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【摘要】 目的 ①运用SF-36量表评估几内亚大学生的生活质量；②探讨几内亚大学生生活质量的影响因素。方法 从2013年4月1日至2013年6月1日开展横断面研究。运用多阶段分层随机抽样在纳赛尔大学（科纳克里）获得样本。测量工具由两部分组成：自行设计的社会人口学资料调查问卷和法语版本的SF-36量表[10]。运用线性回归分析生活质量的主要影响因素。采用SPSS18.0完成统计分析。结果 本次研究共调查了400名学生，收回有效问卷381份。学生年龄在17-28（22.78±2.07）岁之间，男性占68%，单身占90.6%。生活质量调查表8个维度的平均得分分别为PF：73.0，RP：51.7，BP：69.5，GH：58.8，VT：50.2，SF：69.5，RE：50.6，MH：62.6。本研究发现，对于PF和MH两个维度，男生得分高于女生；有学习压力的同学在BP、RE和GH三个维度得分较低，另外，居住地区对于大学生生活质量的影响也具有统计学意义。结论 大学生生活质量有待提高。几内亚大学生生活质量的主要影响因素包括：年龄、性别、专业、年级、居住地区、兼职类型、睡眠时间以及学习压力。
【关键词】 生活质量；SF-36；大学生；几内亚
doi：10.3969/j.issn.1004-7484（x）.2014.04.585
文章編号：1004-7484（2014）-04-2270-03
【Abstract】Objectives The aims of this study were：1.to assess the college students’ quality of life（QOL）in Guinea using SF-36 questionnaire；2.To explore its predicting factors.Methods A cross-sectional study was conducted from April 1st to June 1st，2013.Multiple stratified random sampling methods were used to get the sample in Gamal Abdel Nasser University in Conakry（Guinea）.Measurement in the research was composed by two parts：a demographic information questionnaire made by us and the French language version of the MOS 36-Item Short Form Health Survey（SF-36）[10].The relationship between QOL and the possible predicting factors was examined using linear regression analysis.Statistical analysis was performed by SPSS 18.0.Results A total of 400 students were recruited in the research，and 381 valid questionnaires were collected.Students aged between 17 and 28 years（22.78 ± 2.07）；the majority was men（68%）and single（90.6%）.The mean score of QOL were 73.0，51.7，69.5，58.8，50.2，69.5，50.6 and 62.6 respectively in the PF，RP，BP，GH，VT，SF，RE，and MH domains.In the study，male students scored higher than female students in PF and MH domains.Older students reported higher score in VT domain.Students with study pressure reported lower score in BP，RE and GH domains.Students studying in medical sciences had lower scores than students in computer sciences in BP，GH and VT domains.Also，the residence area was a statistical significant predictor on college students’ QOL.Conclusion The QOL of college students need to be improved.Main predicting factors of college students’ QOL in Republic of Guinea include age，gender，type of faculty，study grade，area，part-time job，sleeping time and the pressure of study.
【Keywords】 Quality of life；SF-36；College students；University，Guinea.
1 INTRODUCTION
QOL is defined by the WHO as ”an individual’s perception of their position in life in the context of the culture and value systems in which they live，and in relation to their goals，expectations，standards and concerns” [1].Health is defined as “a state of complete physical，mental and social wellbeing and not merely the absence of disease and infirmity”.It is an important factor for academic achievement at school，and in higher education[2]. Several studies have demonstrated the importance of QOL assessment among different groups of people，including university students.University life，where major life transition occurs，has often been recognized as a stressful period in one’s life that can result in lowered levels of QOL[3].
The transition from high school to college presents many challenges[4].The university students are subjected to different kinds of stressors，such as academic pressures，social issues and financial problems[5].Their health habits are a special concern，since they represent a major segment of the young population and they are at a stage of their lives during which important lifestyle modifications take place.If these changes become fixed routines，they are likely to determine the person’s future health[6].
The QOL is culture depended.QOL among university students has never been assessed in Guinea，despite the fact that it’s measuring enables researchers and policy makers to perceive trends in the student well-being，to evaluate the remote effects of education process，health and social policies，and to determine allocation of resources.Also，there is no pre-information about the predicting factors in Guinea.
Thus，the current study aims to：1）assess the quality of life（QOL）of college students in Guinea using SF-36 questionnaire，and 2）explore its predicting factors.After that，recommendation could be made to establish an evidence-based decision-making for the implementation of health promotion structure in university setting in Guinea.
2 METHODS
2.1 Data Collection This cross-sectional survey was conducted at Gamal Abdel Nasser University in Conakry from April 1st to June 1st 2013，using a multiple stratified random sampling method [7].
2.2 Instruments Two instruments were used for data collection：（1）a sociodemographic questionnaire to obtain information about students’ age，gender，grade，marital status，and their parents’（father and mother）education level，occupation and monthly income；and（2）a French version of the MOS 36-Item Short Form Health Survey（SF-36）.
The SF-36 is a well-known generic QOL that has been developed in the United State of America and translated into a variety of languages [8].The SF-36 addresses both physical and emotional health states and provides validated scores indicating health variations in eight domains：physical functioning（PF），role physical（RP），bodily pain（BP），general health perception（GH），vitality（VT），social functioning（SF），role emotional（RE），and mental health（MH）.There is in addition a single-item measure of Health Transition（HT）.Each domain is scored from 0to 100，with a higher score indicating better function [9].The convergent and discriminant validity of French version of SF-36 is 100% and 97.9% respectively，and the reliability index of PF，RP，BP，GH，VT，SF，RE and MH are 0.92，0.84，0.78，0.77，0.81，0.77，0.76 and 0.86 respectively，ranged from 0.76 to 0.92 [10]. This study was approved by the ethics committee of Central South University.Students who decide to participate were also informed that the information collected would be anonymous.Participants were required to complete the questionnaire by self-administration.
2.3 Statistical Analysis The Chi-square statistics（x2）were performed for demographic dimensions.Linear regression analysis was also performed to analyze the combined effect of predictors（independent variables）on SF-36 dimensions（dependent variables）.The Statistical Package for Social Science（SPSS）version 18.0 was used in the analysis of the data.All tests of significance were two-tailed.P ≤ 0.05 was taken as the critical level of significance.
3 REULTS
A sample of 400 undergraduate students was recruited.A total of 381 self-reported valid questionnaires were returned，that is 95.25% valid response rate.
3.1 Socio-demographic Characteristics The basic socio-demographics characteristics of participants stratified by gender are presented in Table 1.The participants’ age was between 17 and 28 years，with the mean equal to 22.78（SD = 2.07）.
3.2 QOL In the study，all of the respondents have correctly completed the questionnaire concerning QOL measure.The mean scale scores of SF-36 in each domain were showed in Table 2.The highest values of SF-36 were obtained for PF（73.0 ± 25.7）and the lowest values were obtained for VT（50.2±15.4）.
3.3 Predicting factors of QOL After linear regression analysis（Table 3），predictors were found in the eight domains respectively.For example，the predictors of PF were gender，type of faculty，the money gives by government，sleeping time，attending a conference and on satisfactory offers；these predictors positively influence students’ PF score except for gender and type of faculty.
According to the results of linear regression analysis，it was found out that female student had lower scores in PF and MH domains.The age of students was positively associated with VT.Students studying in medical sciences had lower scores in BP and VT domains but higher score in PF domain compared to students in polytechnic institute，and lower scores than students in faculty of sciences in GH domains.The scores of RP and RE increase with grade.Students living around Conakry had higher scores than those living in Conakry in RP and RE domains.Having part-time job after the course was linked to higher scores of RP，SF and RE，but lower score of VT.The score of PF increase with sleeping time.Students visiting a friend or going to drink bar two or more time in a month had higher scores in GH and MH domains respectively，while attending a conference showed opposite result in PF domain.Having study pressure or transport difficulties，or lacking of partner both had negatively influence on students’ QOL. 4 DISCUSSION
The aim of the current study was to assess the college students’ QOL and explore its predictors.
In our study，the results showed that the highest values of the SF-36 scales were obtained for PF and the lowest one for VT.These findings are compatible with those obtained in QOL studies of students in Serbia [11]，Turkey [12]，and Canada [13].
A comparison of SF-36 scores in our university students with the university students in Lebanon showed the higher scores in domains of BP，SF，RE，and MH；and lower in the domains of PF，RP，GH，and VT[14].These scores compared with the SF-36 scores in the Serbian college students，can show all of our domain scores were lower [11]，it is the same report when we compared them with the US general population aged 25-34 years [13].Unfortunately，the standard for the SF-36 questionnaire in the Guinean general population do not exist，thus there was no possibility to compare the QOL of students to our age-matched general population.
According to the gender，our study proved that，males students scored higher compared to female students in PF and MH dimensions of the QOL instruments.Following the study about QOL among medical students done in Brazil [15]，female students had lower SF-36 scores than males in the domains of PF，BP，VT，SF，and RE.This could be explained by the fact that women may experience a wider range of stressful life events compared to men [16-17].
Considering academic discipline，there are relationships between SF-36 scales and type of faculty in PF，BP，GH and VT domains；students studying in medical sciences had lower scores in BP and VT domains but higher score in PF domain compared to students in polytechnic institute，and lower scores than students in faculty of sciences in GH domain.In survey conducted in Lithuania，the similar results were obtained [18].Barbist et al.[19]emphasized that medical students might have a different perception of health and therefore value health status differently compared to the general population.
In this study，participants living around Conakry have higher scores than those living in Conakry in RP and RE domains.The results obtained by Sabbah et al.[11]in survey conduct in Lebanon，show that patients resident in rural areas had higher VT scores than those in urban areas.This could be explained by the fact that people living in urban areas may experience a wider range of stressful life events compared to those in rural areas.
5 CONCLUSIONSAND RECOMMENDATIONS In conclusion，the main predicting factors of the QOL of college students in Republic of Guinea include age，gender，type of faculty，study grade，area，part-time job，sleeping time and the pressure of study.The appropriate health-promoting actions，social support，and counseling services should be implemented in the campus.At the same time，it will be a necessary step towards the main goal of improving the overall QOL of university students in Guinea.It is not only in the best interests of an institution but also it is its responsibility to invest in a student’s wellbeing.In the future public health strategies，special attention should be paid on the improvement of psychological factors influencing QOL in college student population.
REFERENCES
[1] The World Health Organization Quality of Life Assessment（WHOQOL）：development and general psychometric properties.Soc Sci Med，1998，46（12）：p.1569-85.
[2] Mikolajczyk，R.T.，et al.Factors associated with self-rated health status in university students：a cross-sectional study in three European countries.BMC Public Health，2008，8（215）：p.1471-2458.
[3] Bhandari，P.，Stress and health related quality of life of Nepalese students studying in South Korea：A cross sectional study.Health and quality of life outcomes，2012，10（1）：p.1-9.
[4] Taylor，D.J.，et al.Epidemiology of Insomnia in College Students：Relationship with Mental Health，Quality of Life，and Substance Use Difficulties.Behavior therapy，2012.
[5] Klemenc-Ketis，Z.，et al.Factors associated with health-related quality of life among university students.Srp Arh Celok Lek，2011，139（3-4）：p.197-202.
[6] Madureira，A.S.，et al.[Association between stages of behavior change related to physical activity and nutritional status in university students].Cad Saude Publica，2009，25（10）：p.2139-46.
[7] Jha，A.，et al.Exploring the quality of life（QOL）in the Indian software industry：a public health viewpoint.Int J Public Health，2012，57（2）：p.371-81.
[8] Montazeri，A.，et al.The Short Form Health Survey（SF-36）：translation and validation study of the Iranian version.Qual Life Res，2005，14（3）：p.875-82.
[9] Taylor，D.J.and A.D.Bramoweth，Patterns and consequences of inadequate sleep in college students：substance use and motor vehicle accidents.Journal of Adolescent Health，2010，46（6）：p.610-612.
[10] Perneger，T.V.，et al.Validation of a French-language version of the MOS 36-Item Short Form Health Survey（SF-36）in young healthy adults.J Clin Epidemiol，1995，48（8）：p.1051-60. [11] Pekmezovic，T.，et al.Factors associated with health-related quality of life among Belgrade University students.Qual Life Res，2011，20（3）：p.391-7.
[12] Arslan，G.，et al.Prevalence of depression，its correlates among students，and its effect on health-related quality of life in a Turkish university.Ups J Med Sci，2009，114（3）：p.170-7.
[13] Raj，S.R.，et al.Health-related quality of life among final-year medical students.Cmaj，2000，162（4）：p.509-10.
[14] Sabbah，I.，et al.Health related quality of life of university students in Lebanon：Lifestyles behaviors and socio-demographic predictors.life，2013，1（15）：p.16.
[15] Paro，H.B.，et al.Health-related quality of life of medical students.Med Educ，2010，44（3）：p.227-35.
[16] Schmidt，M.，Predictors of self-rated health and lifestyle behaviours in Swedish university students.Glob J Health Sci，2012，4（4）：p.1-14.
[17] Sabbah，I.，et al.Quality of life in rural and urban populations in Lebanon using SF-36 health survey.Health Qual Life Outcomes，2003，1：p.30.
[18] Ducinskiene，D.，R.Kalediene，and J.Petrauskiene，Quality of life among Lithuanian university students.Acta Medica Lituanica，2003，10（2）：p.76-81.
[19] Barbist，M.T.et al.How do medical students value health on the EQ-5D？ Evaluation of hypothetical health states compared to the general population.Health Qual Life Outcomes，2008，6（111）：p.1477-7525.
【关键词】 生活质量；SF-36；大学生；几内亚
doi：10.3969/j.issn.1004-7484（x）.2014.04.585
文章編号：1004-7484（2014）-04-2270-03
【Abstract】Objectives The aims of this study were：1.to assess the college students’ quality of life（QOL）in Guinea using SF-36 questionnaire；2.To explore its predicting factors.Methods A cross-sectional study was conducted from April 1st to June 1st，2013.Multiple stratified random sampling methods were used to get the sample in Gamal Abdel Nasser University in Conakry（Guinea）.Measurement in the research was composed by two parts：a demographic information questionnaire made by us and the French language version of the MOS 36-Item Short Form Health Survey（SF-36）[10].The relationship between QOL and the possible predicting factors was examined using linear regression analysis.Statistical analysis was performed by SPSS 18.0.Results A total of 400 students were recruited in the research，and 381 valid questionnaires were collected.Students aged between 17 and 28 years（22.78 ± 2.07）；the majority was men（68%）and single（90.6%）.The mean score of QOL were 73.0，51.7，69.5，58.8，50.2，69.5，50.6 and 62.6 respectively in the PF，RP，BP，GH，VT，SF，RE，and MH domains.In the study，male students scored higher than female students in PF and MH domains.Older students reported higher score in VT domain.Students with study pressure reported lower score in BP，RE and GH domains.Students studying in medical sciences had lower scores than students in computer sciences in BP，GH and VT domains.Also，the residence area was a statistical significant predictor on college students’ QOL.Conclusion The QOL of college students need to be improved.Main predicting factors of college students’ QOL in Republic of Guinea include age，gender，type of faculty，study grade，area，part-time job，sleeping time and the pressure of study.
【Keywords】 Quality of life；SF-36；College students；University，Guinea.
1 INTRODUCTION
QOL is defined by the WHO as ”an individual’s perception of their position in life in the context of the culture and value systems in which they live，and in relation to their goals，expectations，standards and concerns” [1].Health is defined as “a state of complete physical，mental and social wellbeing and not merely the absence of disease and infirmity”.It is an important factor for academic achievement at school，and in higher education[2]. Several studies have demonstrated the importance of QOL assessment among different groups of people，including university students.University life，where major life transition occurs，has often been recognized as a stressful period in one’s life that can result in lowered levels of QOL[3].
The transition from high school to college presents many challenges[4].The university students are subjected to different kinds of stressors，such as academic pressures，social issues and financial problems[5].Their health habits are a special concern，since they represent a major segment of the young population and they are at a stage of their lives during which important lifestyle modifications take place.If these changes become fixed routines，they are likely to determine the person’s future health[6].
The QOL is culture depended.QOL among university students has never been assessed in Guinea，despite the fact that it’s measuring enables researchers and policy makers to perceive trends in the student well-being，to evaluate the remote effects of education process，health and social policies，and to determine allocation of resources.Also，there is no pre-information about the predicting factors in Guinea.
Thus，the current study aims to：1）assess the quality of life（QOL）of college students in Guinea using SF-36 questionnaire，and 2）explore its predicting factors.After that，recommendation could be made to establish an evidence-based decision-making for the implementation of health promotion structure in university setting in Guinea.
2 METHODS
2.1 Data Collection This cross-sectional survey was conducted at Gamal Abdel Nasser University in Conakry from April 1st to June 1st 2013，using a multiple stratified random sampling method [7].
2.2 Instruments Two instruments were used for data collection：（1）a sociodemographic questionnaire to obtain information about students’ age，gender，grade，marital status，and their parents’（father and mother）education level，occupation and monthly income；and（2）a French version of the MOS 36-Item Short Form Health Survey（SF-36）.
The SF-36 is a well-known generic QOL that has been developed in the United State of America and translated into a variety of languages [8].The SF-36 addresses both physical and emotional health states and provides validated scores indicating health variations in eight domains：physical functioning（PF），role physical（RP），bodily pain（BP），general health perception（GH），vitality（VT），social functioning（SF），role emotional（RE），and mental health（MH）.There is in addition a single-item measure of Health Transition（HT）.Each domain is scored from 0to 100，with a higher score indicating better function [9].The convergent and discriminant validity of French version of SF-36 is 100% and 97.9% respectively，and the reliability index of PF，RP，BP，GH，VT，SF，RE and MH are 0.92，0.84，0.78，0.77，0.81，0.77，0.76 and 0.86 respectively，ranged from 0.76 to 0.92 [10]. This study was approved by the ethics committee of Central South University.Students who decide to participate were also informed that the information collected would be anonymous.Participants were required to complete the questionnaire by self-administration.
2.3 Statistical Analysis The Chi-square statistics（x2）were performed for demographic dimensions.Linear regression analysis was also performed to analyze the combined effect of predictors（independent variables）on SF-36 dimensions（dependent variables）.The Statistical Package for Social Science（SPSS）version 18.0 was used in the analysis of the data.All tests of significance were two-tailed.P ≤ 0.05 was taken as the critical level of significance.
3 REULTS
A sample of 400 undergraduate students was recruited.A total of 381 self-reported valid questionnaires were returned，that is 95.25% valid response rate.
3.1 Socio-demographic Characteristics The basic socio-demographics characteristics of participants stratified by gender are presented in Table 1.The participants’ age was between 17 and 28 years，with the mean equal to 22.78（SD = 2.07）.
3.2 QOL In the study，all of the respondents have correctly completed the questionnaire concerning QOL measure.The mean scale scores of SF-36 in each domain were showed in Table 2.The highest values of SF-36 were obtained for PF（73.0 ± 25.7）and the lowest values were obtained for VT（50.2±15.4）.
3.3 Predicting factors of QOL After linear regression analysis（Table 3），predictors were found in the eight domains respectively.For example，the predictors of PF were gender，type of faculty，the money gives by government，sleeping time，attending a conference and on satisfactory offers；these predictors positively influence students’ PF score except for gender and type of faculty.
According to the results of linear regression analysis，it was found out that female student had lower scores in PF and MH domains.The age of students was positively associated with VT.Students studying in medical sciences had lower scores in BP and VT domains but higher score in PF domain compared to students in polytechnic institute，and lower scores than students in faculty of sciences in GH domains.The scores of RP and RE increase with grade.Students living around Conakry had higher scores than those living in Conakry in RP and RE domains.Having part-time job after the course was linked to higher scores of RP，SF and RE，but lower score of VT.The score of PF increase with sleeping time.Students visiting a friend or going to drink bar two or more time in a month had higher scores in GH and MH domains respectively，while attending a conference showed opposite result in PF domain.Having study pressure or transport difficulties，or lacking of partner both had negatively influence on students’ QOL. 4 DISCUSSION
The aim of the current study was to assess the college students’ QOL and explore its predictors.
In our study，the results showed that the highest values of the SF-36 scales were obtained for PF and the lowest one for VT.These findings are compatible with those obtained in QOL studies of students in Serbia [11]，Turkey [12]，and Canada [13].
A comparison of SF-36 scores in our university students with the university students in Lebanon showed the higher scores in domains of BP，SF，RE，and MH；and lower in the domains of PF，RP，GH，and VT[14].These scores compared with the SF-36 scores in the Serbian college students，can show all of our domain scores were lower [11]，it is the same report when we compared them with the US general population aged 25-34 years [13].Unfortunately，the standard for the SF-36 questionnaire in the Guinean general population do not exist，thus there was no possibility to compare the QOL of students to our age-matched general population.
According to the gender，our study proved that，males students scored higher compared to female students in PF and MH dimensions of the QOL instruments.Following the study about QOL among medical students done in Brazil [15]，female students had lower SF-36 scores than males in the domains of PF，BP，VT，SF，and RE.This could be explained by the fact that women may experience a wider range of stressful life events compared to men [16-17].
Considering academic discipline，there are relationships between SF-36 scales and type of faculty in PF，BP，GH and VT domains；students studying in medical sciences had lower scores in BP and VT domains but higher score in PF domain compared to students in polytechnic institute，and lower scores than students in faculty of sciences in GH domain.In survey conducted in Lithuania，the similar results were obtained [18].Barbist et al.[19]emphasized that medical students might have a different perception of health and therefore value health status differently compared to the general population.
In this study，participants living around Conakry have higher scores than those living in Conakry in RP and RE domains.The results obtained by Sabbah et al.[11]in survey conduct in Lebanon，show that patients resident in rural areas had higher VT scores than those in urban areas.This could be explained by the fact that people living in urban areas may experience a wider range of stressful life events compared to those in rural areas.
5 CONCLUSIONSAND RECOMMENDATIONS In conclusion，the main predicting factors of the QOL of college students in Republic of Guinea include age，gender，type of faculty，study grade，area，part-time job，sleeping time and the pressure of study.The appropriate health-promoting actions，social support，and counseling services should be implemented in the campus.At the same time，it will be a necessary step towards the main goal of improving the overall QOL of university students in Guinea.It is not only in the best interests of an institution but also it is its responsibility to invest in a student’s wellbeing.In the future public health strategies，special attention should be paid on the improvement of psychological factors influencing QOL in college student population.
REFERENCES
[1] The World Health Organization Quality of Life Assessment（WHOQOL）：development and general psychometric properties.Soc Sci Med，1998，46（12）：p.1569-85.
[2] Mikolajczyk，R.T.，et al.Factors associated with self-rated health status in university students：a cross-sectional study in three European countries.BMC Public Health，2008，8（215）：p.1471-2458.
[3] Bhandari，P.，Stress and health related quality of life of Nepalese students studying in South Korea：A cross sectional study.Health and quality of life outcomes，2012，10（1）：p.1-9.
[4] Taylor，D.J.，et al.Epidemiology of Insomnia in College Students：Relationship with Mental Health，Quality of Life，and Substance Use Difficulties.Behavior therapy，2012.
[5] Klemenc-Ketis，Z.，et al.Factors associated with health-related quality of life among university students.Srp Arh Celok Lek，2011，139（3-4）：p.197-202.
[6] Madureira，A.S.，et al.[Association between stages of behavior change related to physical activity and nutritional status in university students].Cad Saude Publica，2009，25（10）：p.2139-46.
[7] Jha，A.，et al.Exploring the quality of life（QOL）in the Indian software industry：a public health viewpoint.Int J Public Health，2012，57（2）：p.371-81.
[8] Montazeri，A.，et al.The Short Form Health Survey（SF-36）：translation and validation study of the Iranian version.Qual Life Res，2005，14（3）：p.875-82.
[9] Taylor，D.J.and A.D.Bramoweth，Patterns and consequences of inadequate sleep in college students：substance use and motor vehicle accidents.Journal of Adolescent Health，2010，46（6）：p.610-612.
[10] Perneger，T.V.，et al.Validation of a French-language version of the MOS 36-Item Short Form Health Survey（SF-36）in young healthy adults.J Clin Epidemiol，1995，48（8）：p.1051-60. [11] Pekmezovic，T.，et al.Factors associated with health-related quality of life among Belgrade University students.Qual Life Res，2011，20（3）：p.391-7.
[12] Arslan，G.，et al.Prevalence of depression，its correlates among students，and its effect on health-related quality of life in a Turkish university.Ups J Med Sci，2009，114（3）：p.170-7.
[13] Raj，S.R.，et al.Health-related quality of life among final-year medical students.Cmaj，2000，162（4）：p.509-10.
[14] Sabbah，I.，et al.Health related quality of life of university students in Lebanon：Lifestyles behaviors and socio-demographic predictors.life，2013，1（15）：p.16.
[15] Paro，H.B.，et al.Health-related quality of life of medical students.Med Educ，2010，44（3）：p.227-35.
[16] Schmidt，M.，Predictors of self-rated health and lifestyle behaviours in Swedish university students.Glob J Health Sci，2012，4（4）：p.1-14.
[17] Sabbah，I.，et al.Quality of life in rural and urban populations in Lebanon using SF-36 health survey.Health Qual Life Outcomes，2003，1：p.30.
[18] Ducinskiene，D.，R.Kalediene，and J.Petrauskiene，Quality of life among Lithuanian university students.Acta Medica Lituanica，2003，10（2）：p.76-81.
[19] Barbist，M.T.et al.How do medical students value health on the EQ-5D？ Evaluation of hypothetical health states compared to the general population.Health Qual Life Outcomes，2008，6（111）：p.1477-7525.