Psychosomatic response to acute emotional stress in healthy students.

The multidimensionality of the stress response has shown the complexity of this phenomenon and therefore the impossibility of finding a unique biomarker among the physiological variables related to stress. An experimental study was designed and performed to guarantee the correct synchronous and concurrent measure of psychometric tests, biochemical variables and physiological features related to acute emotional stress. The population studied corresponds to a group of 120 university students between 20 and 30 years of age, with healthy habits and without a diagnosis of chronic or psychiatric illnesses. Following the protocol of the experimental pilot, each participant reached a relaxing state and a stress state in two sessions of measurement for equivalent periods. Both states are correctly achieved evidenced by the psychometric test results and the biochemical variables. A Stress Reference Scale is proposed based on these two sets of variables. Then, aiming for a non-invasive and continuous approach, the Acute Stress Model correlated to the previous scale is also proposed, supported only by physiological signals. Preliminary results support the feasibility of measuring/quantifying the stress level. Although the results are limited to the population and stimulus type, the procedure and methodological analysis used for the assessment of acute stress in young people can be extrapolated to other populations and types of stress.

Measuring acute stress response through physiological signals: towards a quantitative assessment of stress.

Social and medical problems associated with stress are increasing globally and seriously affect mental health and well-being. However, an effective stress-level monitoring method is still not available. This paper presents a quantitative method for monitoring acute stress levels in healthy young people using biomarkers from physiological signals that can be unobtrusively monitored. Two states were induced to 40 volunteers, a basal state generated with a relaxation task and an acute stress state generated by applying a standard stress test that includes five different tasks. Standard psychological questionnaires and biochemical markers were utilized as ground truth of stress levels. A multivariable approach to comprehensively measure the physiological stress response is proposed using stress biomarkers derived from skin temperature, heart rate, and pulse wave signals. Acute physiological stress levels (total-range 0-100 au) were continuously estimated every 1 min showing medians of 29.06 au in the relaxation tasks, while rising from 34.58 to 47.55 au in the stress tasks. Moreover, using the proposed method, five statistically different stress levels induced by the performed tasks were also measured. Results obtained show that, in these experimental conditions, stress can be monitored from unobtrusive biomarkers. Thus, a more general stress monitoring method could be derived based on this approach. Graphical abstract Stress measurements of different healthy young people throughout a Stress Session that includes a pre-relax stage (BLs), memory test (ST and MT), stress anticipation time (SA), video display (VD) and arithmetic task.

Effectiveness of patient empowerment over stress related to knee arthroplasty surgery / Efectividad del empoderamiento del paciente sobre el estrés relacionado con la cirugía de artroplastia de rodilla

OBJECTIVE: This study aims to show evidence of the Empowerment Session's effectiveness through measurements of surgery related emotional stress before and after this session. Method: The study was performed on 41 patients with knee arthroplasty surgery prescription by measuring the evolution of their emotional stress generated by surgery expectative, during the empowerment session. Two sets of measurements per patient were performed, before and after the empowerment session. Each set consisted of recording an electrocardiogram for 10min while the patients were seated and then applying two standard psychometric tests: State-Trait Anxiety Inventory test and Visual Analog Stress test. Differences in emotional stress were analyzed using psychometric tests and heart rate variability (HRV) analysis as stress biomarkers. RESULTS: Psychometric stress measurement shows a 17.8% reduction in stress according to the total stress scale value, and a 41.9% reduction in stress between test results before and after the session. Mean heart rate values increased by 7.4% with respect to the initial values, very low frequency power and total power also change in value suggesting more sympathetic and less parasympathetic activity. CONCLUSIONS: Both psychological and physiological measurements suggest the effectiveness of the empowerment session due to a significant increase in the wellness state of PATIENTS: Additionally, the correlation between psychometric tests and HRV indices demonstrates that both emotional stress indicators could be used as feedback on the empowerment sessions or as a reference to enhance surgical outcomes

OBJETIVO: Este estudio tiene como objetivo dar evidencias de la eficacia de la sesión de empoderamiento a través de mediciones del estrés emocional relacionado con la cirugía antes y después de esta sesión. MÉTODO: El estudio se realizó en 41 pacientes con prescripción de cirugía de artroplastia de rodilla durante la sesión de empoderamiento. Se realizaron 2 conjuntos de medidas por paciente, antes y después de la sesión. Cada conjunto consistió en registrar el electrocardiograma durante 10min mientras los pacientes estaban sentados y luego aplicando 2 test psicométricos estándar: test State-Trait Anxiety Inventory y escala análoga visual. Las diferencias en el estrés emocional se analizaron mediante test psicométricos y el análisis de la variabilidad del ritmo cardíaco (HRV) como biomarcadores de estrés. RESULTADOS: Los puntajes en los test psicométricos muestran una reducción del 17,8% en el estrés según el valor de la escala de estrés total, y una reducción del 41,9% en el estrés entre los resultados de las pruebas antes y después de la sesión. Los valores medios de ritmo cardíaco aumentaron un 7,4%. Las variaciones en la potencia ultra baja frecuencia y la potencia total sugieren una mayor actividad simpática y menor parasimpática. CONCLUSIONES: Tanto las mediciones psicológicas como fisiológicas sugieren la efectividad de la sesión de empoderamiento debido a un aumento significativo en el estado de bienestar de los pacientes. Además, la correlación entre las pruebas psicométricas y los índices de HRV demuestra que ambos indicadores de estrés emocional podrían utilizarse como retroalimentación en las sesiones de empoderamiento o como una referencia para mejorar los resultados quirúrgicos

Effectiveness of patient empowerment over stress related to knee arthroplasty surgery.

OBJECTIVE: This study aims to show evidence of the Empowerment Session's effectiveness through measurements of surgery related emotional stress before and after this session. METHOD: The study was performed on 41 patients with knee arthroplasty surgery prescription by measuring the evolution of their emotional stress generated by surgery expectative, during the empowerment session. Two sets of measurements per patient were performed, before and after the empowerment session. Each set consisted of recording an electrocardiogram for 10min while the patients were seated and then applying two standard psychometric tests: State-Trait Anxiety Inventory test and Visual Analog Stress test. Differences in emotional stress were analyzed using psychometric tests and heart rate variability (HRV) analysis as stress biomarkers. RESULTS: Psychometric stress measurement shows a 17.8% reduction in stress according to the total stress scale value, and a 41.9% reduction in stress between test results before and after the session. Mean heart rate values increased by 7.4% with respect to the initial values, very low frequency power and total power also change in value suggesting more sympathetic and less parasympathetic activity. CONCLUSIONS: Both psychological and physiological measurements suggest the effectiveness of the empowerment session due to a significant increase in the wellness state of patients. Additionally, the correlation between psychometric tests and HRV indices demonstrates that both emotional stress indicators could be used as feedback on the empowerment sessions or as a reference to enhance surgical outcomes.