Qom University of Medical Sciences Journal

fa آنالیز چند‌سطحی بررسی کیفیت زندگی دستیاران پزشکی بیمارستان آموزشی منتخب شهر تهران سال 1402: یک مطالعه مقطعی A multi-level analysis of the quality of life of medical residents in an educational hospital in Tehran: A cross-sectional study بهداشت عمومی بهداشت عمومی مقاله پژوهشي Original Article زمینه و هدف: فشارهای جسمی، عاطفی و مالی اغلب منجر به پریشانی قابل‌توجهی در میان دستیاران پزشکی می‌شود که ممکن است منجر به افزایش بروز خودکشی شود، بنابراین هدف از مطالعه حاضر تعیین ارتباط کیفیت زندگی دستیاران پزشکی با تعداد ساعات سپری‌شده در بیمارستان آموزشی منتخب بود. روش بررسی: این مطالعه مقطعی بر روی 55 دستیار پزشکی با نمونه‌گیری در‌دسترس در یکی از بیمارستان‌های آموزشی در شهر تهران در سال 1402 انجام شد. متغیر وابسته مقیاس 26 سؤالی کیفیت زندگی سازمان جهانی بهداشت و متغیر مستقل تعداد ساعات حضور در بیمارستان به‌عنوان متغیر بود. با استفاده از رگرسیون خطی چندگانه دو‌سطحی‌، رشته تحصیلی به‌عنوان سطح اول و افراد شرکت‌کننده به‌عنوان سطح دوم وارد مدل شدند. سطح معنی‌داری کمتر از 0/05در نظر گرفته شد. یافته‌ها: میانگین نمره کیفیت زندگی دستیاران پزشکی2/56±‌19/12 بود. حیطه سلامت جسمانی پایین‌ترین نمره کیفیت زندگی را داشت. پس از کنترل وضعیت سکونت و سابقه مصرف دخانیات در مدل رگرسیون خطی دو‌سطحی چندگانه، ارتباطی بین کیفیت زندگی و تعداد ساعات سپری‌شده در بیمارستان در هفته مشاهده نشد (0/01=B، 0/24=‌P). اما ارتباط معکوس بین کیفیت زندگی و سن دیده شد (0/19- = β، 0/01 = P). 14 درصد از تغییرات کیفیت زندگی دستیاران پزشکی به تفاوت در رشته‌های تحصیلی نسبت داده شد. نتیجه‌گیری: در بیمارستان‌ آموزشی منتخب‌، دستیاران پزشکی کیفیت زندگی پایینی دارند. ضرورت تمرکز بر سلامت جسمی و روانی برای بهبود و درمان سلامت جامعه ضروری است. Introduction: Medical residents face various positive and negative situations in their personal and training lives throughout their educational journey, leading to diverse impacts on their overall well-being. The demanding work process, hard shifts, and high workload faced by medical residents in today's society emphasize the need for supervision and quality of life assessment for this group more than ever before which this issue has not been adequately examined. in this study we were address to determine a relationship between quality of life and the number of hours spent in hospitals among medical residents. Methods: In This cross-sectional study all medical residents in the selected teaching hospital affiliated to Tehran University of Medical Sciences in Tehran were included in the study by available sampling method. The number of medical residents during the study period was 70, of which 10 were not included in the study due to unwillingness to participate in the study and two individuals due to not having Iranian nationality. Three participants were excluded from the analysis due to not completing the questionnaire form. at the end 55 medical residents from April to the end of May 2023 participated.  The dependent variable was the 26-item World Health Organization Quality of Life score, The tool's reliability, measured using Cronbach's alpha, was 0.70 for the physical health dimension, 0.73 for the mental health dimension, 0.55 for the social health dimension and 0.84 for the environmental health dimension. the number of hours spent in the hospital as the independent variable and demographic characteristics as a confounder. Descriptive statistics, including frequency and percentage, were used for categorical variables, mean and standard deviation were used for quantitative variables, and median and range were used for non-normally distributed variables. Using multilevel multiple linear regression, the educational field was entered as the first level, and individuals were entered as the second level in the model. The analysis was conducted using Stata statistical software. p-value less than 0.05 was considered. Results: Fifty-five participants, 69% of whom were female, had a median age of 30 years. The residents' average quality of life was 19.12(2.56). The physical health domain had the worst quality of life score. bivariate analysis test including correlation coefficient (spearman and Pearson), paired t-test and one way of Anova was utilized to examine the association between demographic variables and quality of life to adjust for confounding effects, demographic variables with significance levels below 0.2 were included in the selected linear regression model. After adjusting for residency status and smoking history in the multilevel multiple linear regression model, there was not enough evidence to reject null hypothesis of no relationship between quality of life and the number of hours spent in the hospital per week (B=0.01, p =0.24). also, there was evidence of negative association between quality of life and age (B=-0.19, p=0.01). 14% of the variation of residents' quality of life was attributed to differences in educational fields. Discussion: An important point is that despite sending the questionnaire twice to be completed at the right time and place by individuals who actually bear the most pressure in the educational journey, the desire to participate in the study is very low. It is suggested that future studies look at it in depth. The main limitation of the present study was the small number of participants due to the time constraints of the sampling and data collection period. Therefore, caution should be exercised when generalizing the results obtained in this study. To address this issue, conducting a series of similar longitudinal studies is recommended, as these are expected to complement the findings of this cross-sectional study    Conclusion      In selected educational hospitals, residents have a low quality of life and are dissatisfied with their physical health. The necessity of focusing on physical and mental health is essential for improving and treating community health. Further studies in this area are necessary to implement interventions to reduce risky behaviors such as smoking and substance abuse. Additionally, some dimensions influencing physical health were not clearly identified; qualitative studies may help uncover the depth of these unknown factors.   دستیاران پزشکی, آنالیز چند‌سطحی, کیفیت زندگی, بیمارستان آموزشی Medical Student, Mixed Model, Residency, Hospital School, Training Hospital 457 468 http://journal.muq.ac.ir/browse.php?a_code=A-10-3116-1&slc_lang=fa&sid=1 Sedigheh Hantoushzadeh صدیقه حنطوش‌زاده hantoushzadeh@tums.ac.ir 0000-0003-3779-9218 No Department of Obstetrics and Gynecology, Breastfeeding Research Center, School of Medicine, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran. گروه بیماری‌های زنان و زایمان، مرکز تحقیقات تغذیه با شیر مادر، دانشکده پزشکی، پژوهشکده سلامت خانواده، دانشگاه علوم پزشکی تهران، تهران، ایران. Elahe Amirkhalili الهه امیرخلیلی elahe.amirkhalili@yahoo.com 0000-0002-1667-2149 Yes Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. گروه اپیدمیولوژی و آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران. Mamak Shariat مامک شریعت mshariat@tums.ac.ir 0000-0002-7547-8004 No Maternal, Fetal, and Neonatal Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran. مرکز تحقیقات مادر، جنین و نوزاد، پژوهشکده سلامت خانواده، دانشگاه علوم پزشکی تهران، تهران، ایران. Mansoureh Jamshidimanesh منصوره جمشیدی‌منش m.jamshidimanesh@gmail.com 0000-0001-7831-2520 No Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. گروه مامایی، بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.