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Original Research

Prevalence of stress among first year medical students and its effect on heart rate variability

Evelyn Thomas, Silpa Sasi, Geetha Devi Madhavikutty.


Background: A high prevalence of stress is seen among 1st-year medical students. Stress has profound effects on mental and physical health and is seen to affect the autonomic balance with an increase in sympathetic and a decrease in parasympathetic activity.

Aim and Objectives: The objectives of the study were to estimate the prevalence of stress among 1st-year medical students, the distribution of stress in both genders and the association of heart rate variability (HRV) with stress.

Materials and Methods: A cross-sectional analytical study was conducted among 70 1st-year medical students (35 males and 35 females) aged between 18 and 23 years. A self-scoring medical students stress questionnaire was used to assess their degrees of stress. Short-term HRV was recorded by lead II electrocardiogram (ECG) using physiopac.

Results: The prevalence of stress was found to be 97.2% among 1st-year medical students. Majority (65.7%) of females had severe stress, while majority of males (51.4%) had only mild to moderate stress. Although not significant, the mean values of low frequency (LF) power, normalized LF, and LF to high frequency (LF/HF) ratio were higher in mild to moderate and severe groups, compared to no stress group. The mean values of normalized HF were found to be lower in mild to moderate stress and severe stress groups, compared to no stress group, which was also not significant.

Conclusion: The 1st-year medical students are stressed, with more stress among females. It is found to affect their autonomic balance reflected in their HRV values. Hence, to reduce stress, they are advised to adopt various stress-relieving measures.

Key words: Stress; First Year Medical Students; Heart Rate Variability

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