The relationship between quality of life and physical activity in college students attending a physical education course

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1 EISSN doi: /fpj e The relationship between quality of life and physical activity in college students attending a physical education course Original Article Fabrício Cieslak 1 facieslak@gmail.com Gustavo Levandoski 2 gustavocref10123@hotmail.com Suelen Meira Góes 1 su.goes@gmail.com Thiago Krzesinski dos Santos 1 t.krzesinski@hotmail.com Guanis de Barros Vilela Junior 3,4,5 guanis@gmail.com Neiva Leite 1 neivaleite@gmail.com 1 Universidade Federal do Paraná - UFPR 2 Universidade do Estado de Santa Catarina - UDESC 3 Universidade Estadual de Ponta Grossa - UEPG 4 Universidade Estadual de Campinas - UNICAMP 5 Faculdades Integradas Metropolitanas de Campinas - METROCAMP Cielask F, Levandoski G, Góes SM, Santos TK, Vilela Jr GB, Leite N. The relationship between quality of life and physical activity in college students attending a physical education course. Fit Perf J. 2007;6(6): ABSTRACT: Introduction: The present study aimed to identify the relationship between quality of life (QL) and physical activity (PA) in college students attending a Physical Education Course. Materials and Methods: The research had a traverse and descriptive method, with 85 college students (46 male and 39 female) from Ponta Grossa - PR municipal district. The level of PA (physical activity) by IPAQ (brief version) and QL were measured applying the WHOQOL-Bref. To verify association between sex and PA the test quisquare was used. In the WHOQOL analysis the U test of Mann-Whitney was used to examine the possible differences between sexes and to measure internal consistency the coeffi cient Alpha of Cronbach was used, for the analysis of relationship between PA and QL the Spearman s Rho correlation was used, with signifi cance of p <0.05. Results: The results were satisfactory for PA (most of the participants were classifi ed as very active ) and QL (however the environmental domain presented the worst indexes in both sexes). Relationship between PA and QL was found just for the masculine sex. Conclusion: We also consider the necessity of carrying out prospective studies referring to the variables which were found and of investing in public policies which would focus on better life conditions for the population. Keywords: physical activity, quality of life, WHOQOL. Correspondence to: Travessa Coração de Maria, n. 92 Curitiba - PR CEP Submitted: August / 2007 Accepted: Octuber / 2007 Copyright 2008 por Colégio Brasileiro de Atividade Física, Saúde e Esporte Fit Perf J Rio de Janeiro Nov/Dec

2 RESUMO Relação do nível de qualidade de vida e atividade física em acadêmicos de educação física Introdução: O presente estudo visou identificar as relações entre qualidade de vida (QV) e atividade física (AF) em acadêmicos do curso de Educação Física. Materiais e Métodos: A pesquisa teve método transversal e descritivo, com 85 acadêmicos (46 do sexo masculino e 39 do sexo feminino) do município de Ponta Grossa (PR). Mensuraram-se o nível de AF pelo IPAQ (versão curta), e a QV por intermédio do WHOQOL-Bref. Para verificar as associações de sexo e AF foi utilizado o teste qui-quadrado, na análise do WHOQOL foi empregado o teste U de Mann-Whitney para examinar as possíveis diferenças entre os sexos e para consistência interna foi utilizado o coeficiente Alfa de Cronbach, para análise das relações entre AF e QV foi empregada a correlação de Spearman rho, com significância de p<0,05. Resultados: Os resultados foram satisfatórios para AF, de modo que a maioria dos participantes foi classificada como muito ativos, e QV de uma forma geral, sendo que o domínio ambiental apresentou os piores índices em ambos os sexos. Foram encontradas relações de AF e QV apenas para o sexo masculino. Conclusão: Considera-se a necessidade de estudos prospectivos referentes as variáveis deste estudo, além de investimentos em políticas públicas que evidenciem melhores condições de vida na população. Palavras-chave: atividade física, qualidade de vida, WHOQOL. RESUMÉN Relación del nivel de calidad de vida y actividad física en académicos de educación física Introducción: El actual estudio tuvo como objetivo para identificar a las relaciones entre la calidad de la vida (QV) y la actividad física (AF) en el académico del curso de la Educación Física. Materiales y Métodos: La investigación tenía método transversal y descriptivo, con 85 académico (46 del sexo masculino y 39 del sexo femenino) de la ciudad de Ponta Grossa (PR). Mensuraram el nivel del AF para el IPAQ (versión corta), y el QV para el intermediario del WHOQOL-Bref. Verificar las asociaciones del sexo y del AF la prueba era qui-cuadrado usado, en el análisis del WHOQOL estaba la prueba usada U de Mann-Whitney para examinar las diferencias posibles entre los sexos y para la consistencia interna fue utilizado el coeficiente del alfa de Cronbach, para el análisis de las relaciones entre el AF y el QV fue utilizado la correlación de rho del Spearman, con la significación de p< 0,05. Resultados: Los resultados habían sido satisfactorios para el AF, de la manera que clasificaron a la mayoría de los participantes como muy activa, y del QV de una forma general, siendo que el dominio ambiente presentó los índices peores en ambos los sexos. Las relaciones del AF y del QV solamente para el sexo masculino habían sido encontradas. Conclusión: Se considera necesidad de referir estudios de los prospectivos las variables de este estudio, más allá de inversiones en las políticas públicas que evidencian condiciones de la vida mejores en la población. Palabras clave: actividad física, calidad de la vida, WHOQOL. INTRODUCTION The term quality of life (QL) is treated under several glances, as the science, common sense, objective or subjective point of view or in individual and collective approaches. In the context of health, the support is in the understanding of the fundamental human needs, materials, spiritual and it has in the concept of promotion of health its more relevant focus. In the specifi c analysis of QL in health, its centrality is in the capacity to live without diseases and to overcome the diffi culties of the states or morbidity conditions 1. The World Organization of the Health (WOH) considers QL as being: the individual s perception of his position in the life in the context of the culture and system of values in which he lives and in relation to his objectives, expectations, patterns and worries 2. One of the possible ways for the determination of QL is using the instrument World Health Organization Quality of Life (WHO- QOL), which has been used recently in national studies 3,4 and international 5,6, for the determination of the countless factors related to QL. Considered one of the instruments more used, WHOQOL-100 is a complex protocol, constituted of 100 questions regarding to 6 aspects: spirituality, physical, independence level, psychological, social relationships and environment 2. However, in the interest of the use an instrument of fewer complexes and of easy applicability, it was developed the WHOQOL-Bref, a questionnaire (with the same essence of WHOQOL -100) containing 26 questions bounded to four domains mentioned previously, being them: physical, psychological, social relationships and environment 7. The protocol presents high acceptance, being tested and validated at several countries, also in Brasil 8. QL can also be visualized of multidimensional form, being constituted of parameters modifi ed or not, inserted in the man s daily, as an individual way are regarding the hereditariness and to the lifestyle (alimentary habits, control of the stress, habitual physical activity, relationships and preventive behavior) simultaneously with the parameters social-environmental (home, transport, safety, environment, among others) 9. Seeking for a greater search for ideal QL, and considering that this concept is usually used as synonym of the health condition 10,11, the study of the determinants factors of the health it becomes relevant for better understanding of QL. Several studies have been demonstrated the relation of the lack of physical activity (PA) as an infl uential negative factor on the health condition, predisposing to a larger incidence of diseases 12,13. According to Bauman & Craig 14 and Hallal et al. 15, the low taxes of PA verifi ed in the last decades could be one of the main risk factors modifi ed associates to the high cases of morbidity and mortality, increasing the prevalence of several chronic-degenerative diseases, mental disturbances and premature death. This theme has been used in several actual studies 6,16,17, however it is verifi ed the insuffi ciency of researches relating QL to other infl uential variables, like PA, in this context, this research had as objective, to relate the level of QL and PA in students of the course of Physical Education of the municipal district of Ponta Grossa - PR. MATERIALS AND METHODS Participants The present research of observing character, descriptive and traverse it was accomplished in the municipal district of Ponta Grossa, year of Fit Perf J, Rio de Janeiro, 6, 6, 358, Nov/Dec 2007

3 The participant subjects are from 85 students of Physical Education Course, being 46 of the male and 39 of the female, with medium age of years. All of them were informed on the used procedures, possible benefi ts and risks regarding the execution of the study, conditioning their later participation. Only the participants who obeyed the following criteria were included: (1) the appropriate completion of the research instruments; (2) condition voluntary participative in the process by signing the term of formal consent. Instruments The level of QL was determined through the use of WHOQOL- Bref, a questionnaire composed by 26 relative questions to the last fi fteen previous days to the evaluation. Two questions refer to the individual perception of the quality life and the others are subdivided in 4 domains, each one of the 24 aspects that compose the original instrument acting (WHOQOL -100), being them: (a) Domain I - Physical: pain and discomfort, energy and fatigue, sleep and rest, mobility, activities of the daily life, dependence of medication or treatments and work capacity; (b) Domain II - Psychological: positive feelings, think, learn, memory and concentration, self-esteem, body image and appearance, negative feelings, spirituality, religion and personal faiths; (c) Domain III - Social Relationships: personal relationships, social support (base), sexual activity; (d) Domain IV - Environment: physical security and protection, atmosphere in the home, fi nancial resources, cares of health and social: readiness and quality, opportunity to acquire new information and abilities, participation in, and recreation / leisure opportunities, physical atmosphere: pollution, noise, traffi c, climate and transport 7. For measurement of the level of PA the International Questionnaire of Physical Activity(IPAQ), short version was used, that investigates the degree of PA of the respondent s last seven days, this instrument is constituted of questions regarding frequency of PA vigorous, moderate and walk done in the last week by the interviewee and it is separated in fi ve categories according to the classifi cation of the condition of AF: sedentary, insuffi ciently active A, insuffi ciently active B, active and very active 18. Statistical Analysis The data regarding the questionnaire of QL were analyzed as the criteria proposed by the australian version of WHOQOL 19. The verifi cation of the consistence interns (in other words, the degree for which the items inside of a domain they are cohesive and homogeneous in content) was obtained through the trustworthy s coeffi cient of Alfa Cronbach (α). According to Streiner 20, this coeffi cient is being used thoroughly to attest the reliability of the answers obtained in analyses accomplished through questionnaires. Its variability is understood between 0.00 (reliability absence) to 1.00 (perfect reliability). Measures of central tendency, variability and percentile were used. To verify the normality of the data of QL the test of Shapiro- Wilk was made, confi rmed the normality absence the test U of Mann-Whitney was used for comparison of QL among the sexes, Chi-square test was applied to compare the proportions between the sexes for the level of PA and the correlation of Spearman Rho was used to verify the relationship of QL on PA. The statistical procedures of the present study were accomplished by Statistical Package for Social Sciences (SPSS, version 13.0) it goes Windows, with signifi cance level fastened in p < RESULTS The value of the consistence interns of the answers of the questionnaire was obtained through the trustworthy coeffi cient Alpha of Cronbach; the found values present a good trustworthy (Table 1). Table 1. Values of the trustworthy coefficients obtained through the answers of the questionnaire WHOQOL. Consistence Interns Masculine (n=46) Feminine (n=39) Alfa Cronbach Coefficients The measures of central tendency presented in a general way a satisfactory QL for both genders, so that, the male students obtained the largest values for the physical domain and the female students for the domain of social relationships. The environmental domain presented the smallest indexes for the two genders. The comparison between the genders identifi ed differences in the Domain III. Social Relationships, in that the women presented larger indexes than the men (p = 0.027). However, for the Domain I - Physical (p = 0.298), Domain II - Psychological (p = 0.712), Domain IV - Environment (p = 0.198) and general QL (p = 0.629) they were not found signifi cant differences (Table 2). The percentile of male PA levels demonstrates that most of the students is classifi ed as very active (Graphic 1). In the same way, the female students are classifi ed as very active in larger percentile (Graphic 2). In general, the male students present larger values in relation to the levels of PA, however, for the participants of this study the level of PA didn t present associations with the sex for the Chi-square test (p=0.109). The values of the correlations indicate strong relationships among the variables of QL: Domain I - Physical, Domain II - Psychological, Domain III - Social Relationships, Domain IV - Environment and General QL (p < 0.001). They were found signifi cant correlations for the levels of PA with the Domain III - Social Relationships (p=0.037), Domain IV Environment (p=0.043) and General Table 2. Values of WHOQOL-Bref presented by domains expressed on average and standard deviation quality life masculine M+SD (n=46) feminine M+SD (n=39) Domain I - physical 77.2± ±12.5 Domain II - psychological 72.0± ±14.8 Domain III social relationships 73.9±16.9* 79.7±16.1* Domain IV - environment 61.0± ±12.5 general quality life 71.0± ±14.0 p < 0.05 Fit Perf J, Rio de Janeiro, 6, 6, 359, Nov/Dec

4 Graph 1. Values of the male students PA levels (IPAQ) (n =46) expressed in percentile. Graph 2 - Values of the female students PA levels (IPAQ) (n =39) expressed in percentile QL (p=0.049), besides tendencies of relationships among PA (p < 0.10 and > 0.05) with the Domain I - Physical (p=0.057) and the Domain II - Psychological (p=0.083) (Table 3) The values of the correlations indicate strong relationships among the variables of QV: Domain I. Physical, Domain II. Psychological, Domain III. Social Relationships, Domain IV. Middle-atmosphere and General QV (p < 0.001). Between the levels of AF and the variables of QV they were not found signifi cant relationships (Table 4). DISCUSSION Several are the meanings attributed to the good Quality of Life (QL), where diffi cultly an unanimity is gotten among the same community s, who will say of an entire society. In that context, some elements are showed in most of the opinions as: safety, happiness, leisure, health, stable fi nancial condition, family, love and work. The researchers elaborated methods for study of those meanings, fi nding a group of parameters related to the term QL, among them: cultural aspects, historical and social classes, group of material conditions and no-materials, differences for age groups and conditions of the people s health or of a comunity 21. In this study, the dimensions physical, psychological, social relationships and environment were considered. In general, the students QL established results relatively satisfactory for both sexes, having signifi cant differences just in the Domain III - Social Relationships, where the women presented larger index (p = 0.027). The results for the Domain III- Social Relationships (X = 79.7) presents similarity with other researchs 22, in the analysis of Saupe et al. 23 with 825 nursing students were found superior values for the present domain (X=75.8). In research done by Cieslak et al. 24, the analysis of the QL of the Ponta Grossa-PR municipality students, they obtained the highest values for this domain, demonstrating a favorable point for this population. The male students refl ected their superiority for the Domínio I - Physical (X = 77.2), identifying equivalence to the study of Nunes & Freire 25, that accomplished a transverse observacional study in the QL evaluation of the 237 surgeon-dentists of the Municipal Secretary of Health of Goiânia-GO, in 2004, showing the higher average score average for this domain (X = 70.3).Como a população da pesquisa refere-se a estudantes de Educação Física, podemos considerar que os resultados podem ter sido infl uenciados diretamente ou indiretamente pelo conhecimento da prática da atividade física e seus benefícios. As the population of the research refers to students of Physical Education, we can consider that the results might have been infl uenced directly or indirectly by the knowledge of the practice of the physical activity and their benefi ts. Table 3 - Values of the correlations (R) between the domains of QV and the level of AF for the masculine sex (n =46). Domain I Domain II Domain III Domain IV General QL PA Level Domain I 1 Domain II 0.969* 1 Domain III 0.976* 0.974* 1 Domain IV 0.976* 0.981* 0.976* 1 General QL 0.988* 0.990* 0.992* 0.992* 1 PA Level 0.283*** 0.258*** 0.308** 0.300** 0.292** 1 * p < 0.01; ** p < 0.05; 0.05 < p < 0.10 Table 4 - Values of the correlations (R) between the domains of QV and the level of AF for the feminine sex (n =39). Domain I Domain II Domain III Domain IV General QL PA Level Domain I 1 Domain II 0.981* 1 Domain III 0.971* 0.971* 1 Domain IV 0.987* 0.986* 0.983* 1 General QL 0.993* 0.992* 0.980* 0.997* 1 PA Level *p < Fit Perf J, Rio de Janeiro, 6, 6, 360, Nov/Dec 2007

5 For the two genders, masculine (X=61.0) and feminine (X=63.5) they were identifi ed the worst results in the Domain IV - Environment, corroborating the values found in the study of Gordia et al. 26, where were analyzed 65 individuals male belonging to the Brazilian army, in the municipal districts of Lapa-PR (37 individuals) and Ponta Grossa-PR (28 individuals). In the same way, Wang et al. 6 in the evaluation of QL of 13,083 adults from Taiwan, were observed the largest offenses in the results for this domain in both genders, and thus, the main vulnerable aspect of participants in this study. The analyses of the information regarding the levels of PA demonstrated that the men present a more active lifestyle when compared the women, corroborating the results of other studies 15,27, however they were not found signifi cant differences among the sexes, what characterizes similarity with others evidences 28,29. The relationships between level of PA and QL presented signifi cant correlations just for the male students, this factor might have been infl uenced by the number of participants involved in this study, so that, the questionnaires are commonly instruments applied in epidemic samples and, above all IPAQ has been demonstrating diffi culties in the results in studies with low number of participants 30. However, even with the possible limitations presented, this research seems to be one of the fi rst reports about the relationship between QL and PA in Brazilians. FINAL CONSIDERATIONS As knowing the diffi cult process that involves the measurement of PA and QL, the present study made possible a refl exive vision of the analysis of this concept in the Physical Education university students. Through the results obtained in this research, we can infer that the university students of the Physical Education course of the municipal district of Ponta Grossa-PR presented satisfactory levels of PA and QL in a general way. And, for this study most of the participants is inserted in an active lifestyle, for QL the domain social relationships just revealed signifi cant differences among the genders and in the environmental domain they were found the worst values for the two appraised groups. Possible relationships were demonstrated between PA and QL just for the male students, fact that it characterizes the need of referring prospective studies the possible associations among those variables. The considerations on QL of this research attest equivalence with other analyses and it demonstrate the need of investments in public politics, so that, the current societies possess serious structural problems, mainly related to economical factor, education and in the extent of the health. 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