Abstract

The idea of happiness is fundamental to mental health and influences several aspects of life. It is essential to consider the impact of persistent stress on individuals, particularly medical students. This study at Ayub Medical College aimed to evaluate factors influencing happiness among students. A cross-sectional survey was conducted with ethical approval, using stratified random sampling to select participants. Data was gathered through two questionnaires: the Oxford Happiness Questionnaire and another exploring additional factors. A total of 69 students participated, with an average happiness score of 4.01 ± 1.12. Results revealed that students who regularly engaged in physical activities, such as visiting the gym, reported higher happiness levels. Additionally, active involvement in social and religious organizations was linked to increased happiness. SPSS was used for data analysis. Also, people's happiness levels were much greater when they were actively involved in their social and religious organizations. 

Key Words

Happiness, Mental Health, Oxford Happiness Questionnaire, Physical Activity

Introduction

The concept of "health" encompasses not only the absence of sickness or disability but also the emotional, psychological, and social equilibrium of a person. When it comes to an individual's overall health, every facet of their life is a critical factor Etemaad et al. (2019). The World Health Organisation (WHO) argues that one of the most important aspects of mental health is the degree to which a person is satisfied with their life Francis et al. (2018). By a long-term tendency to often experience positive emotions (such as pleasure and tranquility) and to seldom encounter negative emotions (such as grief, concern, or fury), happiness may be described as an individual's subjective feeling of well-being. Happiness is marked by a long-term tendency to experience positive emotions, Turner (2019).

The cultivation of positive characteristics such as optimism, kindness, and generosity is one possible strategy that may be used to increase one's level of contentment. The benefits of happiness extend to both the physical and mental health of an individual. People who report greater levels of happiness have a lower chance of developing cardiovascular disease and some malignancies, and they also tend to live longer and better lives overall. 

According to the findings of psychologists Siamian et al. (2012), pleasure is not only a fleeting, fleeting thrill but rather a continuous situation. It is not sufficient to just experience a number of positive emotions in order to guarantee that a person will be happy. The vast majority of professionals in the field of mental health are in agreement that happiness is not only a state of mind but also an activity that can be continuously maintained and improved over time. 

According to Diener et al. (2020), in order to achieve happiness, a person must be able to recognize and experience pleasure, experience completion, and have a strong sense of purpose. For a great number of people, happiness is not only a necessary condition for carrying out activities that are part of their daily lives, but it is also a major goal in its own right. One of the most important aspects is the widespread acceptance of the concept that finding fulfillment in one's life is an essential element of human flourishing. Throughout the course of their pursuit of higher education, students are confronted with a number of psychological and social problems, each of which has the potential to impact their level of pleasure. It is more probable that college students who feel pleasure during their studies will perform academically, and it is also possible that they will continue to enjoy happiness after those individuals join the workforce. For a number of teachers in the fields of health and social sciences, the well-being of their pupils has become an increasingly important focus of their attention. Previous studies have shown that thirty-eight percent of young people in Switzerland, sixty-three percent of young people in Iran, and sixty-five percent of young people in Chile express happiness. This was the situation that occurred with students attending universities in Chile. According to the findings of an Iranian researcher (Frey & Stutzer, 2002), there is a correlation between happiness and a variety of traits. This category includes factors such as gender, socioeconomic position, engagement in extracurricular activities, perspective on future employment, degree of academic satisfaction, average test scores, housing location, and stress levels encountered over the course of the previous year. The individuals who took part in the study were students in their first year at Kashan University of Medical Sciences. 

Numerous research have been conducted to investigate the factors that determine happiness among students in Pakistan as well as the variables that are associated with it. With that being said, every single research relied on data from a particular region and used very small sample sizes. The prevalence of happiness and the characteristics that are associated with it among college students has been the subject of a great deal of study. On the other hand, there is little evidence of connected components in the research, such as challenges with mental health, personal medical histories, and the implications of lifestyle choices. 

Research Objectives

An inventory of the reasons for this inquiry is presented in the following: 

1. Determining the extent to which university students in Pakistan are content with their lives.

2. To identify the factors that influence college students' happiness in Pakistan.




Research Contributions

It is possible that the major objective of this current study is to contribute to the existing body of knowledge about the elements that are connected with the happiness of college students. The examination of these data would be of great assistance in the search for a solution to the problem of the happiness of college students.

Literature

Researchers have conducted a number of research 

works to investigate the psychological, biological, and social elements that have an impact on happiness. For instance, Kim, Young Suk, and Mi Young Han (2015), Grey RS, et al. (2018), and Mili? J., et al. (2019) are the studies that fall within this study category. As a result of the fact that genes are responsible for forty to fifty percent of the diversity in happiness, the bulk of an individual's pleasure is determined by their genes. In addition to this, it was hypothesized that demographic factors such as age, gender, educational achievement, and marital status would have a 10% impact on one's level of happiness. Conscious activities such as generosity, positive thinking, and stress management are examples of activities that, according to studies, may contribute forty percent to individual happiness. 

These characteristics have been shown to have an effect on an individual's level of happiness (Appel H, et al., 2016; Greitemeyer T, Brauer M., 2010). The absence of stress in the preceding six months, marital status, employment, and educational achievement are all factors that have been studied. It has also been shown via research that working in the medical industry may dramatically reduce one's levels of happiness owing to the high levels of stress that are typical in that professional setting. Students eventually have a better sense of personal satisfaction as a result of the obstacles they confront in the classroom, which in turn leads to an increase in their levels of happiness. People who were 21 years old were found to be happy, according to the findings of a poll that was conducted in the United States in 2018. It was determined that this was a consequence of the very difficult nature of the working environment at the hospital. The evidence that is to be provided below provides support for this conclusion. 

(Kashdan, 2004b) carried out research in India with the purpose of determining the level of contentment that medical students have with their lives. The results of the survey reveal that students who live with their families and make an effort to pursue their hobbies are more likely to be satisfied with their educational experience. During the course of the school year, the levels of pleasure that youngsters experience steadily decrease, according to the findings. 

Conclusion

First, an individual's emotional state, in which they experience joy; second, their social environment, in which they form strong bonds with others and receive social support; and third, their cognitive state, in which they process and interpret information in a specific way, leading them to feel more joy and optimism. Happiness is the result of a trifecta of factors, which results in an individual experiencing joy. Notes to Conclude Taking into consideration the information shown above, it is reasonable to assert that the degree of contentment experienced by the nation's young and active population, including students and persons, is a significant factor in determining their health and their capacity to accomplish their objectives. Because students are a dynamic community that is working to construct its scientific and ethical foundations while also taking part in a diverse array of activities, ensuring that they are happy is of the utmost importance. In addition, taking into consideration the fact that students go through a stage of their academic careers that is not only exciting but also challenging and even stressful, it is essential to take into account characteristics such as happiness. This is due to the fact that the capacity and quality of functioning of pupils are significantly influenced by their power to develop and sustain pleasant psychological states. Taking into consideration the aforementioned, the purpose of this research was to ascertain the level of contentment that students had with their job experiences in Pakistan. 

Methodology:

Materials and Methods

An approach that was both descriptive and cross-sectional was used in the execution of this investigation. Every single undergraduate student who was enrolled at Ayub Medical College in the year 2021 participated in this research. The selection of these individuals was accomplished by a method known as stratified random sampling. The study was carried out with the participation of one hundred individuals, all of whom were students at Ayub Medical College. Participants had to be between the ages of 18 and 30 years old, be enrolled as undergraduates at Ayub Medical College, and provide their agreement to fill out the instruments in order to be eligible for participation in the research. Two of the grounds for withdrawal were an unwillingness to participate in the survey and an age that was more than thirty years. For the purpose of data collection, the surveys that are indicated below are performed. 

The first kind of survey is a demographic survey that asks individuals to fill out their name, date of birth, gender, marital status, degree, major, semester, and place of residence. In this particular investigation, the questionnaire was developed by the researchers themselves.

Demographic Questionnaire; including age, sex, marital status, academic degree, field of study, semester, and residence. The researchers conducting this investigation have developed this questionnaire.

The Oxford Happiness Scale uses a Likert scale from 0 to 3 to assess an individual's happiness level via its 29-item inventory. The notion of happiness proposed by Argyle et al. (2015) underpins this study by providing conceptual support. The Beck Depression Inventory (BDI) served as the basis for the questionnaire developed by Argyle et al., (2002). With the addition of twenty-one questions, the Beck Depression Inventory (BDI) became a more comprehensive tool for evaluating mental health. In addition, there were eleven questions in this. The dependability of the Oxford Questionnaire was found to be 90% according to Cronbach's alpha, and 78% after retesting after a seven-week hiatus, according to Argyle and colleagues. This questionnaire has a concurrent validity of 0.43 according to the examination of an individual's relationships. 

The Oxford Happiness Index (OHI Argyle) was the subject of a reliability assessment that Alipour and colleagues conducted. The study found a statistically significant correlation between the overall percentage and each of the 29 items on the list. Every entry in the list has been shown to be reliable with a Cronbach's alpha value of 0.91. In contrast to the overall mean score of 42.07, Argyle et al. found that Iranians had an average score of 35.6 on the Oxford Happiness Index. Based on the results, it seems that the OHI is a valid and trustworthy way to gauge happiness in Iran. Consequently, the OHI is undeniably an accurate tool. However, quantitative factors were shown as means with standard deviations given as plus or minus, and qualitative features were portrayed as percentage frequencies. The univariate analysis was conducted using the independent t-test, and the multivariable analysis was finished using linear regression modeling in SPSS 18.0. Both analyses were considered statistically significant when the p-value was less than 0.05. 

Results:

Pilot Study

Pilot studies, which are also sometimes referred to as pilot projects, tests, or experiments, are conducted in research initiatives that are conducted on a smaller scale before beginning a research endeavor that is more substantial. The purpose of the pilot study is to analyze a variety of factors, such as the duration of the research efforts, the costs associated with the research, and the likelihood of adverse impacts. For the purpose of determining whether or not a large-scale, expensive research project is feasible, it is strongly recommended, and in some cases even vital, to carry out pilot studies. As shown by the results of (Dyrbye et al., 2005), it is advised that a preliminary inquiry be conducted prior to beginning the thorough research. Furthermore, as a result of this, the likelihood of unfavorable results would be reduced, and resources that would otherwise be wasted on research that was not essential would be conserved.  

Prior to the formal beginning of the distribution of questionnaires and the processing of data, an initial study was conducted specifically for the purpose of gathering baseline information for this research project. In the next part, a summary of the results from the exploratory investigation is presented: 

Table 1




Cronbach's Alpha	N of Items
0.702	05

The Cronbach's Alpha number can be used to figure out how reliable the device is. If the instrument's Cronbach Alpha number is 0.60 or less, it means it is not reliable enough to be used in different scenarios. The Cronbach's alpha number should be between 0.60 and 0.80 for it to be called a good middle point within the range. A reliability score between 0.6 and 0.7 is impressive, and a score of 0.8 or higher is truly amazing. In line with the measure that most people picked. The researchers Hulin, Netemeyer, and Cudeck (2001) show results that are more than 0.95 are not always seen as good. In particular, this is because it's possible for material to be duplicated. Since the results were taken into account, we can say that the poll is reliable and can be used for more actual research. The following tests are used in this study, along with the ideas that go with them. 

Demographics

In this discussion, "demography" denotes the statistical analysis of populations, with the majority of the research sample consisting of persons engaged in the nursing sector. For our research, we used data obtained from a statistically meaningful sample of the whole population. During our investigation, we gathered the data. The word "demographic analysis" denotes the examination of populations, including the assessment and quantification of their sizes and the changes that have occurred within them. The study in this domain may concentrate on whole civilizations or groups that may be differentiated based on characteristics such as educational attainment, nationality, religious affiliation, or ethnicity, among other potential criteria for distinction. This research will address concerns and factors about the sample population's gender, age, educational attainment, and other characteristics. All of these factors are considered.




Gender

The outcomes of the investigation are shown in Table 2, which serves as a concise overview. It presents the demographics of the community that was investigated, including the gender distribution of its members. This survey was sent to a total of one hundred individuals, and 69 of them responded to it. In addition to other individuals, this category includes both male and female nurses, care workers, and other individuals. There were 46 women, constituting 66.7% of the total, and 23 men, comprising 33.3% of the total. This data is shown in Table 2. Considering all of this evidence, it is reasonable to conclude that a substantial proportion of the respondents were female. 

Table 2

	Frequency	Percent
Female	45	65.9
Male	24	34.1
Total	69	100.0

Respondents Age

The results of the inquiry are shown in Table 2, which provides a succinct summary. The investigation outlines the community's demographics, including the gender distribution of its members. A total of one hundred participants received this survey, with 69 providing responses. This group includes both male and female nurses, care workers, and other personnel. There were 46 females, constituting 66.7% of the total, and 23 males, representing 33.3% of the total. This data is shown in Table 2. Considering all this evidence, it is reasonable to conclude that a substantial proportion of the respondents were female. 

Table 3

S. No	Group	Frequency	Percent
1.	18 to 23 years	10	12.9.0
2.	23 to 30 years	13	21.3
3.	30 to 39 years	24	36.2
4.	40 years and above	22	30.4
	Total	69	100.0

Respondents Qualification

As seen in Table 4, the qualities of the individuals who participated in the survey are an essential component of our investigation. There are a total of sixty-nine responses, and nineteenth of them have a nursing diploma, which accounts for 27.5% of the total. 37.7% of the total respondents had a bachelor's degree in nursing, which is represented by twenty-six out of sixty-nine that responded to the survey. Seven out of the total of 69 responders, which accounts for 10.1% of the total, have a master's degree in nursing. In a similar vein, twenty-four point six percent of the respondents, or seventeen individuals, have successfully finished a nursing training program or course. 

Table 4



The participants' levels of happiness varied from 2 to 87, with a mean of 40.9 and a standard deviation of 13.1. The independent t-test showed that men generally reported higher levels of happiness than women (40.1 ± 12.4, p=0.01). To be more precise, males reported an average contentment level of 43.5 ± 15.0. The mean happiness ratings of married students were significantly different from those of single students; however, the difference was not statistically significant (p = 0.48). The subgroups of age and residence status in Table 2 did not show any significant differences (p = 0.15 and p = 0.17, respectively). After running the numbers through the linear regression, we found that gender is the only significant predictor of happiness. On average, men scored 3.19 points higher on the happiness scale than women did (p = 0.02). 

	Frequency	Percent
Degree	26	37.7
Diploma	19	27.5
Masters	7	10.1
Training/Course for Care Workers	17	24.6
Total	69	100.0

Table 5

Characteristic	Subgroup			Happiness (Mean ± SD)			p-value
Sex	Male			42.5 ± 14.0			0.01
	Female			39.1 ± 11.4
Respondent Age	? 20			40.4 ± 11.5			0.19
	>20			39.1 ± 14.5
status Marital	Single			39.6 ± 12.9			0.47
	Married			40.1 ± 12.8
Residence	Home			40.6 ± 11.8			0.18
	Dormitory			39.1 ± 12.3
Major	Medical, dental, or pharmaceutical			40.8 ± 11.5			0.16
	Other			39.1 ± 12.3
Subgroup	Coefficient	SE				p-value
Age (years)			-0.08		0.18		0.65
Sex	Male		Reference		1.39		0.02
	Female		-3.18
Marital status	Single		Reference		1.86		0.26
	Married		2.08
Residence	Home		1.46		1.2		0.22
	Residence		Reference
Foremost	Medical		1.73		1.24		0.16
	Non-Medical		Reference

Discussion

Based on the findings of the research, it was determined that students attending Medical Sciences University had a moderate level of satisfied behavior. Additionally, it is possible that this conclusion coincides with the results that (Gray et al., 2011), (Lyubomirsky et al., 2005), and (Kashdan, 2004) discovered in their own study initiatives. It is important to emphasize, in order to provide more clarification about these results, that students attending the University of Medical Sciences display beneficial features as a result of their high level of intellect and remarkable cognitive ability. The opposite is also true: these characteristics make it easier for them to achieve larger levels of success. Within our culture, (Gray et al., 2011) say that there are some characteristics that are considered to be very significant. As a consequence of this, individuals make an effort to give the impression that they possess certain characteristics. Characteristics that fall under this category, include autonomy, enjoyment in life, interpersonal closeness, timeliness, impact on others, and a feeling of commitment. As a consequence of this, it is very probable that the individuals who took part in the study answered the questionnaire only because of the significance of these characteristics, rather than for any other reason. It is more probable that students who are having difficulty building their futures will have improved mental health, which in turn adds to the total happiness that they experience. It is possible that this is an additional justification that might be offered for the findings of the research. As a consequence, enhancing one's level of pleasure and mental health may result in an increase in one's own sense of competence. As a consequence of this, these people have reported an increase in their feelings of self-efficacy and effectiveness in educational disciplines, which may have resulted in a higher level of pleasure. As a result, happiness increases the pleasure that one derives from life and offers the best possible basis for the development and accomplishment of personal capabilities in a variety of areas. Attaining whole-life happiness is a result of these traits, which include developing effective interpersonal relationships, improving academic performance, and increasing general life enjoyment. Several parts of a person's life may become more enjoyable as an outcome of this. Doing this is within the realm of possibility. Results from the study's t-test showed that, compared to female students, male students reported far higher levels of happiness. The only variable that reliably predicted the levels of pleasure reported by students was related to their gender, according to the regression analysis. This remained totally correct regardless of the supplied demographic data. Contrary to previous research by Siamian et al. (2012), (Frey & Stutzer, 2002), and (Mohamadpour et al., 2015), which found no significant association between intersexual contact and happiness, this study shows that there is a connection between the two. This study's conclusions are in agreement with those of Turner (2019), Francis et al. (2018), Etemaad et al. (2018), and Tavan et al. (2020). The results of other research investigations corroborate this outcome. All of these studies indicate that the theory is correct. 

Given the facts, it is reasonable to conclude that this is the most reasonable conclusion to draw, considering that depression affects more women than men. Here, we give due weight to each of these factors. The things that make people happy may be more or less accessible to men and women depending on their gender. This can be considered a plausible option. However, males are less likely to feel the impact on their health than women are when it comes to their families and children. Personal differences, the level of financial pleasure gained from achievements, and the extent to which variances impact one's vocation are more likely to have an impact on men. The rationale for this phenomenon is that males are more easily influenced by these cues compared to women. Research shows that women, compared to males, are more prone to negativity and low self-esteem. Included in this group of felt emotions are constant pessimism and sadness. Research done by Etemaad et al. in 2019 shows that negative emotions, such as guilt and shame, have a negative impact on women's happiness. The findings allow for the formation of a conclusion. What the researchers found throughout their examination proves this. When it comes to sentiments of shame and guilt, women are more susceptible than males, even if men are more prone to experiencing them. This is mostly because these emotions are more often experienced by women than men. Physiological factors, cultural and socioeconomic factors, and other variables all have a role in the genesis of this situation. The present state of affairs is the result of a combination of a few factors. The discrepancy between the present study's findings and those of previous studies is likely the product of a complex interplay of variables, and its existence is almost certainly guaranteed. That is a matter that has to be considered. Methods from all around the world are used in this discipline, as are different historical periods, different study groups, and, most crucially, cultural variations are taken into account. 

Conclusions

Due to specific limitations, the results of this research may not be generalizable to a wider population. This is feasible. This scientific investigation exhibits several deficiencies: it lacks a qualitative research design, fails to implement a random sampling procedure, disregards additional psychological factors influencing students' enjoyment, and employs a limited statistical population—students from Ayub Medical College—to formulate conclusions. These represent but a fraction of the disadvantages. It is advisable to use caution when generalizing the findings to other towns and colleges, rather than drawing definitive conclusions. Consequently, an investigation into the influence of additional psychological elements on the satisfaction levels of children attending schools globally has been suggested. To undertake a comprehensive assessment of student happiness, demographic aspects must be taken into account. Future research is advised to use longitudinal processes, mixed-methodological techniques (integrating qualitative and quantitative methods), and analogous tactics. Additionally, it must consider the influence of many psychological factors on students' well-being.

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