Job strain and heart rate variability in resident physicians within a general hospital

Hernández‐Gaytan, Sendy Isarel; Rothenberg, Stephen J.; Landsbergis, Paul; Becerril, Leonor Cedillo; León‐León, Guillermo De; Collins, Sean M.; Díaz‐Vásquez, Francisco Javier

doi:10.1002/ajim.22098

Cited by 36 publications

(48 citation statements)

References 42 publications

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“…13 Current study reported similar findings as HF was decreased in stressed subjects showing decrease parasympathetic control. Hernandez-Gaytan et al, (2012) proposed that stress is associated with vagal withdrawl and confirmed his hypothesis by reporting low HF in doctors complaining of strain at work 14 and our results were in accordance with the findings of that study. Results of current study were consistent with the findings of Eller's et al, (2011) who reported decrease in HF component of HRV in teachers and engineers due to vagal withdrawl.…”

Section: Discussionsupporting

confidence: 93%

Stress Response; Psychologically Stressed and Control Subjects; Comparison of Autonomic and Neuro Endocrine Response

Jawwad¹,

Khan

Ali

2017

TPMJ

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Section: Discussionsupporting

confidence: 93%

Stress Response; Psychologically Stressed and Control Subjects; Comparison of Autonomic and Neuro Endocrine Response

Jawwad¹,

Khan

Ali

2017

TPMJ

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“…Finally, Hernandez-Gaytan, in a sample of 54 male physicians, has shown lower values of SDNN registered during WD in subjects characterized by high job strain [20]. Summarizing, results from 3 out of all the previously mentioned studies, which adopted, as we did, 24-h ECG recording support, corroborate our findings showing significant correlation between high job strain and lower values of SDNN [17,18,20], registered during a working day. Even if a direct comparison is not completely appropriate, also 2 studies with the short ECG recording have reported the same results [15,16].…”

Section: Discussionsupporting

confidence: 89%

“…The heterogeneity of these results is not surprising, since it is known that short-term ECG recording requires well-standardized measurement conditions to assess HRV parameters, hardly obtainable in the case of field studies [5]. Among the studies adopting long-ECG recordings (24 h or more), a reduction in time-domain HRV parameters among the high strain subjects have been reported by most authors [12,[17][18][19][20][21], although they were limited to working days only. In a sample of 109 male, white-collar workers working in a computer company, high effort-reward imbalance was found to be associated with lower rMSSD, on working days but not on resting days [12].…”

Section: Strengths Of the Studymentioning

confidence: 99%

“…Studies registering ECG for short durations (5 or 10 min) reported reductions of the standard deviation of the NN interval (SDNN) during working periods in high strain workers [14][15][16]. Among the studies adopting long-ECG recordings (24 h or more) reductions of time-domain HRV parameters in high JS subjects during working days (WDs) have been reported by many authors [12,[17][18][19][20][21], but only one study found some effects of job strain on resting days (RDs) in exhausted subjects [18]. As reported by many studies, positive family histories of cardiovascular or metabolic diseases have influence on HRV.…”

Section: Introductionmentioning

confidence: 99%

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Prolonged job strain reduces time-domain heart rate variability on both working and resting days among cardiovascular-susceptible nurses

Borchini

Bertù

Veronesi

et al. 2014

IJOMEH

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Objectives: Modifications of hearth rate variability (HRV) constitute a marker of the autonomic nervous system (ANS) deregulation, a promising pathway linking job strain (JS) and cardiovascular diseases (CVD). The study objective is to assess whether exposures to recent and prolonged JS reduce time-domain HRV parameters on working days (WD) among CVD-susceptible nurses and whether the association also persists on resting days (RD). Material and Methods: 313 healthy nurses were investigated twice with one year interval to assess JS based on the demand-control and the effort-reward models. 36, 9 and 16 CVD-susceptible nurses were classified as low JS in both surveys (stable low strain -SLS), recent high JS (high JS at the second screening only-RHS) and prolonged high JS (high strain in both surveys-PHS), respectively. In 9, 7 and 10 of them, free from comorbidities/treatments interfering with HRV, two 24-h ECG recordings were performed on WD and RD. Differences in the time domain HRV metrics among JS categories were assessed using ANCOVA, adjusted for age and smoking. Results: In the entire sample (mean age: 39 years, 83% females) the prevalence of high job strain was 38.7% in the second survey. SDNN (standard deviation of all normal RR intervals) on WD significantly declined among JS categories (p = 0.02), with geometric mean values of 169.1, 145.3 and 128.9 ms in SLS, RHS, PHS, respectively. In the PHS group, SDNN remained lower on RD as compared to the low strain subjects (142.4 vs. 171.1 ms, p = 0.02). Similar findings were found for the SDNN_Index, while SDANN (standard deviation of average RR intervals in all 5 min segments of registration) mean values reduced in the PHS group during WD only. Conclusions: Our findings suggest that persistent JS lowers HRV time-domain parameters, supporting the hypothesis that the ANS disorders may play an intermediate role in the relationship between work stress and CVD. tone in the offspring of hypertensive patients compared to those without a family story of hypertension, and Mavel et al. [23] have reported similar findings in normotensive subjects with family story of hypertension. A reduction in HRV was also reported among healthy subjects with positive family history of diabetes [24,25] or premature heart attack and sudden death [26]. Genetic susceptibility to cardiovascular diseases (CVD) [27] has been considered when a positive history of any of the mentioned above disorders was determined. The aims of the present study are: 1. To assess differences between time-domain HRV parameters during WD, in 3 groups of CVD-susceptible healthy nurses characterized by stable low strain, recent and prolonged (lasting at least one year) high job strain. 2. To assess whether such differences extend to RD, supporting the theory of persistent effects of job strain on the cardiovascular system. MATERIAL AND METHODS Study populationNurses and nurse assistants working for at least one year in medical and surgical wards of a Northern Italian university hospital were asked to parti...

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“…[13] This type of observation has been used in sports training in order to identify stressors and optimize the athlete's training and overall performance. [14] However, few studies have analyzed actual physiological responses during surgical practice, [4,[15][16][17] and what factors may modify (i.e. attenuate) these responses.…”

Section: Introductionmentioning

confidence: 99%

Physiological and psychological responses to surgery and non-surgery days in orthopaedic surgeons: A case study

Abatzoglou

Milne

Howard

et al. 2017

CSS

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Objective: Performing surgical procedures can increase the physiological stress and mental strain experienced by practicing surgeons. This may affect negatively work capacity and quality of patient care by increasing the incidence of burnout, sleep disorders, fatigue and substance abuse. The purpose of this pilot case study was to track physiological and psychological responses to clinical duties in an expert arthroplasty orthopaedic surgeon. Methods: Heart rate (HR), breathing rate, heart rate variability (HRV) and anxiety ratings were observed in an expert orthopaedic surgeon using a wearable Equivital EQO2 physiological monitor and the state-trait anxiety inventory (STAI), respectively. Data was recorded for 8 surgery, 1 clinic and 1 rest day. Physiological data was recorded for 6-8 hours/day. Results: The surgeon spent significantly more time with elevated HRs on surgery days versus either clinic or rest days (10% of the day over 100 bpm). This was not the case for respiratory rate. STAI responses were significantly greater pre versus post surgery and at baseline. Psychological and physiological markers of stress were elevated prior to each surgery regardless of surgery type and task. Notably, the HR never returned to baseline on surgery days. Discussion: This study provides a baseline on which to compare procedural and trainee differences during surgical procedures. Expert surgeons may demonstrate elevated stress levels on days of surgery, as indicated by self-reported anxiety scores as well as physiologic measures. Understanding the stress and anxiety present may direct interventions that enable improved surgeon health, surgical performance, and an improved learning environment.

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Job strain and heart rate variability in resident physicians within a general hospital

Abstract: High job strain and low job control among medical residents were associated with several indicators of lowered heart rate variability. Thus, analysis of heart rate variability may be an informative marker for evaluating the physiological impacts of workplace stressors.

Cited by 36 publications

References 42 publications

Stress Response; Psychologically Stressed and Control Subjects; Comparison of Autonomic and Neuro Endocrine Response

Stress Response; Psychologically Stressed and Control Subjects; Comparison of Autonomic and Neuro Endocrine Response

Prolonged job strain reduces time-domain heart rate variability on both working and resting days among cardiovascular-susceptible nurses

Physiological and psychological responses to surgery and non-surgery days in orthopaedic surgeons: A case study

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