudi G, Fathizadeh S, et al. Validity and reliability Beck
Depression Inventory‑II among the Iranian elderly Population.
JSUMS 2015;22:189‑98.
23. Kjeldstadli K, Tyssen R, Finset A, Hem E, Gude T, Gronvold NT,
et al. Life satisfaction and resilience in medical school – A six‑year
longitudinal, nationwide and comparative study. BMC Med Educ
24. Paro HB, Morales NM, Silva CH, Rezende CH, Pinto RM,
MoralesRR, et al. Health‑related quality of life of medical students.
Med Educ 2010;44:227‑35.
25. Hovdhaugen E. Working while studying: The impact of term‑time
employment on dropout rates. JEW 2015;28:631‑51.
26. Aboalshamat K, HouXY, Strodl E. Psychological well‑being status
among medical and dental students in Makkah, Saudi Arabia:
A cross‑sectional study. Med Teach 2015;37 Suppl 1:S75‑81.
27. Angkurawaranon C, Jiraporncharoen W, Sachdev A,
Wisetborisut A, Jangiam W, Uaphanthasath R. Predictors of
quality of life of medical students and a comparison with quality
of life of adult health care workers in Thailand. Springerplus
28. Melchior M, Chastang JF, Walburg V, Arseneault L, Galéra C,
Fombonne E. Family income and youths’ symptoms of depression
and anxiety: A longitudinal study of the French GAZEL Youth
cohort. Depress Anxiety 2010;27:1095‑103.
29. Pekmezovic T, Popovic A, Tepavcevic DK, Gazibara T,
Paunic M. Factors associated with health‑related quality
of life among Belgrade University students. Qual Life Res
30. Yorks DM, Frothingham CA, Schuenke MD. Effects of group
fitness classes on stress and quality of life of medical students.
J Am Osteopath Assoc 2017;117:e17‑e25.
31. Wu X, Tao S, Zhang Y, Zhang S, Tao F. Low physical activity and
high screen time can increase the risks of mental health problems
and poor sleep quality among Chinese college students. PLoS One
32. Pillay N, Ramlall S, Burns JK. Spirituality, depression and quality
of life in medical students in KwaZulu‑Natal. S Afr J Psychiatr
33. Gan GG, Yuen Ling H. Anxiety, depression and quality of life
of medical students in Malaysia. Med J Malaysia 2019;74:57‑61.
34. Ratnani IJ, Vala AU, Panchal BN, Tiwari DS, Karambelkar SS,
Sojitra MG, et al. Association of social anxiety disorder with
depression and quality of life among medical undergraduate
students. J Family Med Prim Care 2017;6:243‑8.
35. Arslan G, Ayranci U, Unsal A, Arslantas D. Prevalence of
depression, its correlates among students, and its effect on
health‑related quality of life in a Turkish university. Ups J Med
Sci 2009;114:170‑7.
36. Lins L, Carvalho FM, Menezes MS, Porto‑Silva L, Damasceno H.
Health‑related quality of life of students from a private medical
school in Brazil. Int J Med Educ 2015;6:149‑54.