Profile of occupational therapy students at public higher education institutions in Brazil: an analysis of the relationship between work and studyAbstract
Introduction This research analyzed the profile of students in Occupational Therapy programs at public institutions in Brazil, focusing on the relationship between study and work. Additionally, the study explores the different interactions between the roles of student and worker, considering variables such as age, gender, ethnic-racial background, and education.
Objective To compare the profiles of students who balance work and study with those of full-time students in Occupational Therapy programs at public institutions in Brazil.
Method A quantitative cross-sectional study in which students from public institutions completed an online questionnaire about demographic, academic, and professional characteristics. Multiple Correspondence Analysis (MCA) was conducted to build profiles, and Binary Logistic Regression was used to investigate the relationship between socioeconomic and academic variables, with data analysis assisted by software.
Results A total of 277 students from all five regions of Brazil participated. MCA revealed distinct regional profiles. At the national level, it was observed that white students are more likely not to work, not to be in affirmative action programs, to have attended private schools, and not to receive student aid. In contrast, black and brown students are more likely to be in affirmative action programs, come from public schools, receive student aid, and be working students. Binary logistic regression indicated that working increases the likelihood of failing courses, not participating in academic projects, and needing to drop courses. Moreover, black and brown students have a higher probability of failure compared to white students.
Conclusion The research highlighted not only the influence of work but also the impact of ethnic-racial background on the daily lives of students in Occupational Therapy programs at public institutions in Brazil.
Keywords:
Teaching; Universities; Occupational Therapy; Occupational Groups
Resumo
Introdução Esta pesquisa analisou o perfil dos estudantes dos cursos de graduação em terapia ocupacional em instituições públicas brasileiras, com enfoque na relação entre estudo e trabalho. Além disso, o estudo explora as diferentes interações entre os papéis de estudante e de trabalhador, levando em conta variáveis como idade, gênero, origem étnico-racial e trajetória escolar.
Objetivo Comparar o perfil de estudantes que conciliam trabalho e estudo com o de estudantes em tempo integral nos cursos de terapia ocupacional em instituições públicas no Brasil.
Método Estudo quantitativo transversal, no qual estudantes de instituições públicas preencheram um questionário online sobre características demográficas, acadêmicas e profissionais. Foram realizadas análises de correspondência múltipla (ACM) para construir os perfis e regressões logísticas (binomial) para investigar a relação entre variáveis socioeconômicas e acadêmicas, com uso de softwares.
Resultados Participaram 277 estudantes das cinco regiões do Brasil. A ACM revelou perfis regionais distintos. No perfil nacional, observou-se que estudantes brancos tendem a não trabalhar, não ser cotistas, ser egressos de escola particular e não receber auxílio estudantil, enquanto estudantes pretos e pardos são mais propensos a ser cotistas, ser egressos de escola pública, receber auxílio e trabalhar. A regressão logística binomial indicou que trabalhar aumenta a chance de reprovação, de não participar de projetos acadêmicos e de trancar disciplinas. Além disso, pessoas pretas e pardas apresentam maior probabilidade de reprovação do que pessoas brancas.
Conclusão A pesquisa evidenciou não só a influência do trabalho, como também da origem étnico-racial no cotidiano de estudantes de terapia ocupacional em instituições públicas do Brasil.
Palavras-chave:
Formação Acadêmica; Ensino Superior; Terapia Ocupacional; Trabalhadores
Introduction
Access to higher education has expanded considerably since 2007, driven by a Federal Government initiative that created the Support Program for the Restructuring and Expansion of Federal Universities (REUNI) through decree no. 6.096, with the aim of promoting expansion, restructuring, and improvements in Brazil’s federal universities (Brasil, 2007). This program sought to transform the higher education landscape in the country and to benefit working students by providing better conditions for retention during undergraduate education, as well as by expanding evening programs.
Although access to higher education has expanded, enabling more students to enroll, there are disparities in retention conditions and in opportunities available to these individuals (Trópia & Souza, 2023). While some students can devote themselves full time to their studies, others need to balance academic activities with work. This situation is even more pronounced among individuals in socioeconomically disadvantaged contexts, who remain inadequately supported by the State (Trópia & Souza, 2023).
In this context, it is necessary to characterize the different interactions that may exist between the roles of those who work and those who can devote themselves full time to their studies. A distinction should be made between working students and nonworking students. Working students need to balance academic and work obligations, often devoting less time to studying and to other academic activities. By contrast, nonworking students may choose programs and career paths that require full-time time investment and may participate more actively in academic activities, as they do not need to divide their time between studying and working (Vargas & Paula, 2013).
In 2018, the National Association of Directors of Federal Higher Education Institutions (ANDIFES) conducted a survey indicating that 29.9% of students at federal universities balance work and study. Among them, 61.5% have a per capita income of up to one and a half minimum wages. This finding highlights the social vulnerability affecting a substantial portion of undergraduates.
Additionally, some students experience work overload, which is often necessary to sustain student life, making it difficult to balance these two roles (Ambiel et al., 2021). Another important barrier that students may face, requiring them to balance work and studies, is family responsibility, as they also assume caregiving duties and have limited time to meet academic demands (Maier & Mattos, 2016). As a result, finding an adequate support network, managing time, and remaining at the university are ongoing challenges in these individuals’ everyday lives.
Moreover, ethnoracial issues also shape this scenario. According to the 5th National Survey of the Socioeconomic and Cultural Profile of Undergraduate Students at Federal Higher Education Institutions, conducted by Associação Nacional dos Dirigentes das Instituições Federais de Ensino Superior (2019), the number of Black and Brown students in these institutions has increased, but they remain at a greater economic disadvantage. The data also show that, despite governmental efforts, racism persists, with inclusion and equity in academic settings remaining key challenges.
Thus, the relationship between work and study leads these students to face multiple obstacles to remaining at the university, including insufficient support, limited access to academic opportunities, and difficulties completing the program because of the aforementioned variables, such as work overload, financial hardship, family responsibilities, and delayed graduation (Ambiel et al., 2021).
Accordingly, work is understood as a factor that influences students’ profiles. Although this topic has been widely studied, no studies were found that analyze these influences among undergraduate occupational therapy students. This study therefore asks how work influences the academic lives of undergraduate occupational therapy students. The aim of this study is to analyze the profile of working students and full-time students enrolled in occupational therapy undergraduate programs at public institutions in Brazil.
Method
This is a cross-sectional quantitative study that identifies students’ sociodemographic profiles and their academic status in relation to work. Data were collected using an online questionnaire with closed-ended and open-ended questions. The questionnaire was divided into six sections: demographic, academic and professional characteristics, goals and motivations, behavior and preferences, and support network. This article presents data on sociodemographic profiles and their academic and professional characteristics.
Participants were students enrolled in occupational therapy programs at public institutions in Brazil. According to data retrieved from the e-MEC system of the Ministry of Education, there are 20 active undergraduate bachelor’s programs in occupational therapy at public institutions in the country: one in the Midwest, five in the Northeast, two in the North, nine in the Southeast, and three in the South regions. These programs offer 50 to 100 admissions per year each. Inclusion criteria were being enrolled in an occupational therapy program at a public institution in Brazil and being able to complete the study questionnaire. Exclusion criteria were being younger than 18 years and being in the first semester of the undergraduate program.
Before the study was broadly disseminated, a pretest of the questionnaire was conducted and subsequently reviewed carefully by two evaluators. Suggestions from participants in this stage were also considered in the final version.
Next, the researchers developed a digital flyer to publicize the study, including a QR code and a link to the Google Forms survey. The study was promoted in Facebook and WhatsApp groups, as well as through social media profiles that promote occupational therapy.
To characterize the sample, absolute and relative frequency analyses of sociodemographic and academic data were performed. To analyze student profiles overall and by region, multiple correspondence analysis (MCA) was used. MCA is a statistical technique used to explore and visualize associations in datasets with multiple categorical variables. It allows patterns and profiles to be identified by mapping relationships between variable categories in a space of two or more dimensions. MCA transforms categorical variables into numerical coordinates, enabling a two-dimensional plot in which proximity between categories indicates the strength of the association between them (Ayele et al., 2014). The following variables were considered in constructing the profiles: race/ethnicity, educational background, quota status, receipt of student aid, and labor market participation.
To investigate the relationship between socioeconomic variables and students’ academic characteristics, binomial logistic regression analyses were conducted to model the probability of the binary academic outcomes, given the risk factors identified. The independent covariates (predictors) were labor market participation, educational background, quota status, receipt of student aid, race/ethnicity, and region of Brazil. The dependent variables (DV) for specific academic outcomes were failing courses, withdrawing from enrollment or courses, reducing the number of courses per semester, participation in projects, and receipt of a scholarship for projects. Each outcome was modeled separately, resulting in five distinct regression models. To facilitate interpretation, odds ratios (OR) were calculated for each covariate, indicating the change in the odds of the outcome associated with each factor. Coefficient significance was tested using p values, with a 5% significance level (p <0.05) to determine which variables were significant predictors for each outcome. Analyses were conducted using SPSS, version 27.0, and Jamovi 2.6.13.
The study was approved by the Research Ethics Committee of the School of Medicine at Universidade Federal de Pelotas, under CAAE: 76595023.6.0000.5317, and followed the ethical principles set forth in National Health Council Resolutions 466/12 and 510/2016. All participants provided written informed consent (ICF), and their identities were protected.
Results
Regarding sociodemographic characteristics, most participants in this study were full-time students (67.4%), women (88.8%), single (89.1%), in the young adult age group (80.8%), White (55.8%), and had attended public schools (65.9%). Most lived with their family (66.7%), in an owner-occupied home (52.5%), had no children (88.4%), and came from families in which family members had completed higher education (62.3%). Of these participants, 2.2% were from the Midwest, 19.9% from the Northeast, 12.0% from the North, 33.0% from the Southeast, and 33.0% from the South regions, as detailed in Table 1.
Considering academic characteristics, most students did not enter through the quota system (51.4%). Most did not receive student financial aid (69.2%) and were able to participate in teaching, research, and outreach projects (73.6%). However, most had not received and were not receiving scholarships for teaching, research, and outreach projects (70.7%). Most had never withdrawn from courses during the program (63.4%) and had not needed to enroll in fewer courses than those specified in the curriculum (59.4%). Finally, 70.3% had never failed a course, as detailed in Table 1.
Regarding professional characteristics, 32.6% of participants were working, most commonly 21 to 30 hours per week (43.3%), with informal work being the most frequent employment category (31.1%). When asked about job seeking, 45.1% of participants reported that they were not looking for work, whereas 23.6% reported that they were looking for a job. Finally, among students who worked, 52.1% self-identified as White.
Analysis of the profiles formed by the MCA showed similarities across regions, as illustrated in Figures 1, 2, and 3.
In the national profile (Figure 1), the variables being White, not working, not being a quota student, having attended a private school, and not receiving student financial aid are closer to one another. Another association cluster involves being Brown and working. A third cluster includes being a quota student, needing financial aid, and having attended a public school.
When each region was examined, the overall pattern was similar to the national profile, with more noticeable differences in race/ethnicity and work. Across all regions, White students tended to share a consistent profile: they were more likely to have attended private school, not to be quota students, not to receive student financial aid, and not to work. Indigenous students, in turn, appeared more isolated from the other variables, which may reflect their low representation in the sample. Other groups, however, showed region-specific features.
Black students tended to be associated with having attended public school, being quota students, and receiving student financial aid in the Northeast, North, and Southeast regions (Figures 2 and 3). In the Midwest and South regions (Figures 1 and 3), these characteristics were also associated with the need to work.
A strong association between being Brown and working was observed in all regions, with proximity to being a quota student and having attended public school, but not to receiving student financial aid.
Regarding the relationship between sociodemographic variables and academic characteristics, the binomial logistic regression results (Table 2 and Table 3) show that students who work have 3.34 times higher odds of failing courses than those who do not work (p < 0.001).
For course failure, race/ethnicity was also statistically significant: compared with White individuals, Black individuals had 3.07 times higher odds of failing (p = 0.034), and Brown individuals had 2.44 times higher odds of failing (p = 0.024).
In addition, students who work had 2.4 times higher odds of being unable to participate in teaching, research, and outreach projects (p = 0.018) and, consequently, 2.1 times higher odds of not receiving a scholarship in projects of the same nature (p = 0.049).
Finally, students who work had 2.11 times higher odds of needing to withdraw from courses or enrollment than those who do not work (p = 0.02). The only academic variable that did not show a statistically significant difference in relation to work status was reducing the number of courses per semester (p = 0.059).
Discussion
In the dynamics of being a working student, this condition affects academic performance and academic opportunities, since students who work fail courses more often than full-time students. According to Souza et al. (2020), work has implications for education because, in addition to work overload, students who study and work often experience sleep changes, stress, limited time for leisure, demotivation, and academic difficulties. Overload and lack of time to devote to academic activities affect students who often depend on their own work to secure their subsistence, making work a necessity rather than a choice.
In this regard, of the 20 occupational therapy programs at public institutions in Brazil, 19 are full-time, and all include at least one daytime shift. This structure can often make it unfeasible to reconcile work and study, especially because, as this study shows, most students work in informal jobs. As a result, there is a risk of lower academic performance and delayed progression in the program, since to maintain financial stability, academic activities become secondary or, in some cases, lead to dropout.
It is important to analyze retention and dropout data to reconsider strategies that support these students’ learning process, because there are multiple reasons why students face difficulties during their trajectory in higher education (Abbad et al., 2014).
With regard to undergraduate dropout, universities show growing concern. The 5th Associação Nacional dos Dirigentes das Instituições Federais de Ensino Superior (2019) survey reports that more than half of undergraduate students (52.8%) have considered leaving their program and that, among those who leave, 23.6% do so because of difficulties balancing study and work.
Regarding course failure, Freitas et al. (2017, p. 3) warn that there may be a tendency to blame students for difficulties entering and remaining in higher education, as if those difficulties were related to their lack of ability. This perspective does not consider students’ social context and reinforces feelings of incapacity (Veras, 2022), which can intensify dropout and, according to Daolio and Neufeld (2017), contribute to irreversible mental health problems.
Article 207 of Brazil’s Federal Constitution states that teaching, research, and outreach are inseparable in higher education to ensure quality (Brasil, 1988). This triad is essential for building an inclusive university and for valuing science as a means of producing knowledge. The opportunity to participate in projects is crucial for students because it brings them closer to practices related to the program and to the profession. When students cannot devote themselves to these activities, this also limits access to scholarships, which are important for encouraging student participation and supporting academic retention (Universidade Federal de Santa Maria, 2023).
Moreover, academic scholarships require a weekly workload of 10 to 20 hours and a commitment of 6 months to 1 year, which, combined with students’ work schedules, often prevents students from balancing these activities. Even so, the scholarship amount, around Brazilian reais (Brasil, 2023), is insufficient for students to give up their jobs because it does not cover basic living needs, even after a readjustment that increased the amount received by 75% (Brasil, 2023).
Given that working students are more likely to withdraw from courses and that their course failure rate is also a meaningful finding, the number of courses in which they enroll did not decrease, despite these challenges. This suggests that, even under overload, there is a desire to continue studying, often driven by the possibility of social mobility, but without structural conditions that allow them to reconcile these activities.
Balancing work and study, according to the International Labor Organization and the Institute for Applied Economic Research (2015), poses many challenges for young people aged 15 to 29 years who need to work while seeking to increase their educational attainment. In this age group, those who combine work and study have a higher rate of informal employment than those who only work. This scenario can be explained, in part, by the higher prevalence of informality in part-time work schedules1 (Organização Internacional do Trabalho & Instituto de Pesquisa Econômica Aplicada, 2015). The data from this study align with these findings, showing that among working students, most are in informal employment, accounting for 31.1%.
According to Zorzo & Reis (2024), university life requires a series of investments, and it is not uncommon for students to rely on informal work to secure material resources, given that they have little or no means of subsistence and that student assistance programs have limited reach. This includes initiatives such as National Student Assistance Plan (PNAES), established under law no. 14.914 (Brasil, 2024), which do not always meet these needs from the beginning of undergraduate education. In this context, informal work becomes an available option for socially vulnerable young people. As a result, it often emerges as a recurring alternative for this group (Zorzo & Reis, 2024), which also represents most participants (80.8%) in this study.
In ethnoracial terms, and beyond work, given that most working students are White, the results showed that race/ethnicity influences academic success, since Black and Brown students have a higher statistical probability of failing courses. This finding seems to indicate a structural and institutional failure with a substantial impact on these individuals’ academic trajectories. This phenomenon may be understood as a consequence of structural racism and institutional racism, which, although often conflated, are distinct phenomena and should be described as such (Almeida, 2019).
From a more critical and reflective perspective, Almeida (2019) discusses institutional racism as resulting from the functioning of institutions, which operate through dynamics that privilege individuals based on ethnicity. The predominance of White men in public institutions is grounded in patterns that hinder the advancement of Black people and in the lack of spaces to discuss racial inequality, normalizing domination by this group. Structural racism, in turn, is present in the functioning of political, economic, legal, and family relations. It is not a deviation but part of the structure itself. It involves both individuals’ actions and institutional practices, showing that racism is deeply rooted in society. For this reason, the foundations of these relationships that sustain this structure must be reconsidered (Almeida, 2019).
In the university context, these dimensions may be expressed through experiences of exclusion and difficulties in access and retention. The weakness of institutional spaces devoted to ethnoracial debate contributes to the reproduction of racism in institutional relations, favoring the invisibility of Black students and the maintenance of a hegemonic university model in Brazilian public universities (Valério et al., 2021).
White individuals still represent the majority in public higher education, accounting for 55.8% of participants. Law no. 12.711/2012, which regulates the quota system for admission to federal educational institutions, expanded access to higher education for Black, Brown, and Indigenous students (Brasil, 2012). Although the Quota Law (Lei de Cotas) promoted greater access for these groups, a long path remains before representation becomes equitable, as shown by this study sample. Even when access is achieved, retention policies must expand substantially to promote quality during undergraduate education, since over 67% of students who do not work receive some type of student financial aid.
This scenario reflects historical legacies of ethnoracial inequality, since White people benefit from the way society has been structured, which allows greater access to and retention in higher education. In this regard, Cida Bento notes:
Descendants of enslavers and descendants of enslaved people live with the accumulated legacies of histories marked by profound pain and violence, which are reflected in the concrete and symbolic lives of contemporary generations. Much is said about the legacy of slavery and its negative impacts on Black populations, but almost never about the legacy of slaveholding and its positive impacts on White people (Bento, 2022, p. 23).
In this context, it becomes essential to understand the processes of oppression and domination that shape university education, recognizing the historical erasure of knowledge from colonized groups and incorporating decolonial perspectives as a foundation for actions, practices, and engagement in this setting (Ambrosio & Silva, 2022).
Although gender was not used in the inferential analyses, there was a predominance of women (88.8%), a cultural phenomenon in the health field. The large proportion of women in occupational therapy programs in Brazil reflects the feminization of the profession. Haddad et al. (2010) conducted a study across 14 health programs and reported that women were the majority in health programs, with the exception of physical education. In that study, speech-language pathology, social work, nutrition, and occupational therapy had more than 90% women among students in each program, which aligns with the present study. Because it is linked to caregiving, this role assigns to women behaviors related to welcoming and empathy in professions that promote health, well-being, and quality of life, as a result of socialization that frames caregiving as an inherent attribute of the female gender. This has been built into the profession since its emergence, as highlighted by Figueiredo et al.:
The gender segregation model influenced the development of several professions aimed at women, such as occupational therapy, since they required the enactment of actions and roles expected of women in society. Stereotypes associated with the female figure, such as the ability to provide care and to perform tasks involving fine movements, linked to attributes such as boundless kindness and patience, became qualities required of the first occupational therapists and shaped the role of women in occupational therapy (Figueiredo et al., 2018, p. 124).
Considering the relationship between work and study, it is important to note that women, who predominate in occupational therapy programs, face academic and professional demands that already create substantial overload, in addition to disproportionate responsibility for domestic labor. The triple shift (profession, family, and education) reflects gender inequalities and social roles that perpetuate this overload. As discussed by Pirrolas & Correia (2020), even when men and women have similar working conditions, women tend to face greater pressure because unequal responsibility-sharing in domestic and family contexts is treated as normal.
Conclusion
This study shows the influence of work and ethnoracial background on the academic experiences of occupational therapy students.
Accordingly, it is clear that the relationship between work and study is affected, especially when students need to balance both activities. Informal work, which represents a substantial proportion and often serves as the main source of income, tends to become a priority and creates an overload of responsibilities. This compromises the academic performance of working students, who have higher odds of failing courses and of needing to withdraw from a course or from program enrollment.
These students face challenges in their academic routines, such as being unable to engage in teaching, research, and outreach projects and barriers to obtaining scholarships within these projects. It is worth highlighting these students’ persistence: even though they fail courses more often, they do not enroll in fewer courses over the program. This occurs in an unfavorable context in which public higher education institutions do not accommodate their realities and do not provide the support needed to address their specific needs.
Additionally, race emerged as a determining factor in this study, revealing significant inequalities in occupational therapy students’ access and retention. Black and Brown students face a higher risk of failing courses compared with White students and are more closely associated with the need to work while studying.
In this context, developing specific public policies to support working students is essential, given the limitations involved in balancing these two roles. Beyond this, expanding the PNAES is urgent to include this population more broadly by providing financial and academic support that fosters degree completion. This expansion should also include programs specifically designed for this group and a more direct approach to retention and dropout.
Responsible bodies should also reconsider guidelines that encourage public universities to expand the availability of evening occupational therapy programs, contributing to working students’ access and retention through greater flexibility in study schedules.
Moreover, occupational therapy program leadership, including program coordinators and the program’s curricular committee, should also make a combined effort to address the needs of working students and to promote actions that support their retention. University faculty could also make project schedules in teaching, research, and outreach more flexible and adaptable, considering the double, and even triple, workload this population faces.
Finally, it is the State’s duty to provide high-quality higher education for all. However, as long as working students are not included in education policies, with guaranteed support and academic opportunities, truly inclusive, high-quality higher education will remain out of reach.
Some limitations should be considered when interpreting these results. At the start of data collection, 69 federal universities initiated a strike by faculty and administrative staff, which hindered dissemination of the study and may explain the low number of responses, particularly in the Midwest region. In addition, differences in sample size across regions limit the interpretation of comparative findings. The low representation of Indigenous participants should also be noted, possibly reflecting historical and structural challenges that restrict this population’s access to academic settings. Future studies using other methodological designs are recommended to explore this topic further and to provide findings that can contribute to ongoing discussions.
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1
The Instituto de Pesquisa Econômica Aplicada considers work to be part-time when it involves up to 30 hours per week.
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How to cite:
Santos, G. D., & Girundi, C. (2026). Perfil dos estudantes de terapia ocupacional em instituições públicas de ensino no Brasil: uma análise da relação entre trabalho e estudo. Cadernos Brasileiros de Terapia Ocupacional, 34, e4124. https://doi.org/10.1590/2526-8910.cto418041242
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Data Availability
The data supporting the findings of this study are available from the corresponding author upon request.
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Edited by
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Section editor
Prof. Patrícia Leme de Oliveira Borba
The data supporting the findings of this study are available from the corresponding author upon request.
