Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data

BackgroundIntensive care unit (ICU) residents are exposed to high stress levels due to the intense nature of their work, which can impact their mental health and job performance. Heart rate measured through wearable devices has the potential to provide insights into residents...

Full description

Saved in:
Bibliographic Details
Main Authors: Ruijing Wang, Olya Rezaeian, Onur Asan, Linghan Zhang, Ting Liao
Format: Article
Language:English
Published: JMIR Publications 2024-11-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2024/1/e60759
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850146711362600960
author Ruijing Wang
Olya Rezaeian
Onur Asan
Linghan Zhang
Ting Liao
author_facet Ruijing Wang
Olya Rezaeian
Onur Asan
Linghan Zhang
Ting Liao
author_sort Ruijing Wang
collection DOAJ
description BackgroundIntensive care unit (ICU) residents are exposed to high stress levels due to the intense nature of their work, which can impact their mental health and job performance. Heart rate measured through wearable devices has the potential to provide insights into residents’ self-reported stress and aid in developing targeted interventions. ObjectiveThis exploratory study aims to analyze continuous heart rate data and self-reported stress levels and stressors in ICU residents to examine correlations between physiological responses, stress levels, and daily stressors reported. MethodsA secondary data analysis was conducted on heart rate measurements and stress assessments collected from 57 ICU residents over a 3-week period using Fitbit Charge 3 devices. These devices captured continuous physiological data alongside daily surveys that assessed stress levels and identified stressors. The study used Spearman rank correlation, point-biserial correlation analysis, 2-tailed paired t tests, and mixed-effect models to analyze the relationship between heart rate features and stress indicators. ResultsThe findings reveal complex interactions between stress levels and heart rate patterns. The correlation analysis between stress levels and median heart rate values across different percentile ranges showed that lower percentile heart rates (bottom 5%, 10%, 25%, and 50%) had modest correlations with stress, whereas higher percentiles (top 50%, 25%, 10%, and 5%) did not correlate significantly (all P>.05). The 2-tailed paired t test indicated significant differences in stress levels reported in midday versus end-of-day surveys (P<.001), although these changes in stress levels were not consistently reflected in heart rate patterns. Additionally, we explored and found that stressors related to “other health” issues had the highest positive correlation with stress level changes from midday to end-of-day surveys. However, the weak effect of these stressors on peak heart rate suggests that their impact on physiological measures like heart rate is not yet clear. According to our mixed-effects model, stress levels significantly influenced heart rate variations when hierarchical data were taken into account (P=.03), meaning that as the stress level increased, there was a significant increase in mean heart rate. ConclusionsThis study highlights the complexity of using heart rate as an indicator of stress, particularly in high-stress environments like the ICU. Our findings suggest that while heart rate is found to correlate with self-reported stress in the mixed-effect model, its impact is modest, and it should be combined with other physiological and psychological measures to obtain a more accurate and comprehensive assessment of residents’ stress levels.
format Article
id doaj-art-bafe5821f1ff475597f877bf8d977453
institution OA Journals
issn 2561-326X
language English
publishDate 2024-11-01
publisher JMIR Publications
record_format Article
series JMIR Formative Research
spelling doaj-art-bafe5821f1ff475597f877bf8d9774532025-08-20T02:27:46ZengJMIR PublicationsJMIR Formative Research2561-326X2024-11-018e6075910.2196/60759Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit DataRuijing Wanghttps://orcid.org/0009-0007-7730-2129Olya Rezaeianhttps://orcid.org/0009-0007-6384-6504Onur Asanhttps://orcid.org/0000-0002-9239-3723Linghan Zhanghttps://orcid.org/0000-0001-8295-4024Ting Liaohttps://orcid.org/0000-0003-1786-8706 BackgroundIntensive care unit (ICU) residents are exposed to high stress levels due to the intense nature of their work, which can impact their mental health and job performance. Heart rate measured through wearable devices has the potential to provide insights into residents’ self-reported stress and aid in developing targeted interventions. ObjectiveThis exploratory study aims to analyze continuous heart rate data and self-reported stress levels and stressors in ICU residents to examine correlations between physiological responses, stress levels, and daily stressors reported. MethodsA secondary data analysis was conducted on heart rate measurements and stress assessments collected from 57 ICU residents over a 3-week period using Fitbit Charge 3 devices. These devices captured continuous physiological data alongside daily surveys that assessed stress levels and identified stressors. The study used Spearman rank correlation, point-biserial correlation analysis, 2-tailed paired t tests, and mixed-effect models to analyze the relationship between heart rate features and stress indicators. ResultsThe findings reveal complex interactions between stress levels and heart rate patterns. The correlation analysis between stress levels and median heart rate values across different percentile ranges showed that lower percentile heart rates (bottom 5%, 10%, 25%, and 50%) had modest correlations with stress, whereas higher percentiles (top 50%, 25%, 10%, and 5%) did not correlate significantly (all P>.05). The 2-tailed paired t test indicated significant differences in stress levels reported in midday versus end-of-day surveys (P<.001), although these changes in stress levels were not consistently reflected in heart rate patterns. Additionally, we explored and found that stressors related to “other health” issues had the highest positive correlation with stress level changes from midday to end-of-day surveys. However, the weak effect of these stressors on peak heart rate suggests that their impact on physiological measures like heart rate is not yet clear. According to our mixed-effects model, stress levels significantly influenced heart rate variations when hierarchical data were taken into account (P=.03), meaning that as the stress level increased, there was a significant increase in mean heart rate. ConclusionsThis study highlights the complexity of using heart rate as an indicator of stress, particularly in high-stress environments like the ICU. Our findings suggest that while heart rate is found to correlate with self-reported stress in the mixed-effect model, its impact is modest, and it should be combined with other physiological and psychological measures to obtain a more accurate and comprehensive assessment of residents’ stress levels.https://formative.jmir.org/2024/1/e60759
spellingShingle Ruijing Wang
Olya Rezaeian
Onur Asan
Linghan Zhang
Ting Liao
Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data
JMIR Formative Research
title Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data
title_full Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data
title_fullStr Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data
title_full_unstemmed Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data
title_short Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data
title_sort relationship between heart rate and perceived stress in intensive care unit residents exploratory analysis using fitbit data
url https://formative.jmir.org/2024/1/e60759
work_keys_str_mv AT ruijingwang relationshipbetweenheartrateandperceivedstressinintensivecareunitresidentsexploratoryanalysisusingfitbitdata
AT olyarezaeian relationshipbetweenheartrateandperceivedstressinintensivecareunitresidentsexploratoryanalysisusingfitbitdata
AT onurasan relationshipbetweenheartrateandperceivedstressinintensivecareunitresidentsexploratoryanalysisusingfitbitdata
AT linghanzhang relationshipbetweenheartrateandperceivedstressinintensivecareunitresidentsexploratoryanalysisusingfitbitdata
AT tingliao relationshipbetweenheartrateandperceivedstressinintensivecareunitresidentsexploratoryanalysisusingfitbitdata