Relationship between psychosocial factors and cardiovascular autonomic function among junior doctors: A cross-sectional study
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Background
Psychosocial factors such as stress, anxiety, and depression, are important causes of CVD by contributing to autonomic dysfunction, predisposing to endothelial dysfunction, arrhythmogenesis, among others. Doctors are at a high risk of psychosocial distress due to factors such as heavy workload and taking end-of-life care decisions. We sought to determine the prevalence of psychosocial factors among junior doctors and explore their relationship with cardiovascular autonomic function.
Methods
A cross-sectional study was conducted among junior doctors at the Korle-bu Teaching Hospital from April to August 2023. Data were collected using an electronic questionnaire and a treadmill stress test. The Depression, Anxiety, and Stress Scale −21 items (DASS-21) was incorporated into the questionnaire to assess depressive, anxiety and stress symptoms. Cardiovascular autonomic function was determined by heart rate recovery and chronotropic index. The data collected were analysed with the Stata version 16.1, using descriptive and inferential statistics.
Results
244 junior doctors participated in the study, with a mean age of 31.46. The prevalences of depressive, anxiety and stress symptoms were 29.51%, 48.77% and 48.36% respectively, correlating moderately with one another. Chronotropic index was abnormal for 9.43% of respondents (95% CI = 6.07% - 13.81%) and heart rate recovery-at-1-minute (HRR 1 ), 3.28% (1.43% - 6.36%). There were no differences in autonomic function profile based on tertiles of psychosocial factors using the Kruskal-Wallis test and one-way analysis of variance. Stress scores were associated with increased HRR 1 (β per SD 1.53 bpm, 95% CI 0.03 - 3.02). Higher depression scores were associated with lower odds of chronotropic incompetence (adjusted OR 0.44, 95% CI 0.22 - 0.88).
Conclusion
There is a high prevalence of depressive, anxiety and stress symptoms among junior doctors. This is however associated with augmented rather than impaired cardiovascular autonomic function.
