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Chronic stress profoundly affects mental health, significantly influencing mood, behavior, and overall quality of life. Research closely links chronic stress with mental health conditions such as depression, anxiety, and substance use disorders. Ongoing exposure to stress can lead to physiological and psychological changes, initiating a cycle of emotional distress and maladaptive coping mechanisms.
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Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment
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Acute mental stress and surgical performance.

P D Grantcharov1, T Boillat1,2, S Elkabany3

  • 1Section of Bariatric and Minimally Invasive Surgery, Department of Surgery Stanford University School of Medicine Stanford California USA.

BJS Open
|February 9, 2019
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Summary

Acute mental stress during surgery, measured by heart rate variability (HRV), is linked to poorer technical surgical performance. This finding highlights the need to manage surgeon stress for improved patient safety.

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Area of Science:

  • Medical technology
  • Surgical performance analytics
  • Physiological monitoring

Background:

  • Stress negatively affects critical aspects of surgical performance.
  • Wearable technology offers new ways to monitor surgical stress.
  • Investigating the link between intraoperative stress and surgical skill is crucial.

Purpose of the Study:

  • To examine the association between acute intraoperative mental stress and technical surgical performance.
  • To utilize wearable technology for real-time stress assessment in surgeons.

Main Methods:

  • Continuous electrocardiogram (ECG) data collected to measure heart rate variability (HRV) as a proxy for mental stress.
  • Technical surgical performance assessed using the Operating Room Black Box® platform and the Generic Error Rating Tool (GERT).
  • Analysis of time-stamped HRV and video data segmented into 1, 2, and 5-minute intervals.

Main Results:

  • Higher stress levels correlated with significantly increased rates of surgical events (47-66% higher).
  • The strongest association between stress and adverse events was observed using 1-minute intervals and RMSSD (Root Mean Square of Successive Differences).
  • P-value < 0.001 indicated statistical significance for the observed association.

Conclusions:

  • A clear association exists between acute mental stress indicators and diminished technical surgical performance.
  • Further research is needed to understand the interplay between stress, performance, and identify stress triggers.
  • Mitigating surgical stress is essential for enhancing patient safety and optimizing surgical outcomes.