Health and quality of life during years at university : studies on their development and determinants

Abstract

Transition into and life at university represent a critical period in the formation of the life-pathways of many young adults. The aim of this thesis is to increase knowledge about the health status and quality of life of university students, and also their determinants and impact on academic achievement. The thesis comprises five studies, three of which are cross-sectional and two longitudinal. The study population consists of students registered full-time at Linköping University in Sweden. Students who started on a program in the academic year 1998/99 make up the first study group (n=3,229, response rate 70%), and those who were still registered two years later (2000/2001) and took place in the first survey comprise the second (n=1,160). The groups were surveyed by means of self-administered questionnaires at the end of the spring terms 1999 and 2001. It appears that first-year university students rate their physical, psychological and general health as 'good' or 'very good' in large proportions. General and physical self-rated health show the strongest inter-correlation among the health measures. The most frequently perceived symptoms are tiredness, anxiety and difficulty in concentrating. Students' quality of life is more strongly associated with their self-rated psychological health than with self-rated physical health. They rate their general health and their quality of life lower than their working peers. The vast majority of students who rate their general and psychological health as good after their first year of university maintain that assessment two years later. Binge drinking is common in the first year, and also two years later. Alcohol consumption, however, is not a good predictor of self-rated health. By contrast, use of tobacco, though not highly prevalent among students, is a predictor of less-than-good general and psychological health during the third year of university. There are consistent gender-based differences in health status, health-risk behaviors and perceived quality of life. Also, gender is a week predictor of less-than-good health, general and psychological, and also of several aspects of academic achievement. Sources of stress are very similar, in order and in magnitude, during the first and third year at university. The two most frequent sources are 'not coping academically' and 'poor finances'. 'Not coping academically', 'doubts about the future' and 'loneliness' are strong predictors of less-than-good general and psychological health. The factors that impact on obtaining a degree or on not remaining a full-time student are not that many, and the ones of importance vary in kind according to length of program. Perceived inadequacy in academic coping is a substantial barrier to students obtaining a degree on all programs when measured in 2001, and to those on the two longest kinds of program even in 1999. The factors that impact on not being a full-time equivalent student are mostly of a relational nature. Feeling lonely in both the first and the third year and feeling inadequate for the family in the third year increased the risk of not being a full-time equivalent student at the end of 2003. Replication of the study in a wider student population is important because identification of students' health problems on a large scale will have implications for higher-level decision-making.