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Mansouri M, Mehravar F, Feghhi H, Barati F. The association between happiness and meaning of life in students of Golestan University of Medical Sciences, Iran. IJHMD 2025; 2 (2) :1-6
URL: http://jhd.goums.ac.ir/article-1-54-en.html
URL: http://jhd.goums.ac.ir/article-1-54-en.html
1- Student Research Committee, Golestan University of Medical Sciences, Golestan, Iran
2- Ischemic Disorders Research Center, Jorjani Clinical sciences Research Institute, Golestan University of Medical Sciences, Gorgan, Iran
3- York University, Toronto, Ontario, Canada, North America
4- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Golestan, Iran ,farzanehb86@yahoo.com
2- Ischemic Disorders Research Center, Jorjani Clinical sciences Research Institute, Golestan University of Medical Sciences, Gorgan, Iran
3- York University, Toronto, Ontario, Canada, North America
4- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Golestan, Iran ,
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Introduction
The pursuit of meaning and happiness represents a fundamental aspect of human psychological well-being. Meaning in life, encompassing both the presence of purpose and the active search for it, provides a critical framework for understanding human experience (1-3). A substantial body of literature has demonstrated that a strong sense of meaning is positively associated with key indicators of well-being, including happiness, life satisfaction, and general health, while being inversely related to depression, anxiety, and stress (4-10). Happiness itself is recognized as a core psychological need and a multifaceted construct, shaped by the interaction of internal dispositions and external sociocultural, economic, and environmental factors (10-13).
University students, particularly those engaged in medical education, constitute a population exposed to considerable psychological strain. The transition to adulthood, combined with intensive academic demands, financial pressures, and, for medical students, early clinical exposure to suffering and death, creates a high-risk environment for reduced well-being (14,15). Global trends indicating increasing dissatisfaction and depressive symptoms further underscore the urgency of this issue (15,16). Existing research provides a baseline, suggesting that students often report only moderate levels of both happiness and meaning in life. For example, studies among Iranian and Turkish students have reported suboptimal or lower-than-normal scores on these constructs (21,22). Although a positive correlation (R = 0.45 - 0.60) between the presence of meaning and happiness is consistently observed in student samples, the dynamics of this relationship within specific high-stress academic contexts require further investigation (23).
Despite this existing knowledge, significant gaps remain. There is a paucity of research that simultaneously examines both dimensions of meaning - presence and search - in relation to happiness, particularly within non-Western cultural contexts (24,25). Moreover, although the mental health challenges faced by medical students are well documented (26), fewer studies have specifically explored the potential protective role of meaning in life in relation to their happiness. This study seeks to address these gaps by examining the association between meaning in life and happiness among medical students at Golestan University of Medical Sciences in Iran. The findings are intended to contribute to a more nuanced understanding of well-being in this vulnerable student population and to inform the development of targeted support strategies.
Methods
This analytical cross-sectional study was conducted among Iranian, Persian-speaking students enrolled at Golestan University of Medical Sciences in Gorgan, Iran, during the academic period from September 2023 to June 2024. Participants were required to meet three key eligibility criteria: (1) Current full-time enrollment at Golestan University of Medical Sciences, (2) completion of at least two academic semesters, and (3) voluntary provision of informed consent to participate in the study. These criteria ensured that participants had sufficient academic exposure to the university environment while adhering to ethical research standards through appropriate consent procedures.
The required sample size was calculated for a Pearson correlation analysis examining the association between happiness and meaning in life. Based on Cohen’s (1988) conventions for correlation studies, a small effect size (R = 0.12) was assumed, reflecting conservative estimates from prior literature on similar psychosocial constructs (27). Using G*Power 3.1, with a significance level (α) of 0.05 and statistical power (1 - β) of 95%, and accounting for potential covariates (e.g., age and gender), the minimum required sample size was estimated to be 423 participants. To ensure adequate statistical power, allow for subgroup analyses, and reduce the impact of non-response bias, the target sample size was increased to 500 students.
A stratified convenience sampling approach (Non-probability stratified sampling) was employed, in which each faculty within the university was treated as a distinct stratum. The sample size allocated to each stratum was determined proportionally based on student enrollment numbers within each school. Following stratification, participants were selected through convenience sampling from each school population. After estimating the total sample size, a proportion of the sample corresponding to the size of each school was allocated accordingly.
Data were collected using three instruments: (1) A demographic information form (age, gender, ethnicity, educational level, school, residential status, and employment status), (2) the standardized Oxford Happiness Questionnaire (OHQ), and (3) Crumbaugh and Maholick’s Purpose in Life Test (PIL). The PIL is a 20-item instrument designed to assess existential purpose and meaning in life, with responses rated on a 7-point Likert scale (28). The total score is obtained by summing all item responses, yielding a composite score ranging from 20 to 140, with higher scores indicating a greater self-reported sense of existential meaning and purpose in life. Developed in accordance with Frankl’s logotherapy principles, the PIL demonstrates strong content validity (29). In the Iranian context, the instrument has shown excellent reliability (Cronbach’s α = 0.93) when administered to 206 students at Mashhad University using stratified random sampling (30).
The Oxford Happiness Questionnaire (OHQ) is a validated 29-item self-report instrument designed to assess subjective happiness across multiple psychological domains, including positive affect, life satisfaction, and personal fulfillment. Using a four-point Likert scale, the questionnaire yields a total score ranging from 0 to 87, with scores below 40 - 42 indicating clinically significant depressive symptomatology (31). The psychometric properties of the Persian version were previously validated in a sample of 727 Iranian university students by Liaghatdar et al. (2008), demonstrating strong internal consistency (Cronbach’s α = 0.87) and acceptable test–retest reliability over a two-week interval (R = 0.82), thereby supporting its suitability for use in the present study (32).
The questionnaires were administered through supervised, paper-based sessions conducted on campus. A trained researcher provided standardized instructions, ensured confidentiality, and collected completed questionnaires to maximize response completeness and minimize variability. Data were analyzed using SPSS version 26 and included descriptive statistics, normality testing, and bivariate analyses (t-test, ANOVA, and Pearson’s correlation). A multivariable linear regression model (Adjusted R2 = 0.45) was used to assess the association between happiness (Independent variable) and meaning in life (Dependent variable), adjusting for gender, ethnicity, income, and employment status. All statistical assumptions were verified, and the significance level was set at 0.05.
Results
A total of 457 students participated in the study (Response rate: 91.4%), of whom 68.3% were female, with a mean age of 24.13 ± 9.12 years. Most participants were enrolled in the faculties of Nursing (33%) and Medicine (28.4%). As shown in Table 1, the mean scores for happiness and meaning in life were 38.58 ± 12.54 and 95.88 ± 18.76, respectively. Overall, 5.7% of students were within the normal range for happiness (Scores of 40 to 42), whereas 54.3% were below the desirable range for happiness (scores less than 40). The results further indicated that gender (P = 0.0001), ethnicity (P = 0.030), educational level (P = 0.030), school (P = 0.020), residential status (P = 0.020), and employment status (P = 0.040) were significantly associated with happiness scores among medical students.
The pursuit of meaning and happiness represents a fundamental aspect of human psychological well-being. Meaning in life, encompassing both the presence of purpose and the active search for it, provides a critical framework for understanding human experience (1-3). A substantial body of literature has demonstrated that a strong sense of meaning is positively associated with key indicators of well-being, including happiness, life satisfaction, and general health, while being inversely related to depression, anxiety, and stress (4-10). Happiness itself is recognized as a core psychological need and a multifaceted construct, shaped by the interaction of internal dispositions and external sociocultural, economic, and environmental factors (10-13).
University students, particularly those engaged in medical education, constitute a population exposed to considerable psychological strain. The transition to adulthood, combined with intensive academic demands, financial pressures, and, for medical students, early clinical exposure to suffering and death, creates a high-risk environment for reduced well-being (14,15). Global trends indicating increasing dissatisfaction and depressive symptoms further underscore the urgency of this issue (15,16). Existing research provides a baseline, suggesting that students often report only moderate levels of both happiness and meaning in life. For example, studies among Iranian and Turkish students have reported suboptimal or lower-than-normal scores on these constructs (21,22). Although a positive correlation (R = 0.45 - 0.60) between the presence of meaning and happiness is consistently observed in student samples, the dynamics of this relationship within specific high-stress academic contexts require further investigation (23).
Despite this existing knowledge, significant gaps remain. There is a paucity of research that simultaneously examines both dimensions of meaning - presence and search - in relation to happiness, particularly within non-Western cultural contexts (24,25). Moreover, although the mental health challenges faced by medical students are well documented (26), fewer studies have specifically explored the potential protective role of meaning in life in relation to their happiness. This study seeks to address these gaps by examining the association between meaning in life and happiness among medical students at Golestan University of Medical Sciences in Iran. The findings are intended to contribute to a more nuanced understanding of well-being in this vulnerable student population and to inform the development of targeted support strategies.
Methods
This analytical cross-sectional study was conducted among Iranian, Persian-speaking students enrolled at Golestan University of Medical Sciences in Gorgan, Iran, during the academic period from September 2023 to June 2024. Participants were required to meet three key eligibility criteria: (1) Current full-time enrollment at Golestan University of Medical Sciences, (2) completion of at least two academic semesters, and (3) voluntary provision of informed consent to participate in the study. These criteria ensured that participants had sufficient academic exposure to the university environment while adhering to ethical research standards through appropriate consent procedures.
The required sample size was calculated for a Pearson correlation analysis examining the association between happiness and meaning in life. Based on Cohen’s (1988) conventions for correlation studies, a small effect size (R = 0.12) was assumed, reflecting conservative estimates from prior literature on similar psychosocial constructs (27). Using G*Power 3.1, with a significance level (α) of 0.05 and statistical power (1 - β) of 95%, and accounting for potential covariates (e.g., age and gender), the minimum required sample size was estimated to be 423 participants. To ensure adequate statistical power, allow for subgroup analyses, and reduce the impact of non-response bias, the target sample size was increased to 500 students.
A stratified convenience sampling approach (Non-probability stratified sampling) was employed, in which each faculty within the university was treated as a distinct stratum. The sample size allocated to each stratum was determined proportionally based on student enrollment numbers within each school. Following stratification, participants were selected through convenience sampling from each school population. After estimating the total sample size, a proportion of the sample corresponding to the size of each school was allocated accordingly.
Data were collected using three instruments: (1) A demographic information form (age, gender, ethnicity, educational level, school, residential status, and employment status), (2) the standardized Oxford Happiness Questionnaire (OHQ), and (3) Crumbaugh and Maholick’s Purpose in Life Test (PIL). The PIL is a 20-item instrument designed to assess existential purpose and meaning in life, with responses rated on a 7-point Likert scale (28). The total score is obtained by summing all item responses, yielding a composite score ranging from 20 to 140, with higher scores indicating a greater self-reported sense of existential meaning and purpose in life. Developed in accordance with Frankl’s logotherapy principles, the PIL demonstrates strong content validity (29). In the Iranian context, the instrument has shown excellent reliability (Cronbach’s α = 0.93) when administered to 206 students at Mashhad University using stratified random sampling (30).
The Oxford Happiness Questionnaire (OHQ) is a validated 29-item self-report instrument designed to assess subjective happiness across multiple psychological domains, including positive affect, life satisfaction, and personal fulfillment. Using a four-point Likert scale, the questionnaire yields a total score ranging from 0 to 87, with scores below 40 - 42 indicating clinically significant depressive symptomatology (31). The psychometric properties of the Persian version were previously validated in a sample of 727 Iranian university students by Liaghatdar et al. (2008), demonstrating strong internal consistency (Cronbach’s α = 0.87) and acceptable test–retest reliability over a two-week interval (R = 0.82), thereby supporting its suitability for use in the present study (32).
The questionnaires were administered through supervised, paper-based sessions conducted on campus. A trained researcher provided standardized instructions, ensured confidentiality, and collected completed questionnaires to maximize response completeness and minimize variability. Data were analyzed using SPSS version 26 and included descriptive statistics, normality testing, and bivariate analyses (t-test, ANOVA, and Pearson’s correlation). A multivariable linear regression model (Adjusted R2 = 0.45) was used to assess the association between happiness (Independent variable) and meaning in life (Dependent variable), adjusting for gender, ethnicity, income, and employment status. All statistical assumptions were verified, and the significance level was set at 0.05.
Results
A total of 457 students participated in the study (Response rate: 91.4%), of whom 68.3% were female, with a mean age of 24.13 ± 9.12 years. Most participants were enrolled in the faculties of Nursing (33%) and Medicine (28.4%). As shown in Table 1, the mean scores for happiness and meaning in life were 38.58 ± 12.54 and 95.88 ± 18.76, respectively. Overall, 5.7% of students were within the normal range for happiness (Scores of 40 to 42), whereas 54.3% were below the desirable range for happiness (scores less than 40). The results further indicated that gender (P = 0.0001), ethnicity (P = 0.030), educational level (P = 0.030), school (P = 0.020), residential status (P = 0.020), and employment status (P = 0.040) were significantly associated with happiness scores among medical students.
|
Table 1. The mean scores of the meaning of life and happiness by characteristics of medical sciences students in Golestan, N=457
.PNG) *Independent t test or ANOVA tests |
Furthermore, residential status (P = 0.020) and employment status (P < 0.001) showed statistically significant associations with students’ meaning in life scores. Employed students reported significantly higher levels of happiness (41.49 ± 12.89, P = 0.040) and meaning in life (101.95 ± 19.25, P < 0.001) compared with unemployed students. Analysis of demographic characteristics revealed significant variations in happiness and meaning in life among medical students. Male students reported significantly higher happiness scores (42.28 ± 12.14) than female students (36.86 ± 12.37, P < 0.001), whereas no significant gender difference was observed in meaning in life scores (P = 0.710). Ethnicity was also significantly associated with happiness (P = 0.030), with Sistani students reporting the highest happiness scores (42.33 ± 11.71), while Turk students exhibited the lowest meaning in life scores (87.50 ± 21.46). Higher family income (Over 20 million Tomans) was associated with greater happiness (39.83 ± 12.90) and meaning in life (98.11 ± 18.17); however, these differences were not statistically significant (P > 0.05). Students enrolled in the Doctor of Medicine program demonstrated higher levels of happiness (40.18 ± 13.00) and meaning in life (96.82 ± 18.26) compared with students in other academic levels (P = 0.030 for happiness and P = 0.045 for meaning in life).
As shown in Table 2, Pearson’s correlation analysis indicated a strong positive correlation between happiness and age (R = 0.63, P = 0.0001). A weak but statistically significant positive correlation was also observed between happiness and grade point average (GPA) (R = 0.11, P = 0.020). No significant correlations were found between happiness and the number of family members (R = 0.01, P = 0.670), birth rank (R = 0.04, P = 0.300), academic semester (R = -0.06, P = 0.190), or age (R = 0.01, P = 0.720). In addition, Pearson’s correlation analysis showed no significant associations between meaning in life and any of the examined variables, including age (R = 0.05, P = 0.230), number of family members (R = 0.06, P = 0.150), birth rank (R = 0.01, P = 0.760), academic semester (R = -0.05, P = 0.280), or GPA (R = 0.08, P = 0.080).
As shown in Table 2, Pearson’s correlation analysis indicated a strong positive correlation between happiness and age (R = 0.63, P = 0.0001). A weak but statistically significant positive correlation was also observed between happiness and grade point average (GPA) (R = 0.11, P = 0.020). No significant correlations were found between happiness and the number of family members (R = 0.01, P = 0.670), birth rank (R = 0.04, P = 0.300), academic semester (R = -0.06, P = 0.190), or age (R = 0.01, P = 0.720). In addition, Pearson’s correlation analysis showed no significant associations between meaning in life and any of the examined variables, including age (R = 0.05, P = 0.230), number of family members (R = 0.06, P = 0.150), birth rank (R = 0.01, P = 0.760), academic semester (R = -0.05, P = 0.280), or GPA (R = 0.08, P = 0.080).
|
Table 2. The correlation coefficients of mean scores of happiness and meaning of life with characteristics of medical sciences students in Golestan, N=457
.PNG) |
|
Table 3. Multivariable linear regression analysis of the association between happiness and meaning in life, adjusted for confounding variables (N=457)
.PNG) |
Discussion
The present study identified a positive correlation between meaning in life and happiness among medical students, which is consistent with previous research demonstrating a significant relationship between these constructs (33). Supporting evidence also indicates that meaning in life is negatively correlated with anxiety, suggesting a buffering effect against psychological stress (34). The broader literature further confirms that a sense of purpose enhances coping abilities, information processing, and future orientation (35,36), thereby serving as an important adaptive resource (2,6,37). The mean meaning in life score observed in this study (95.88) reflects a moderate to high level among students, a finding that is consistent with reports from other Iranian student populations (38,39).
The study also found that male students reported significantly higher happiness scores than female students. This finding is consistent with the results reported by Sharifi et al. (40), but contrasts with studies that have found no significant gender differences (41) or higher happiness scores among female students (42). Additionally, other studies have documented associations between gender and meaning in life, further supporting the relevance of gender as an influential factor in psychological well-being (43,44).
Educational level and type of school were not significantly associated with meaning in life among students; however, both variables were related to happiness scores. Specifically, students at the Master’s and Doctoral levels reported the highest happiness scores, a finding consistent with some previous studies. The highest levels of happiness were observed among students in the School of Dentistry, whereas the lowest scores were reported by students in the School of New Technologies. Similarly, Chaleshgar-Kordasiabi et al. reported higher happiness scores among dental students compared with those in other faculties (45). This pattern may be attributed to the relatively high professional status of dentistry or to characteristics of the profession itself, which may contribute to greater satisfaction with the chosen field of study. As also noted by Thomas, satisfaction with one’s field of study plays an important role in student happiness (46). In contrast, some studies, such as that conducted by Jiang et al. (47), did not identify a significant relationship in this regard.
The findings of the present study also indicated that students who were native to Golestan province and those living outside dormitories reported higher happiness scores, which is consistent with the results of some previous studies (40,48). In addition, a significant association was observed between ethnicity and happiness, with happiness levels ranked as follows: Sistanian, Turkmen, Other, Turk, and Fars. However, ethnicity was not significantly associated with meaning in life.
The study identified a significant association between overall GPA and happiness, which is consistent with findings from previous research (49). While academic achievement appears to be related to happiness, it does not show a significant association with meaning in life (50). The pursuit of meaningful goals has been shown to play an important role in cognitive and mental health within this population (51). Accordingly, educational planning in the medical sciences should place greater emphasis on strategies that enhance students’ happiness and overall satisfaction. Future studies should focus on developing and evaluating interventions that simultaneously target happiness and meaning in life, and students should be equipped with skills that promote psychological well-being and improve future professional performance.
This study has several limitations that should be acknowledged. Its cross-sectional design precludes causal inferences. The use of self-reported measures introduces the possibility of response bias. Convenience sampling may limit the generalizability of the findings, and unmeasured confounding variables could have influenced the observed associations. In addition, the Persian versions of the OHQ and PIL may not fully capture all cultural nuances related to happiness and meaning in life.
Conclusion
This study confirms a strong association between happiness and meaning in life among medical students, while also demonstrating that both constructs are influenced by demographic and socioeconomic factors. Overall, students exhibited moderate levels of well-being, with gender, ethnicity, and employment status independently predicting meaning in life. These findings underscore the need for tailored support programs that address specific vulnerabilities, particularly among female students, unemployed students, and certain ethnic minority groups.
Application of results
The strong correlation between happiness and meaning in life suggests that these constructs may mutually reinforce one another among medical students. Given that the majority of students scored below desirable levels of happiness, the implementation of targeted interventions should be prioritized. The significant associations with employment and residential status further highlight the importance of addressing socioeconomic factors within student support programs. Moreover, the observed relationship between happiness and academic performance (GPA) underscores the potential academic benefits of integrating well-being initiatives into medical education.
Recommendations for future research
To build on the present findings, future research should prioritize longitudinal study designs to clarify causal relationships between happiness, meaning in life, and academic outcomes. Intervention-based studies are also needed to develop and evaluate targeted well-being programs, particularly for demographic groups at higher risk. In addition, qualitative approaches and comparative multi-site studies are recommended to explore underlying contextual factors and enhance the generalizability of findings. Further investigations should examine differential outcomes across demographic subgroups and explore potential threshold effects whereby happiness exerts a significant influence on academic performance.
Acknowledgement
The authors sincerely thank the students who participated in the study for their time and cooperation. The authors also acknowledge the Student Research Committee Affairs at Golestan University of Medical Sciences for their support.
Funding sources
This project was financially supported by the Deputy of Research and Technology of Golestan University of Medical Sciences.
Ethical statement
Ethical approval for this study was obtained from the Ethics and Research Committee of Golestan University of Medical Sciences (IR.GOUMS.REC.1402.452). All procedures involving human participants adhered strictly to the principles of beneficence, non-maleficence, veracity, confidentiality, and voluntarism, in accordance with the Helsinki Declaration. Participants incurred no costs for participation, and no financial incentives were provided.
Conflicts of interest
The authors declare no conflicts of interest related to the material presented in this paper.
Author contributions
M. M., F. M., and F. B. conceptualized the study design. All authors contributed to the implementation of the study. F. M. performed the data analysis and interpretation. M. M. and F. M. drafted the manuscript. All authors participated in revising the manuscript, and all authors read and approved the final version.
Data availability statement
The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
The present study identified a positive correlation between meaning in life and happiness among medical students, which is consistent with previous research demonstrating a significant relationship between these constructs (33). Supporting evidence also indicates that meaning in life is negatively correlated with anxiety, suggesting a buffering effect against psychological stress (34). The broader literature further confirms that a sense of purpose enhances coping abilities, information processing, and future orientation (35,36), thereby serving as an important adaptive resource (2,6,37). The mean meaning in life score observed in this study (95.88) reflects a moderate to high level among students, a finding that is consistent with reports from other Iranian student populations (38,39).
The study also found that male students reported significantly higher happiness scores than female students. This finding is consistent with the results reported by Sharifi et al. (40), but contrasts with studies that have found no significant gender differences (41) or higher happiness scores among female students (42). Additionally, other studies have documented associations between gender and meaning in life, further supporting the relevance of gender as an influential factor in psychological well-being (43,44).
Educational level and type of school were not significantly associated with meaning in life among students; however, both variables were related to happiness scores. Specifically, students at the Master’s and Doctoral levels reported the highest happiness scores, a finding consistent with some previous studies. The highest levels of happiness were observed among students in the School of Dentistry, whereas the lowest scores were reported by students in the School of New Technologies. Similarly, Chaleshgar-Kordasiabi et al. reported higher happiness scores among dental students compared with those in other faculties (45). This pattern may be attributed to the relatively high professional status of dentistry or to characteristics of the profession itself, which may contribute to greater satisfaction with the chosen field of study. As also noted by Thomas, satisfaction with one’s field of study plays an important role in student happiness (46). In contrast, some studies, such as that conducted by Jiang et al. (47), did not identify a significant relationship in this regard.
The findings of the present study also indicated that students who were native to Golestan province and those living outside dormitories reported higher happiness scores, which is consistent with the results of some previous studies (40,48). In addition, a significant association was observed between ethnicity and happiness, with happiness levels ranked as follows: Sistanian, Turkmen, Other, Turk, and Fars. However, ethnicity was not significantly associated with meaning in life.
The study identified a significant association between overall GPA and happiness, which is consistent with findings from previous research (49). While academic achievement appears to be related to happiness, it does not show a significant association with meaning in life (50). The pursuit of meaningful goals has been shown to play an important role in cognitive and mental health within this population (51). Accordingly, educational planning in the medical sciences should place greater emphasis on strategies that enhance students’ happiness and overall satisfaction. Future studies should focus on developing and evaluating interventions that simultaneously target happiness and meaning in life, and students should be equipped with skills that promote psychological well-being and improve future professional performance.
This study has several limitations that should be acknowledged. Its cross-sectional design precludes causal inferences. The use of self-reported measures introduces the possibility of response bias. Convenience sampling may limit the generalizability of the findings, and unmeasured confounding variables could have influenced the observed associations. In addition, the Persian versions of the OHQ and PIL may not fully capture all cultural nuances related to happiness and meaning in life.
Conclusion
This study confirms a strong association between happiness and meaning in life among medical students, while also demonstrating that both constructs are influenced by demographic and socioeconomic factors. Overall, students exhibited moderate levels of well-being, with gender, ethnicity, and employment status independently predicting meaning in life. These findings underscore the need for tailored support programs that address specific vulnerabilities, particularly among female students, unemployed students, and certain ethnic minority groups.
Application of results
The strong correlation between happiness and meaning in life suggests that these constructs may mutually reinforce one another among medical students. Given that the majority of students scored below desirable levels of happiness, the implementation of targeted interventions should be prioritized. The significant associations with employment and residential status further highlight the importance of addressing socioeconomic factors within student support programs. Moreover, the observed relationship between happiness and academic performance (GPA) underscores the potential academic benefits of integrating well-being initiatives into medical education.
Recommendations for future research
To build on the present findings, future research should prioritize longitudinal study designs to clarify causal relationships between happiness, meaning in life, and academic outcomes. Intervention-based studies are also needed to develop and evaluate targeted well-being programs, particularly for demographic groups at higher risk. In addition, qualitative approaches and comparative multi-site studies are recommended to explore underlying contextual factors and enhance the generalizability of findings. Further investigations should examine differential outcomes across demographic subgroups and explore potential threshold effects whereby happiness exerts a significant influence on academic performance.
Acknowledgement
The authors sincerely thank the students who participated in the study for their time and cooperation. The authors also acknowledge the Student Research Committee Affairs at Golestan University of Medical Sciences for their support.
Funding sources
This project was financially supported by the Deputy of Research and Technology of Golestan University of Medical Sciences.
Ethical statement
Ethical approval for this study was obtained from the Ethics and Research Committee of Golestan University of Medical Sciences (IR.GOUMS.REC.1402.452). All procedures involving human participants adhered strictly to the principles of beneficence, non-maleficence, veracity, confidentiality, and voluntarism, in accordance with the Helsinki Declaration. Participants incurred no costs for participation, and no financial incentives were provided.
Conflicts of interest
The authors declare no conflicts of interest related to the material presented in this paper.
Author contributions
M. M., F. M., and F. B. conceptualized the study design. All authors contributed to the implementation of the study. F. M. performed the data analysis and interpretation. M. M. and F. M. drafted the manuscript. All authors participated in revising the manuscript, and all authors read and approved the final version.
Data availability statement
The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
Type of Study: Original Article |
Subject:
Public health
Received: 2025/10/21 | Accepted: 2025/12/1 | Published: 2026/09/5
Received: 2025/10/21 | Accepted: 2025/12/1 | Published: 2026/09/5
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