Abstract
There has been an increasing attention to the study of stress. Particularly, college students often experience high levels of stress that are linked to several negative outcomes concerning academic functioning, physical, and mental health. In this paper, we introduce the EuStress Solution, that aims to create an Information System to monitor and assess, continuously and in real-time, the stress levels of the students in order to predict burnout. The Information System will use a measuring instrument based on wearable device and machine learning techniques to collect and process stress-related data from the students without their explicit interaction. In the present study, we focus on heart rate and heart rate variability indices, by comparing baseline and stress condition. We performed different statistical tests in order to develop a complex and intelligent model. Results showed the neural network had the better model fit.
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References
Fink, G., Stress: Concepts, Definition and History. Ref. Modul. Neurosci. Biobehav. Psychol.:1–9, 2017.
Lazarus, R. S., Theory-based stress measurement. Psychol. Inq. 1(1):3–13, Jan. 1990.
Pagnin, D., de Queiroz, V., Carvalho, Y. T. M. S., Dutra, A. S. S., Amaral, M. B., and Queiroz, T. T., The relation between burnout and sleep disorders in medical students. Acad. Psychiatry 38(4):438–444, 2014.
Abdel Wahed, W. Y., and Hassan, S. K., Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J. Med. 53(1):77–84, 2017.
Jackson, E. R., Shanafelt, T. D., Hasan, O., Satele, D. V., and Dyrbye, L. N., Burnout and alcohol abuse/dependence among U.S. medical students. Acad. Med. 91(9):1251–1256, 2016.
Soares, J. M. et al., Stress-induced changes in human decision-making are reversible. Transl. Psychiatry 2(7):e131–e137, 2012.
Soares, J. M. et al., Plasticity of resting state brain networks in recovery from stress. Front. Hum. Neurosci. 7:1–10, 2013.
Garg, K., Agarwal, M., and Dalal, P. K., Stress among medical students: A cross-sectional study from a north Indian Medical University. Indian J. Psychiatry 59(4):502–504, 2017.
Dyrbye, L. N., Harper, W., Durning, S. J., Moutier, C., Thomas, M. R., Massie FS Jr, Eacker, A., Power, D. V., Szydlo, D. W., Sloan, J. A., and Shanafelt, T. D., Patterns of distress in US medical students. Med. Teach. 33(10):834–839, 2011.
Puthran, R., Zhang, M. W. B., Tam, W. W., and Ho, R. C., Prevalence of depression amongst medical students: A meta-analysis. Med. Educ. 50(4):456–468, 2016.
Galán, F., Sanmartín, A., Polo, J., and Giner, L., Burnout risk in medical students in Spain using the Maslach burnout inventory-student survey. Int. Arch. Occup. Environ. Health 84(4):453–459, 2011.
Bellido, A., Ruisoto, P., Beltran-Velasco, A., and Clemente-Suárez, V. J., State of the Art on the Use of Portable Digital Devices to Assess Stress in Humans. J. Med. Syst. 42(6), 2018.
Selye, H., Stress without distress. In: Serban, G. (Ed.), Psychopathology of human adaptation. Boston, MA: Springer US, 1976, 137–146.
C.-T. Li, J. Cao, and T. M. H. Li, “Eustress or distress,” pp. 1209–1217, 2016.
Kozusznik, M. W., Rodríguez, I., and Peiró, J. M., Eustress and distress climates in teams: Patterns and outcomes. Int. J. Stress. Manag. 22(1):1–23, 2015.
Swetaa, A., and Priya, A. J., Intensity of stress among exam going students among South Indian population. 10(11):2201–2205, 2018.
Maslach, C., Burnout: A multidimensional perspective. In: Professional burnout: Recent developments in theory and research. Philadelphia: Taylor & Francis, 1993, 19–32.
De Kloet, E. R., Joëls, M., and Holsboer, F., Stress and the brain: From adaptation to disease. Nat. Rev. Neurosci. 6(6):463–475, 2005.
Kumar, A., Rinwa, P., Kaur, G., and MacHawal, L., Stress: Neurobiology, consequences and management. J. Pharm. Bioallied Sci. 5(2):91–97, 2013.
Blasche, G., Zilic, J., and Frischenschlager, O., Task-related increases in fatigue predict recovery time after academic stress. J. Occup. Health 58(1):89–95, 2016.
Cohen, S., Kamarck, T., and Mermelstein, R., A global measure of perceived stress. J. Health Soc. Behav. 24(4):385–396, 1983.
Koh, K. B., Park, J. K., Kim, C. H., and Cho, S., Development of the stress response inventory and its application in clinical practice. Psychosom. Med. 63(4):668–678, 2001.
P. Nogueira et al., A Review of Commercial and Medical-Grade Physiological Monitoring Devices for Biofeedback-Assisted Quality of Life Improvement Studies 1 Introduction 2 Biometric Data Collection.
Duchesne, A., and Pruessner, J. C., Association between subjective and cortisol stress response depends on the menstrual cycle phase. Psychoneuroendocrinology 38(12):3155–3159, 2013.
Muaremi, A., Arnrich, B., and Tröster, G., Towards measuring stress with smartphones and wearable devices during workday and sleep. Bionanoscience 3(2):172–183, Jun. 2013.
Kim, H. G., Cheon, E. J., Bai, D. S., Lee, Y. H., and Koo, B. H., Stress and heart rate variability: A meta-analysis and review of the literature. Psychiatry Investig. 15(3):235–245, 2018.
Berntson, G. G., and Cacioppo, J. T., Heart rate variability: Stress and psychiatric conditions. Dyn. Electrocardiogr.:57–64, 2007.
Shaffer, F., and Ginsberg, J. P., An Overview of Heart Rate Variability Metrics and Norms. Front. Public Health 5:1–17, 2017.
Ghamari, M., A review on wearable photoplethysmography sensors and their potential future applications in health care. Int. J. Biosens. Bioelectron. 4(4):195–202, 2018.
Allen, J., Photoplethysmography and its application in clinical physiological measurement. Physiol. Meas. 28(3), 2007.
Acknowledgements
This work was supported by the Portuguese Foundation for Science and Technology within NUP=NORTE-01-0247-FEDER-017832 (EUSTRESS Project) and by the QVida+ Project (FEDER-003446, supported by Norte Portugal Regional Operational Programme, under the PORTUGAL 2020 Partnership Agreement). The authors also acknowledge to the LIACC, ALGORITMI and Litec.
Funding
This work was supported by the Portuguese Foundation for Science and Technology within NUP=NORTE-01-0247-FEDER-017832 (EUSTRESS Project) and by the QVida+ Project (FEDER-003446, supported by Norte Portugal Regional Operational Programme, under the PORTUGAL 2020 Partnership Agreement).
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Silva, E., Aguiar, J., Reis, L.P. et al. Stress among Portuguese Medical Students: the EuStress Solution. J Med Syst 44, 45 (2020). https://doi.org/10.1007/s10916-019-1520-1
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DOI: https://doi.org/10.1007/s10916-019-1520-1