Measurement of Trauma Caregiver Stress: Validation of Heart rate variability in a Real-World Surgical Setting.

The Journal of Surgical Research
Johnathan KentJack Sava

Abstract

Acute stress is a potentially modifiable risk-factor that contributes to errors in trauma care. Research on stress mitigation is limited by the lack of a validated objective measure of surgeon stress. We sought to validate HRV in a real-world surgical setting by comparison to the Subjective Units of Distress Score (SUDS), and correlation with self-reported peak stress moments. Attending and resident surgeons on the trauma team at a Level I Trauma Center wore armbands to measure HRV. Stress-associated blunting of HRV was analyzed using the standard deviation of N-N intervals (SDNN) and the root mean square of successive differences . Perceived stress was measured with the SUDS at random intervals and at perceived stress peaks. SUDS and HRV metrics were compared with a mixed effect regression model. Correlation between binned SUDS quartiles and HRV was evaluated. HRV at reported peak-stress moments were compared to shift baseline values. Twelve participants were monitored for 340 h, producing 135 SUDS responses and 65 peak-stress time points. Regression analysis demonstrated no correlation between HRV and SUDS. With a binned approach, decreased SDNN was associated with an elevated SUDS (P = 0.03). The self-identified peak-stress ...Continue Reading

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