Factors Associated With Longitudinal Psychological and Physiological Stress in Health Care Workers During the COVID-19 Pandemic: Observational Study Using Apple Watch Data.
Factors Associated With Longitudinal Psychological and Physiological Stress in Health Care Workers During the COVID-19 Pandemic: Observational Study Using Apple Watch Data.
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DOI：
10.2196/31295
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发表时间：
2021-09-13
影响因子：
7.4
通讯作者：
Fayad ZA
中科院分区：
文献类型：
--
作者：
Hirten RP;Danieletto M;Tomalin L;Choi KH;Zweig M;Golden E;Kaur S;Helmus D;Biello A;Pyzik R;Calcagno C;Freeman R;Sands BE;Charney D;Bottinger EP;Murrough JW;Keefer L;Suarez-Farinas M;Nadkarni GN;Fayad ZA
COVID-19大流行导致卫生保健工作者（HCWs）产生高度的心理困扰。有必要确定哪些卫生保健员在大流行中产生心理影响的风险更大。鉴于个体对压力的反应不同，对压力源的感知和生理后果的分析可以提供对其影响的全面评估。本研究旨在确定HCWs患者与纵向感知应激相关的特征，并评估自主神经系统功能标志物心率变异性（HRV）的变化是否与纵向应激保护特征相关。在一项正在进行的观察性数字研究中，研究人员使用定制的Warrior Watch研究应用程序对纽约市7家医院的医护人员进行了前瞻性跟踪。参与者在研究期间佩戴Apple Watch，以在整个随访期间测量HRV。在基线和纵向收集测量感知压力、恢复力、情感支持、生活质量和乐观情绪的调查。共纳入361名参与者（平均年龄36.8岁，SD 10.1岁；女性：n=246, 69.3%）。多变量分析发现，纽约市的COVID-19病例数与纵向压力增加有关（P= 0.008）。基线情绪支持、生活质量和恢复力与纵向应激降低相关（P< 0.001）。在COVID-19诊断后的4周内，在最高的情感支持（P=.03）和恢复力（P=.006）中观察到压力的显著减少。基线情绪支持和恢复能力最高区域的参与者纵向采集HRV的昼夜节律模式与低或中区域的受试者有显著不同。高恢复力、情感支持和生活质量使医护人员纵向感知压力的风险降低，并具有独特的生理压力概况。我们的研究结果支持使用这些特征来识别面临大流行心理和生理压力影响风险的卫生保健工作者。
The COVID-19 pandemic has resulted in a high degree of psychological distress among health care workers (HCWs). There is a need to characterize which HCWs are at an increased risk of developing psychological effects from the pandemic. Given the differences in the response of individuals to stress, an analysis of both the perceived and physiological consequences of stressors can provide a comprehensive evaluation of its impact. This study aimed to determine characteristics associated with longitudinal perceived stress in HCWs and to assess whether changes in heart rate variability (HRV), a marker of autonomic nervous system function, are associated with features protective against longitudinal stress. HCWs across 7 hospitals in New York City, NY, were prospectively followed in an ongoing observational digital study using the custom Warrior Watch Study app. Participants wore an Apple Watch for the duration of the study to measure HRV throughout the follow-up period. Surveys measuring perceived stress, resilience, emotional support, quality of life, and optimism were collected at baseline and longitudinally. A total of 361 participants (mean age 36.8, SD 10.1 years; female: n=246, 69.3%) were enrolled. Multivariate analysis found New York City’s COVID-19 case count to be associated with increased longitudinal stress (P=.008). Baseline emotional support, quality of life, and resilience were associated with decreased longitudinal stress (P<.001). A significant reduction in stress during the 4-week period after COVID-19 diagnosis was observed in the highest tertial of emotional support (P=.03) and resilience (P=.006). Participants in the highest tertial of baseline emotional support and resilience had a significantly different circadian pattern of longitudinally collected HRV compared to subjects in the low or medium tertial. High resilience, emotional support, and quality of life place HCWs at reduced risk of longitudinal perceived stress and have a distinct physiological stress profile. Our findings support the use of these characteristics to identify HCWs at risk of the psychological and physiological stress effects of the pandemic.
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