Abstract
Background Medical training is globally recognized as a period marked by significant psychological and lifestyle challenges that may adversely impact students' quality of life (QoL). This issue is particularly critical in low-resource settings, such as Angola, where contextual stressors may further exacerbate these challenges and where no data on the QoL of medical students were previously available. Aim To assess the QoL and its determinants among medical students at Agostinho Neto University in Luanda, Angola. Methods A cross-sectional study was conducted using a convenience sample of 289 undergraduate medical students at the Faculty of Medicine of Agostinho Neto University (FMUAN) in Luanda, Angola. A cross-culturally adapted version of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire was used to assess QoL across four domains: physical, psychological, social relationships, and environment. Data were collected through self-completion of the questionnaire at the university facilities. Statistical analyses included descriptive statistics, t-test, ANOVA, chi-square tests, Pearson correlation, and multivariate regression, the latter of which was applied to identify factors associated with QoL domains. Results The sample consisted of 59.2% females, with a mean age of 26.09±6.99 years. Female students were more prevalent in younger age categories (p=0.001), and most students (84.8%) did not report chronic illnesses. The WHOQOL-BREF instrument demonstrated very good internal consistency (Cronbach's alpha=0.840). Overall, QoL domain scores were low, with the environmental domain showing the lowest mean (45.19±15.70), followed by the physical domain (53.85±15.55). Conversely, the psychological domain had the highest mean score (70.30±11.52). Male students scored significantly lower in the social relationships (62.89 vs. 67.86) and environmental (40.81 vs. 47.14) domains, while female students scored lower in the psychological domain (68.40 vs. 71.63). QoL scores varied across academic years, with third-year students consistently reporting higher scores across most domains, whereas second- and sixth-year students reported the lowest scores. The presence of chronic illnesses was associated with lower QoL in the physical (p=0.016), psychological (p=0.015), and environmental (p=0.007) domains. Most students rated their overall QoL as "neither good nor bad" (51.9%), and about half were satisfied with their health (50.5%). Regression analysis showed that being in the third year and having better perceived overall QoL positively predicted QoL in the physical (β=14.54 and β=10.60, respectively), psychological (β=5.26 and β=5.64, respectively), and social domains (β=6.03 and β=16.27, respectively). Conversely, being a sixth-year student (β=-5.86) and being female (β=-3.72) negatively predicted physical and psychological QoL, respectively. Conclusions Our findings highlight generally low QoL scores among medical students in Angola, especially in the environmental and physical domains and notably during the initial and final academic years. Being in the third year and having a positive self-assessment of overall QoL emerged as protective factors, while female gender and being a sixth-year student were associated with poorer QoL. These insights underscore the necessity of targeted interventions to address the determinants of QoL and support student well-being in resource-constrained medical education settings such as Angola.