Alert interventions and shift work were associated with a decrease in parasympathetic-mediated heart rate variability parameters, indicating increased psychological stress among emergency physicians.
Systematic Review (n=96)
Does alert intervention and shift work reduce heart rate variability in emergency physicians?
Heart rate variability, particularly parasympathetic-mediated parameters like RMSSD, decreases during emergency operations, indicating it is a suitable objective marker for psychological stress in emergency physicians.
BACKGROUND: The workloads of emergency physicians are severe. The prevalence of burnout among emergency physicians is higher than with other physicians or compared to the general population. The analysis of heart rate variability (HRV) is a valid method for objective monitoring of workload. The aim of this paper is to systematically evaluate the literature on heart rate variability as an objective indicator for mental stress of emergency physicians. METHODS: A systematic literature review examining heart rate variability of emergency physicians in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting systematic reviews was performed. PubMed, Ovid, Cochrane Libary, Scopus, and Web of Science electronic databases were used. The methodological quality was evaluated by using a modified STARD for HRV. RESULTS: Two studies matched the inclusion criteria by using HRV between alert intervention and two other studies were considered that used HRV in other question areas. It showed an adaptation of HRV under stress. The studies were not comparable. CONCLUSIONS: There is a need for occupational health studies that examine strains and stress of emergency physicians. The well-established parasympathetic mediated HRV parameters seem to be suitable parameters to objectify the stress.
Thielmann et al. (Tue,) conducted a systematic review in Psychological stress and workload (n=96). Alert interventions and shift work vs. Control day, pre-alert period, or clerical day was evaluated on Heart rate variability (HRV) parameters (e.g., RMSSD, SDNN). Alert interventions and shift work were associated with a decrease in parasympathetic-mediated heart rate variability parameters, indicating increased psychological stress among emergency physicians.