doi:10.3900/fpj.6.6.357.e
EISSN 1676-5133
The relationship between quality of life
and physical activity in college students
attending a physical education course
Original Article
1
Universidade Federal do Paraná - UFPR
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
Fabrício Cieslak1
[email protected]
2
Gustavo Levandoski2
[email protected]
Suelen Meira Góes1
[email protected]
Thiago Krzesinski dos Santos1
[email protected]
Guanis de Barros Vilela Junior3,4,5
[email protected]
Neiva Leite1
[email protected]
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):357-61.
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 coefficient Alpha of Cronbach was used, for the analysis of relationship between PA and QL
the Spearman’s Rho correlation was used, with significance of p <0.05 . Results: The results were satisfactory for PA (most of the
participants were classified 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 80215-370
Submitted: August / 2007
Accepted: Octuber / 2007
Copyright© 2008 por Colégio Brasileiro de Atividade Física, Saúde e Esporte
Fit Perf J
Rio de Janeiro
6
6
357-61
Nov/Dec 2007
357
RESUMO
RESUMÉN
Relação do nível de qualidade de vida e atividade física em acadêmicos
de educação física
Relación del nivel de calidad de vida y actividad física en académicos
de educación 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.
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.
Palavras-chave: atividade física, qualidade de vida, WHOQOL.
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 specific analysis of QL in
health, its centrality is in the capacity to live without diseases and to
overcome the difficulties of the states or morbidity conditions1.
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 worries2.
One of the possible ways for the determination of QL is using
the instrument World Health Organization Quality of Life (WHOQOL), which has been used recently in national studies3,4 and
international5,6 , 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 environment2.
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 environment7. The protocol presents high acceptance, being tested
and validated at several countries, also in Brasil8.
QL can also be visualized of multidimensional form, being constituted of parameters modified or not, inserted in the man’s daily,
as an individual way are regarding the hereditariness and to the
358
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 condition10,11, 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 influential negative factor on the health
condition, predisposing to a larger incidence of diseases 12,13.
According to Bauman & Craig14 and Hallal et al.15, the low taxes
of PA verified in the last decades could be one of the main risk
factors modified 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 studies6,16,17, however
it is verified the insufficiency of researches relating QL to other
influential 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 2006.
Fit Perf J, Rio de Janeiro, 6, 6, 358, Nov/Dec 2007
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 20.74 + 2.79 years. All of them were informed on the used
procedures, possible benefits 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 WHOQOLBref, a questionnaire composed by 26 relative questions to the
last fifteen 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, financial 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, traffic,
climate and transport7.
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 five categories according to the classification of
the condition of AF: sedentary, insufficiently active A, insufficiently
active B, active and very active18.
Statistical Analysis
The data regarding the questionnaire of QL were analyzed as the
criteria proposed by the australian version of WHOQOL19. The
verification 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
coefficient of Alfa Cronbach (α).
According to Streiner20, this coefficient is being used thoroughly to
attest the reliability of the answers obtained in analyses accompli-
shed 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 ShapiroWilk was made, confirmed 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 significance level fastened in p < 0.05.
RESULTS
The value of the consistence interns of the answers of the questionnaire was obtained through the trustworthy coefficient 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
Alfa Cronbach Coefficients
Masculine (n=46)
0.80
Feminine (n=39)
0.77
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 identified 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 significant differences (Table 2).
The percentile of male PA levels demonstrates that most of the
students is classified as very active (Graphic 1). In the same way,
the female students are classified 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 significant 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
Domain I - physical
Domain II - psychological
Domain III – social relationships
Domain IV - environment
general quality life
masculine M+SD (n=46)
77.2±10.6
72.0±12.2
73.9±16.9*
61.0±13.1
71.0±13.2
feminine M+SD (n=39)
72.2±12.5
68.4±14.8
79.7±16.1*
63.5±12.5
70.9±14.0
p < 0.05
Fit Perf J, Rio de Janeiro, 6, 6, 359, Nov/Dec 2007
359
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)
In general, the students’ QL established results relatively satisfactory for both sexes, having significant 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 researchs22, 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 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 significant relationships
(Table 4).
DISCUSSION
Several are the meanings attributed to the good Quality of Life
(QL), where difficultly 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 financial condition, family, love
and work.
The researchers elaborated methods for study of those meanings,
finding 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 comunity21. In this
study, the dimensions physical, psychological, social relationships
and environment were considered.
The male students reflected their superiority for the Domínio I Physical (X = 77.2), identifying equivalence to the study of Nunes
& Freire25, 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
influenciados 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 influenced directly or
indirectly by the knowledge of the practice of the physical activity
and their benefits.
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
0.969*
0.976*
0.976*
0.988*
0.283***
Domain II
Domain III
Domain IV
General QL
PA Level
1
0.974*
0.981*
0.990*
0.258***
1
0.976*
0.992*
0.308**
1
0.992*
0.300**
1
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
0.981*
0.971*
0.987*
0.993*
0.068
Domain II
Domain III
1
0.971*
0.986*
0.992*
0.053
1
0.983*
0.980*
0.048
Domain IV
1
0.997*
0.077
General QL
PA Level
1
0.062
1
*p < 0.01
360
Fit Perf J, Rio de Janeiro, 6, 6, 360, Nov/Dec 2007
For the two genders, masculine (X=61.0) and feminine (X=63.5)
they were identified 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 studies15,27, however
they were not found significant differences among the sexes, what
characterizes similarity with others evidences28,29.
The relationships between level of PA and QL presented significant correlations just for the male students, this factor might
have been influenced 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 difficulties in the results in studies with low number
of participants30.
However, even with the possible limitations presented, this research
seems to be one of the first reports about the relationship between
QL and PA in Brazilians.
4. Gordia AP, Quadros TMB, Vilela Junior GB, Souza EA, Cabral C, Morais TB, et al.
Comparação da qualidade de vida de mulheres idosas praticantes e não praticantes de
exercício físico. Buenos Aires: [atualizada em 2007 mar; acesso em 2007 nov 23]. [1 tela].
Efdeportes.com. Disponível em: <http://www.efdeportes.com/efd106/mulheres-idosaspraticantes-de-exercicio-fisico.htm>.
5. Saxena S, Carlson D, Billington R, Orley J. The WHO Quality Assesment Instrument
(WHOQOL-Bref): the importance of its items for cross-cultural research. Qual Life Res.
2001; 20(2): 580-8.
6. Wang WC, Yao G, Tsai YJ, Wang JD, Hsieh CL. Validating, improving relaibility, and
estimating correlation of the four subscales in the WHOQOL-Bref using multidimensional
Rasch analysis. Qual Life Res 2006; 15 (4): 607-20.
7. The WHOQOL Group. Development of the World Health Organization WHOQOL-Bref.
Quality of Life Assesment. Physicol Méd 1998; 28 (3):551-8.
8. Fleck MPA, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L, et al. Aplicação
da Versão em Português do Instrumento Abreviado de Avaliação da Qualidade de Vida
“WHOQOL-Bref”. Rev saúde pública 2000; 34(2): 178-83.
9. Nahas MV. Atividade física, saúde e qualidade de vida: conceitos e sugestões para um
estilo de vida ativo. 3ª ed. Midiograf. Londrina, 2003.
10. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern
Med. 1993; 118 (8): 622-9.
11. World Health Organization. Quality of life assessment: annotaded bibliography.
Geneva: World Health Organization; 1994.
12. Yancey AK, Wold CM, Mccarthy WJ, Weber MD, Lee B, Simon PA, et al. Physical inactivity
and overweight among Los Angeles county adults. Am J Prev Med 2004; 27(2):146-52.
13. Alexander A, Bergman P, Hagstromer M, Sjostrom M. IPAQ environmental module;
reliability testing. Journal Public Health 2006; 14 (2): 76-80.
14. Bauman A, Craig CL. The place of physical activity in the WHO global strategy on diet
and physical activity. Int J Behav Nutr and Phys Act. 2005; 2: 10.
15. Hallal PC, Matsudo SM, Matsudo VKR, Araújo TL, Andrade DR, Bertoldi AD. Physical
activity in adults from two brazilian areas: similarities and differences. Cad de saúde
pública. 2005; 21(2): 573-80.
FINAL CONSIDERATIONS
16. Eljedi A, Mikolajczyk RT, Kraemer A, Laaser U. Health-related quality of life in diabetic
patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional
study. BMC Public Health. 2006; 268(6):1-7.
As knowing the difficult process that involves the measurement
of PA and QL, the present study made possible a reflexive 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.
17. Tsutsumi A, Izutsu T, Kato S, Islam A, Yamada HS, Kato H, et al. Reliability and validity
of the Bangla version of WHOQOL-Bref in an adult population in Dhaka, Bangladesh.
Psychiatry Clin Neurosci. 2006; 60 (4) 493-8.
And, for this study most of the participants is inserted in an active
lifestyle, for QL the domain social relationships just revealed significant 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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