Continuous heart rate variability monitoring—understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods study

Introduction The medical profession is facing an unprecedented crisis. Reasons for this are complex and multifactorial; however, rising rates of burnout will undoubtedly contribute to problems with recruitment and retention. Chronic workplace stress, whereby there are insufficient resources availabl...

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Main Authors: Kathryn R Martin, Daniel Powell, Leia Kane, Derek Ball
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e097849.full
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author Kathryn R Martin
Daniel Powell
Leia Kane
Derek Ball
author_facet Kathryn R Martin
Daniel Powell
Leia Kane
Derek Ball
author_sort Kathryn R Martin
collection DOAJ
description Introduction The medical profession is facing an unprecedented crisis. Reasons for this are complex and multifactorial; however, rising rates of burnout will undoubtedly contribute to problems with recruitment and retention. Chronic workplace stress, whereby there are insufficient resources available to meet the demands doctors face, is a contributor to burnout. There are a wide variety of available self-report measures for stress, with heart rate variability (HRV) shown to be a biomarker of stress and recovery in doctors. We aim to triangulate continuous HRV measurements with validated self-report measures and qualitative data to better understand the patterns of stress and recovery.Methods and analysis This study has a sequential explanatory mixed-methods design. Participants will be recruited from multiple sites within National Health Service (NHS) Grampian. Initially, participants will complete a suite of validated scales, including the Maslach Burnout Inventory for Medical Personnel, the Resilience Scale for Adults and the Interpersonal, Community, Occupational, Physical, Psychological (ICOPPE) well-being scale. Following this, participants will undertake seven consecutive days of ecological momentary assessment of real-time demands, resources and fatigue, alongside 7 days of continuous ambulatory assessment of HRV via Firstbeat Bodyguard 3 chest-worn monitors. Participants will be provided with a summary report following their study period. If 40 participants are recruited within the recruitment timeframe, multilevel modelling will be used to analyse data; otherwise, N-of-1 statistical techniques will be used. Following initial analysis of the quantitative data, participants of interest will be invited to take part in semistructured interviews, which will be thematically analysed and presented alongside the quantitative data.Ethics and dissemination This study was approved by the University of Aberdeen, School of Medicine, Medical Sciences and Nutrition ethics review board (ref. 3389193) and the NHS Grampian research and development team. Results will be disseminated in international peer-reviewed journals.Trial registration number NCT06721312.
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spelling doaj-art-680acbb0042e4219b3c1fc284a7fffa52025-08-20T02:30:50ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-097849Continuous heart rate variability monitoring—understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods studyKathryn R Martin0Daniel Powell1Leia Kane2Derek Ball3Academic Primary Care and Health Psychology, Institute of Applied Health Sciences, University of Aberdeen School of Medicine Medical Sciences and Nutrition, Aberdeen, Scotland, UKAcademic Primary Care and Health Psychology, Institute of Applied Health Sciences, University of Aberdeen School of Medicine Medical Sciences and Nutrition, Aberdeen, Scotland, UKAcademic Primary Care and Health Psychology, Institute of Applied Health Sciences, University of Aberdeen School of Medicine Medical Sciences and Nutrition, Aberdeen, Scotland, UKInstitute of Education in Healthcare and Medical Sciences, University of Aberdeen School of Medicine Medical Sciences and Nutrition, Aberdeen, Scotland, UKIntroduction The medical profession is facing an unprecedented crisis. Reasons for this are complex and multifactorial; however, rising rates of burnout will undoubtedly contribute to problems with recruitment and retention. Chronic workplace stress, whereby there are insufficient resources available to meet the demands doctors face, is a contributor to burnout. There are a wide variety of available self-report measures for stress, with heart rate variability (HRV) shown to be a biomarker of stress and recovery in doctors. We aim to triangulate continuous HRV measurements with validated self-report measures and qualitative data to better understand the patterns of stress and recovery.Methods and analysis This study has a sequential explanatory mixed-methods design. Participants will be recruited from multiple sites within National Health Service (NHS) Grampian. Initially, participants will complete a suite of validated scales, including the Maslach Burnout Inventory for Medical Personnel, the Resilience Scale for Adults and the Interpersonal, Community, Occupational, Physical, Psychological (ICOPPE) well-being scale. Following this, participants will undertake seven consecutive days of ecological momentary assessment of real-time demands, resources and fatigue, alongside 7 days of continuous ambulatory assessment of HRV via Firstbeat Bodyguard 3 chest-worn monitors. Participants will be provided with a summary report following their study period. If 40 participants are recruited within the recruitment timeframe, multilevel modelling will be used to analyse data; otherwise, N-of-1 statistical techniques will be used. Following initial analysis of the quantitative data, participants of interest will be invited to take part in semistructured interviews, which will be thematically analysed and presented alongside the quantitative data.Ethics and dissemination This study was approved by the University of Aberdeen, School of Medicine, Medical Sciences and Nutrition ethics review board (ref. 3389193) and the NHS Grampian research and development team. Results will be disseminated in international peer-reviewed journals.Trial registration number NCT06721312.https://bmjopen.bmj.com/content/15/6/e097849.full
spellingShingle Kathryn R Martin
Daniel Powell
Leia Kane
Derek Ball
Continuous heart rate variability monitoring—understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods study
BMJ Open
title Continuous heart rate variability monitoring—understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods study
title_full Continuous heart rate variability monitoring—understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods study
title_fullStr Continuous heart rate variability monitoring—understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods study
title_full_unstemmed Continuous heart rate variability monitoring—understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods study
title_short Continuous heart rate variability monitoring—understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods study
title_sort continuous heart rate variability monitoring understanding patterns of stress and recovery and their relationship with self reported burnout resilience and well being in doctors a protocol for a sequential explanatory mixed methods study
url https://bmjopen.bmj.com/content/15/6/e097849.full
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