Factors Associated with Wearable-Derived Physiological Stress Indicators Among Clinical Nurses: A Longitudinal...

Area of Science:

• Occupational Health
• Biomedical Engineering
• Nursing Science

Background:

• Work-related stress negatively impacts nursing quality and staff well-being.
• Traditional self-report stress assessments suffer from recall bias and lack real-time data.
• Consumer-grade wearable devices offer continuous physiological stress monitoring.

Purpose of the Study:

• To utilize a wearable device for continuous physiological stress monitoring in clinical nurses.
• To identify factors associated with work-related stress among nurses using objective physiological data.

Main Methods:

• A longitudinal observational study involving 52 clinical nurses over 90 days.
• Continuous monitoring of physiological stress using a Garmin Vivosmart 4 wearable device.
• Analysis of daily mean stress scores derived from heart rate variability using a generalized estimating equation (GEE) model.

Main Results:

• Older age was linked to lower physiological stress (β = -0.55, p = 0.001).
• Night shift work showed significantly lower stress compared to day shifts (β = -11.97, p < 0.001).
• Increased monthly shift changes (≥2) correlated with lower stress (β = -14.74, p = 0.002), while higher daily step counts were associated with increased stress (β = 1.06, p < 0.001).

Conclusions:

• Younger age, day shifts, consistent schedules, and higher daily step counts were associated with higher physiological stress.
• Wearable-based stress monitoring presents a viable, objective alternative to self-report measures.
• Further validation against self-report measures is recommended before implementing findings in occupational health decisions.