Health related quality of life of university students in Lebanon: Lifestyles behaviors and socio-demographic predictors


Measuring and monitoring health related quality of life (HRQoL) in youth are important for both researchers and decision makers. During the time that young people are at university, many will encounter a number of academic, as well as social, emotional and psychological difficulties. The aims of this study are to: 1) assess the health related quality of life of youths using SF-36 questionnaire and its factor determinants, and 2) provide an objective basis for a health promotion structure. Methods: This is a cross-sectional study in South Lebanon, in a population of 282 young university students attending a public university which is the largest and most widespread institution of higher education in Lebanon. Socioeconomic and lifestyle behaviors data were collected. Students’ HRQoL was measured using the SF-36 Health Survey. Results: The mean age of the respondents was 18.7 years (SD = 1.16), 80.1% were women, 64.5% were living in rural area. The proportion of current smokers was significantly greater among men than women (26.8% vs. 11.5%, p < 0.01). Water pipe was the main type of smoking. Education of the fathers had negatively influenced HRQoL. Younger age scored higher in Social Functioning and Role-Emotional; the area of residence had no influences on SF-36 scales scores. Females had poorer HRQoL than males especially in mental health scales. Smokers had low Vitality and Mental Health scores. Sedentary lifestyle was linked to a lower score of Physical Functioning (β = -5.16, 95% CI = -7.67 -2.65), and Vitality ( β= -5.85, 95% CI = -10.24 -1.45). The HRQoL of the students studying business and economics was higher than those studying health. Conclusion: Youths’ HRQoL is affected by socio-demographic and behavioral characteristics. Effective health-promoting actions, social support, and counseling services should be implemented in the campus and are a necessary step towards the main goal of improving the overall HRQoL of the university young students in Lebanon.

Share and Cite:

Sabbah, I. , Sabbah, H. , Khamis, R. , Sabbah, S. and Droubi, N. (2013) Health related quality of life of university students in Lebanon: Lifestyles behaviors and socio-demographic predictors. Health, 5, 1-12. doi: 10.4236/health.2013.57A4001.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Bakar, A.A. (2012) Health-related quality of life among youth: Evaluating measurement model fit. International Journal of Social Science and Humanity, 2, 282-285.
[2] Ford, J., Spallek, M. and Doson, A. (2008) Self-rated health and a healthy lifestyle are the most important predictors of survival in elderly women. Age and Ageing, 37, 194-200. doi:10.1093/ageing/afm171
[3] Schmidt, M. (2012) Predictors of self-rated health and lifestyle behaviours in Swedish university students. Global Journal of Health Science, 4, 1-14. doi:10.5539/gjhs.v4n4p1
[4] Tümkaya, S. (2011) Humor styles and socio-demographic variables as predictors of subjective well-being of Turkish university students. Education and Science, 36, 158-170.
[5] Moghnie, L. and Kazarian, S.S. (2011) Subjective happiness of Lebanese college youth in Lebanon: Factorial structure and invariance of the Arabic subjective happiness scale. Social Indicators Research, 109, 203-210. doi:10.1007/s11205-011-9895-5
[6] Palepu, A., Hubley, A.M., Russell, L.B., Gadermann, A.M. and Chinni, M. (2012) Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study. Health and Quality of Life Outcomes, 10, 93. doi:10.1186/1477-7525-10-93
[7] Haddock, C.K., Poston, W.S.C., Pyle, S.A., Klesges, R.C., Vander Weg, M.W., Peterson, A. and Debon, M. (2006) The validity of self-rated health as a measure of health status among young military personnel: Evidence from a cross-sectional survey. Health and Quality of Life Outcomes, 4, 57. doi:10.1186/1477-7525-4-57
[8] Zeller, M.H. and Modi A.C. (2006) Predictors of health-related quality of life in obese youth. Obesity, 14, 122-130. doi:10.1038/oby.2006.15
[9] Ravens-Sieberer, U., Gosch, A., Abel, T., Auquier, P., Bellach, B-M., BruiP, J., Dür, W., Power, M., Rajmil, L. and the European KIDSCREEN Group (2001) Quality of life in children and adolescents: A European public health perspective. Sozialund Präventivmedizin, 46, 294-302.
[10] Zullig, K.J., Teoli, D.A. and Ward, R.M. (2011) Not all developmental assets are related to positive health outcomes in college students. Health and Quality of Life Outcomes, 9, 52. doi:10.1186/1477-7525-9-52
[11] Mikolajczyk, R.T., Brzoska, P., Maier, C., Ottova, V., Meier, S., Dudziak, U., Ilieva, S. and El Ansari, W. (2008) Factors associated with self-rated health status in university students: A cross-sectional study in three European countries. BMC Public Health, 8, 215. doi:10.1186/1471-2458-8-215
[12] Chabot, G., Godin, G. and Gagnon, M.-P. (2010) Determinants of the intention of elementary school nurses to adopt a redefined role in health promotion at school. Implementation Science, 5, 93. doi:10.1186/1748-5908-5-93
[13] Eapen, V., Faure-Brac, G., Ward, P.B., Hazell, P., Barton, G., Asghari-Fard, M. and Dullur, P. (2012) Evaluation of weight gain and metabolic parameters among adolescent psychiatric inpatients: Role of health promotion and life style intervention programs. Journal of Metabolic Syndrome, 1, 109. doi:10.4172/2167-0943.1000109
[14] Chen, C.-Y. and Storr, C.L. (2006) Alcohol use and health-related quality of life among youth in Taiwan. Journal of Adolescent Health, 39, 752.e9-752.16.
[15] Medar, M., Õun, K. and Looring M. (2012) Economic growth versus development of social welfare structures in Europe.
[16] Marttinen, E. and Salmela-Aro, K. (2012) Personal goal orientations and subjective well-being of adolescents. Japanese Psychological Research, 54, 263-273. doi:10.1111/j.1468-5884.2012.00521.x
[17] El Ansari, W. and Stock, C. (2012) Is the health and wellbeing of university students associated with their academic performance? Cross sectional findings from the United Kingdom. International Journal of Environmental Research and Public Health, 7, 509-527. doi:10.3390/ijerph7020509
[18] Leontopoulou, S. and Triliva, S. (2012) Explorations of subjective wellbeing and character strengths among a Greek University student sample. International Journal of Wellbeing, 2, 251-270. doi:10.5502/ijw.v2.i3.6
[19] Undpf (1998) Chapter 7: Youth & health. In: The 1998 National Human Development Report: Youth and Development, United Nations Development Programme, Beirut, 87-97.
[20] Bradley, B.J. and Greene, A.C. (2013). Do health and education agencies in the United States share responsibility for academic achievement and health? A review of 25 years of evidence about the relationship of adolescents’ academic achievement and health behaviors. Journal of Adolescent Health, 52, 523-532. doi:10.1016/j.jadohealth.2013.01.008
[21] Wiklund, M., Malmgren-Olsson, E.-B., Öhman, A., Bergström, E. and Fjellman-Wiklund, A. (2012) Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender—A cross-sectional school study in Northern Sweden. BMC Public Health, 12, 993. doi:10.1186/1471-2458-12-993
[22] Chow, H.P. (2010) Predicting Academic success and psychological wellness in a sample of Canadian undergraduate students. Electronic Journal of Research in Educational Psychology, 8, 473-496.
[23] Barnes, V.A., Bauza, L.B. and Treiber, F.A. (2003) Impact of stress reduction on negative school behavior in adolescents. Health and Quality of Life Outcomes, 1, 10. doi:10.1186/1477-7525-1-10
[24] Epton, T., Norman, P., Sheeran, P., Harris, P.R., Webb, T. L., Ciravegna, F., Brennan, A., et al. (2013) A theory-based online health behavior intervention for new university students: Study protocol. BMC Public Health, 13, 107. doi:10.1186/1471-2458-13-107
[25] Correa-Burrows, P., Burrows, R., Uauy, R. and Albala, C. (2012). Health production and risk of obesity among Chilean adolescents: Understanding health related behaviors in youth. Health, 4, 1413-1419. doi:10.4236/health.2012.412A204
[26] National Institute for Health and clinical Excellence (NIH) (2009) Promoting young people’s social and emotional wellbeing in secondary education. NHS, London, 45pp.
[27] Robinson, M., Kendall, G.E., Jacoby, P., Hands, B., Beilin, L.J., Silburn, S., Zubrick, S.R. and Oddy, W.H. (2011) Lifestyle and demographic correlates of poor mental health in early adolescence. Journal of Paediatrics and Child Health, 47, 54-61. doi:10.1111/j.1440-1754.2010.01891.x
[28] Department of Education and Skills/Health Service Executive/Department of Health (2013) Well-being in post-primary schools: Guidelines for mental health promotion and suicide prevention.
[29] O’Brien, M. with the Human Development Team (2008) Student well-being. Well-being and post-primary schooling: A review of the literature and research. National Council for Curriculum and Assessment (NCCA) Research Report No. 6, Dublin.
[30] Salam, A.A., Alshekteria, A.A., Mohammed, H.A.A., Al Abar, N.M., Al Jhany, M.M. and Al Flah, M.F. (2012) Physical, mental, emotional and social health status of adolescents and youths in Benghazi, Libya. Eastern Mediterranean Health Journal, 18, 586-597.
[31] Sabbah, I., Drouby, N., Sabbah, S., Retel-Rude, N. and Mercier M. (2003) Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey. Health and Quality of Life Outcomes, 1, 30. doi:10.1186/1477-7525-1-30
[32] Giannakopoulos, G., Dimitrakaki, C., Pedeli, X., Kolaitis, G., Rotsika, V., Ravens-Sieberer, U. and Tountas, Y. (2009) Adolescents’ wellbeing and functioning: Relationships with parents’ subjective general physical and mental health. Health and Quality of Life Outcomes, 7, 100. doi:10.1186/1477-7525-7-100
[33] Naidoo, J. and Wills, J. (2005) Public health and health promotion Developing practice, 2nd Edition, Balliere Tindall, London.
[34] Wille, N., Bullinger, M., Holl, R., Hoffmeister, U., Mann, R., Goldapp, C., Reinehr, T., Westenhöfer, J., et al. (2010) Health-related quality of life in overweight and obese youths: Results of a multicenter study. Health and Quality of Life Outcomes, 8, 36.
[35] Hume, M. and Mort, G.S. (2012) iLeisure: Conceptualizing youth online leisure and quality of life. International Journal of Organisational Behaviour, 17, 87-107.
[36] Sabbah, I., Vuitton, D.-A., Droubi, N., Sabbah, S. and Mercier, M. (2007) Morbidity and associated factors in rural and urban populations of South Lebanon: A cross-sectional community-based study of self-reported health in 2000. Tropical Medicine and International Health, 12, 907-919. doi:10.1111/j.1365-3156.2007.01886.x
[37] Pisot, R. and Kropej, V.L. (2006) Correlation between perceived quality of life and healthy environment in youth. FACTA UNIVERSITATIS Series: Physical Education and Sport, 4, 115-123.
[38] Jarpe-Ratner, E., Zamula, A., Meyer, D., Nieto, A. and McCord, M. (2013) The healthy schools healthy families program—Physical activity integration into elementary schools in New York city. Journal of Community Medicine & Health Education, 3, 194. doi:10.4172/2161-0711.1000194
[39] WHO (2006) Mental health and psychosocial protection and support for adults and children affected by the Middle East crisis: Inter-agency technical advice for the current emergency.
[40] Tayara, R. (2013) Resiliency and war experiences: A psychometric study of the Lebanese adolescent experience of war. International Journal of Psychology and Behavioral Sciences, 3, 23-33.
[41] UNESCO (2012) Youth policy in Lebanon.
[42] Sabbah, I., Sabbah, H., Sabbah, S., Akoum, H., Droubi, N. and Mercier, M. (2012) Measurement properties of the Arabic Lebanon version of the pediatric quality of life inventory 4.0 generic core scales for young child (5-7 years), and child (5-7 years), and child aged 8-12 Years: Quality of life in urban and rural children in Lebanon. Creative Education, 3, 959-970. doi:10.4236/ce.2012.326146
[43] Sabbah, I., Sabbah, H., Sabbah, S., Akoum, H. and Droubi, N. (2012) Burnout among Lebanese nurses: Psychometric properties of the Maslach burnout inventory-human services survey (MBI-HSS). Health, 4, 644-652. doi:10.4236/health.2012.49101
[44] Farhood, S.L. and Noureddine, S.N. (2003) PTSD, depression, and health status in Lebanese civilians exposed to a church explosion. International Journal of Psychiatry in Medicine, 33, 39-53.
[45] Maroun, N., Kahi, H., Chemaly, N., ElKahi, H. and Akl, E.A. (2013) Needs assessment for a university-based youth clinic in Beirut, Lebanon: A mixed quantitative and qualitative study. The Open Public Health Journal, 6, 21-30.
[46] Harb, C. (2010) Describing the Lebanese youth: A national and psycho-social survey. Youth in the Arab world, Working Paper Series #3.
[47] Mahfoud, Z., Abdulrahim, S., Taha, M.B., Harpham, T., El Hajj, T., Makhoul, J., Nakkash, R., Kanj, M. and Afifi, R. (2011) Validation of the Arab youth mental health scale as a screening tool for depression/anxiety in Lebanese children. Child and Adolescent Psychiatry and Mental Health, 5, 9. doi:10.1186/1753-2000-5-9
[48] Ware, J.E. (1997) SF-36 health survey: Manual and interpretation guide. The Health Institute, New England Medical Center, Boston.
[49] Gan-Yadam, A., Shinohara, R., Sugisawa, Y., Tanaka, E., Watanabe, T., Hirano, M., Tomisaki, E., et al. (2012) Self-assessed health and its aspects in the case of Mongolia. Health, 4, 415-422. doi:10.4236/health.2012.47065
[50] Williams, J.S. and Cunich, M. (2013) The impact of socioeconomic status on changes in the general and mental health of women over time: Evidence from a longitudinal study of Australian women. International Journal for Equity in Health, 12, 25. doi:10.1186/1475-9276-12-25.
[51] National Union of Students Scotland (2010) Silently stressed: A survey into student mental wellbeing, Edinburgh.
[52] Ministry of Education, Ministry of Health in Lebanon (2005) Lebanon, 2005 global school-based student health, Beirut.
[53] Franca, L.R., Dautzenberg, B., Falissard, B. and Reynaud, M. (2010) Peer substance use overestimation among French university students: A cross-sectional survey. BMC Public Health, 10, 169. doi:10.1186/1471-2458-10-169
[54] United Nations (1948) Universal declaration of human rights (Article 22 and Article 2).
[55] Gahagan, J.C., Jason, T. and Pender, C. (2011) Promoting adolescent males’ health: Utilization of school-based youth health centers in Nova Scotia, Canada. Journal of Community Medicine & Health Education, 1, 112.
[56] Block, E., Crochet, F., Jones, L. and Papa, T. (2012) The importance of teacher’s effectiveness. Creative Education, 3, 1164-1172. doi:10.4236/ce.2012.326173
[57] Vogl, L.E., Teesson, M., Newton, N.C. and Andrews, G. (2012) Developing a school-based drug prevention program to overcome barriers to effective program implementation: The CLIMATE schools: Alcohol module. Open Journal of Preventive Medicine, 2, 410-422. doi:10.4236/ojpm.2012.23059

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.