A Study to Correlate Stress Score with Heart Rate Variability among MBBS Students at a Tertiary Care Center, Jaipur

Abstract

Introduction: Medical students have high levels of stress that could be due to stressors related to the academic workload, time pressure competency, professionalism, physical, mental, and emotional issues. This study aimed to find out subjective assessment of stress, stressors, and coping strategies and objective assessment of stress with heart rate variability (HRV) and correlate subjective and objective assessment of stress scores among 1st year MBBS students at RUHS College of Medical Sciences. Materials and Methods: Institutional ethical clearance (EC-P-21/RUHS) was obtained after that study was conducted among a total of 150 1st year MBBS students. The students were asked to fill out a validated general health questionnaire (GHQ-12), “medical student stress questionnaire 40,” and a brief COPE inventory to assess stress, stressors, and various coping strategies for subjective assessment and objective assessment done by time and frequency domain parameters of HRV. Results: The mean age was 20.85 ± 1.56. The severity of stress categorized as mild, moderate, high, and severe were 17%, 40%, 13%, and 10%, respectively. The most affected stressor was academic contributed to 80% followed by teaching–learning related, social, intra- and interpersonal, group activities, drive, and desire-related stressors 78%, 75%, 73%, 70%, and 68%, respectively. Overall, the students’ coping strategies were mostly avoidant followed by emotional and problem based. HRV is measured by time domain, i.e., PNN50, standard deviation of normal to normal RR intervals, root mean square of successive differences, and “frequency domain parameters,” i.e., low frequency (LF), high-frequency (HF), and LF/HF ratio. Conclusion: In the present study, a positive correlation was observed between HRV and stress score. More than 75% of RUHSCMS 1st year medical students were suffering from measurable academic stress. Time domain and frequency domain parameters were positively correlated with stress score.