Study: Resilience, emotional support key to helping healthcare workers fight stress

To understand and combat rising stress levels among healthcare workers, Mount Sinai Health System conducted a study using Apple Watches to gauge the characteristics that were associated with stress over time.

Published in the Journal of Medical Internet Research last week, the study was conducted across seven Mount Sinai hospitals in New York City from April 29, 2020, to Sept. 29, 2020. A total of 361 participants were enrolled in the study, which used a combination of surveys and wearables to measure stress.

Study participants downloaded a custom application, answered brief daily questions and wore Apple Watches to measure heart rate variability.

“Apple Watches collect heart rate variability, which is a calculation of the small time difference between each heartbeat,” said Dr. Robert Hirten, the study’s corresponding author and member of the Hasso Plattner Institute for Digital Health at Mount Sinai and the Mount Sinai Clinical Intelligence Center. “This reflects autonomic nervous system function or the part of the nervous system that controls the body’s functions. This part of the nervous system is also impacted by stress. Therefore, from the Apple Watch we can also see how stress is impacting healthcare workers’ bodies over time.”

Researchers used a multivariate analysis to assess heart rate variability as well as the survey responses,

They found that high resilience, that is, the ability to bounce back from adversity or difficulties, and emotional support were associated with lower stress over time.

“While it is known that factors like resilience and social support can protect against how one perceives stress, it is interesting that we can see how these features have a physical impact over time using a commonly used wearable device such as the Apple Watch,” Hirten said in an email.

On the other hand, worsening stress over time was linked to the number of Covid-19 cases in the community, bolstering research that shows the stress epidemic unfolding among healthcare workers amid the pandemic.

The next step for researchers is to examine interventions that can help alleviate healthcare worker stress.

Resilience, which the study shows is a risk factor for increased long-term stress, is something that can be easily measured, Hirten said. So, it can be used to identify at-risk healthcare workers.

Researchers have launched a follow-up study that provides a digital intervention to help those at-risk workers build resilience.

“We are offering this [intervention] to all interested Mount Sinai healthcare workers in hopes of studying its impact on their mental health, resilience and stress,” Hirten said. “This could then provide an easy-to-implement intervention to help our healthcare workers in need of support.”

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