Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us?

Aim Performance in the operating room is affected by a combination of individual, patient and environmental factors amongst others. Stress has a potential negative impact on performance with the quality of surgical practice and patient safety being affected as a result. In order to appreciate the...

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Main Authors: Jones, K.I., Amawi, F., Bhalla, A., Peacock, O., Williams, John P., Lund, Jonathan N.
Format: Article
Published: Wiley 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/44539/
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author Jones, K.I.
Amawi, F.
Bhalla, A.
Peacock, O.
Williams, John P.
Lund, Jonathan N.
author_facet Jones, K.I.
Amawi, F.
Bhalla, A.
Peacock, O.
Williams, John P.
Lund, Jonathan N.
author_sort Jones, K.I.
building Nottingham Research Data Repository
collection Online Access
description Aim Performance in the operating room is affected by a combination of individual, patient and environmental factors amongst others. Stress has a potential negative impact on performance with the quality of surgical practice and patient safety being affected as a result. In order to appreciate the level of stress encountered during surgical procedures both objective and subjective methods can be used. This study reports the use of a combined objective (physiological) and subjective (psychological) method for evaluating stress experienced by the operating surgeon. Method Six consultant colorectal surgeons were evaluated performing eighteen anterior resections. Heart rate was recorded using a wireless chest strap at eight pre-determined operative steps. Heart Rate Variability indices were calculated offline using computerized software. Surgeon reported stress was collected using the State Trait Anxiety Inventory, a validated clinical stress scale. Results A significant increase in stress was demonstrated in all surgeons whilst operating as indicated by sympathetic tone (control: 4.02 ± 2.28 vs operative: 11.42 ± 4.63; P < 0.0001). Peaks in stress according to operative step were comparable across procedures and surgeons. There was a significant positive correlation with subjective reporting of stress across procedures (r = 0.766; P = 0.0005). Conclusion This study demonstrates a significant increase in sympathetic tone in consultant surgeons measured using heart rate variability during elective colorectal resections. A significant correlation can be demonstrated between HRV measurements and perceived stress using the State Trait Anxiety Inventory. A combined approach to assessing operative stress is required to evaluate any effect on performance and outcomes.
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spelling nottingham-445392020-05-04T20:09:15Z https://eprints.nottingham.ac.uk/44539/ Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us? Jones, K.I. Amawi, F. Bhalla, A. Peacock, O. Williams, John P. Lund, Jonathan N. Aim Performance in the operating room is affected by a combination of individual, patient and environmental factors amongst others. Stress has a potential negative impact on performance with the quality of surgical practice and patient safety being affected as a result. In order to appreciate the level of stress encountered during surgical procedures both objective and subjective methods can be used. This study reports the use of a combined objective (physiological) and subjective (psychological) method for evaluating stress experienced by the operating surgeon. Method Six consultant colorectal surgeons were evaluated performing eighteen anterior resections. Heart rate was recorded using a wireless chest strap at eight pre-determined operative steps. Heart Rate Variability indices were calculated offline using computerized software. Surgeon reported stress was collected using the State Trait Anxiety Inventory, a validated clinical stress scale. Results A significant increase in stress was demonstrated in all surgeons whilst operating as indicated by sympathetic tone (control: 4.02 ± 2.28 vs operative: 11.42 ± 4.63; P < 0.0001). Peaks in stress according to operative step were comparable across procedures and surgeons. There was a significant positive correlation with subjective reporting of stress across procedures (r = 0.766; P = 0.0005). Conclusion This study demonstrates a significant increase in sympathetic tone in consultant surgeons measured using heart rate variability during elective colorectal resections. A significant correlation can be demonstrated between HRV measurements and perceived stress using the State Trait Anxiety Inventory. A combined approach to assessing operative stress is required to evaluate any effect on performance and outcomes. Wiley 2015-04 Article PeerReviewed Jones, K.I., Amawi, F., Bhalla, A., Peacock, O., Williams, John P. and Lund, Jonathan N. (2015) Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us? Colorectal Disease, 17 (4). pp. 335-341. ISSN 1463-1318 Stress; heart rate variability; subjective; objective; surgery http://onlinelibrary.wiley.com/doi/10.1111/codi.12844/abstract doi:10.1111/codi.12844 doi:10.1111/codi.12844
spellingShingle Stress; heart rate variability; subjective; objective; surgery
Jones, K.I.
Amawi, F.
Bhalla, A.
Peacock, O.
Williams, John P.
Lund, Jonathan N.
Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us?
title Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us?
title_full Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us?
title_fullStr Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us?
title_full_unstemmed Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us?
title_short Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us?
title_sort assessing surgeon stress when operating using heart rate variability and the state trait anxiety inventory: will surgery be the death of us?
topic Stress; heart rate variability; subjective; objective; surgery
url https://eprints.nottingham.ac.uk/44539/
https://eprints.nottingham.ac.uk/44539/
https://eprints.nottingham.ac.uk/44539/