Stress, Anxiety, and Depression Are Linked to Heart Rate Variability in Indonesian Anesthesiology and Intensive Therapy Residents: A Cross-Sectional Study

Abstract

Introduction: Psychological stress is a global health issue affecting both mental and physical well-being, particularly among residents. Anesthesiology residency training is recognized as highly stressful, potentially impacting cardiovascular health. Objectives: This study aims to assess the relationship between psychological stress levels and heart rate variability (HRV) in anesthesiology and intensive therapy residents. Methods: This cross-sectional study was conducted in April–May 2024 at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Psychological stress was assessed using the DASS-21 questionnaire. HRV parameters (time and frequency domains) were measured using Actiheart software version 4.0.116. Sociodemographic data were collected for analysis. Spearman’s correlation test was performed to examine relationships between HRV, psychological stress, and sociodemographic variables using SPSS 27. Results: Of the 89 residents, the mean age was 31.07 years. Depression, anxiety, and stress levels were observed in 18%, 24.7%, and 21.3% of residents, respectively. Significant negative correlations were found between HRV parameters (e.g., SDNN, RMSSD, VLF) and the depression and stress subscales (e.g., SDNN r = -0.214, p = 0.044; VLF r = -0.278, p = 0.008). Fewer correlations were observed with the anxiety subscale. Sociodemographic analysis showed a positive correlation between years of education and depression levels (r = 0.311, p = 0.003). Conclusions: Psychological stress, particularly depression and stress, was negatively correlated with HRV parameters, indicating impaired autonomic regulation. HRV may serve as a potential biomarker for monitoring psychological health in anesthesiology residents and warrants further exploration for preventive and early intervention strategies.