Continuous Heart Rate Variability Monitoring in Doctors; Understanding Patterns of Stress and Recovery and Their Relationship With Self-reported Resilience, Burnout and Wellbeing. (HEART-ED)

Burnout is an increasing concern in the medical professions. This study aims to utilise established, validated self-report measures combined with continuous heart rate variability measurements to better understand the stress and recovery patterns experienced by doctors that may contribute to burnout.

This mixed methods study design will consist of an ecological momentary assessment phase where participants will complete commonly used and validated real-time subjective measures while concurrently wearing a heart rate variability monitor to provide an objective measure of stress. Following on from this, participants of interest will be invited to participate in semi structured interviews to further explore their experiences of stress and recovery.

Study Overview

• Status: Completed
• Conditions: Stress; Burnout; Occupational Stress; Burnout Syndrome

• Study Type: Observational
• Enrollment (Actual): 60

Contacts and Locations

Study Locations

• United Kingdom
  • Aberdeen, United Kingdom, AB25 2ZN
    • NHS Grampian

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Medical Doctors working within NHS Grampian

Description

Inclusion Criteria:

• Working within NHS Grampian
• Access to a smartphone

Exclusion Criteria:

• Cardiac arrhythmias/endocrine disease.
• Prescription beta blockers, calcium channel blockers, ACE inhibitors, benzodiazepines, antidepressants and antianxiety medications.
• Insufficient non-working time prior to study commencement.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Heart rate variability	Continuous heart rate variability over 7 day study period	7 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Burnout	Maslach Burnout Inventory - 22 item scale measuring occupational burnout. Each item asks participants to rank on a scale from never to every day. An overall score is then calculated from the results.	Measured on day 1
Resilience	Resilience Scale for Adults The RSA is a 33-item self-report scale examining intrapersonal and interpersonal factors presumed to assist them to be able to adapt to adversities. Responses are provided via 5-point Likert scale.	Measured on day 1
Wellbeing	ICOPPE Wellbeing Scale The I-COPPE scale(21) has 6 individual domains of interpersonal, community, occupational, physical, psychological, and economic - all of which have been individually validated against overall wellbeing. The scale asks participants to rate each of the wellbeing domains at three different time points, now, one year previously and one year in the future totalling 21 items.	Measured on day 1
EMA Measures	Real-Time Job Demands NASA task load index (NASA TLX) is a multidimensional workload assessment tool. It contains six subscales of mental demand, physical demand, temporal demand, performance, effort, and frustration. The overall workload is derived from an average of the six subscales listed. Real-Time Job Resources This is a six-item scale derived from the job-demands resources model of burnout. The items contained within the scale are feedback, rewards, job control, participation, job security and supervisor support. Flow Included is a single item question asking participants "have you felt completely absorbed by a challenging but doable task". Given the paucity of literature understanding what "flow" might mean within this study population and how this may relate to HRV there is a free text box allowing participants to expand on their experience. Fatigue The Rating of Fatigue (ROF) scale(59)is a single-item visual analogue scale.	8 times/day for 7 days

Collaborators and Investigators

• Sponsor: University of Aberdeen

Publications and helpful links

General Publications

• Kane L, Ball D, Martin KR, Powell D. Continuous heart rate variability monitoring-understanding patterns of stress and recovery and their relationship with self-reported burnout, resilience and well-being in doctors: a protocol for a sequential explanatory mixed-methods study. BMJ Open. 2025 Jun 8;15(6):e097849. doi: 10.1136/bmjopen-2024-097849.

Study record dates

Study Major Dates

• Study Start (Actual): December 9, 2024
• Primary Completion (Actual): October 31, 2025
• Study Completion (Actual): August 31, 2026

Study Registration Dates

• First Submitted: December 3, 2024
• First Submitted That Met QC Criteria: December 3, 2024
• First Posted (Actual): December 6, 2024

Study Record Updates

• Last Update Posted (Actual): September 9, 2026
• Last Update Submitted That Met QC Criteria: September 7, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Keywords: fatigue; stress; HRV; Heart rate variability; resilience; burnout; wellbeing; occupational stress
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Occupational Diseases; Pathological Conditions, Signs and Symptoms; Behavior; Signs and Symptoms; Burnout, Psychological; Occupational Stress; Fatigue
• Other Study ID Numbers: 2-015-24

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No