دانلود رایگان مقاله همودینامیک و عملکرد اتونوم فرسودگی مدرسه دانشجویان پزشکی

ABSTRACT

This study investigated the relationship between burnout and hemodynamic and autonomic functioning in both medical students (N = 55) and premedical undergraduate students (N = 77). Questionnaires screened for health related issues and assessed school burnout and negative affect symptomatology (anxiety and depression). Continuous beat-to-beat blood pressure (BP) through finger plethysmography and electrocardiogram (ECG) monitoring was conducted during conditions of baseline and cardiac stress induced via the cold pressor task to produce hemodynamic, heart rate variability, and blood pressure variability indices. Independent sample t-tests demonstrated that medical students had significantly higher school burnout scores compared to their undergraduate counterparts. Controlling for age, BMI, anxiety and depressive symptoms, multiple regression analyses indicated that school burnout was a stronger predictor of elevated hemodynamics (blood pressure), decreased heart rate variability, decreased markers of vagal activity and increased markers of sympathetic tone at baseline for medical students than for undergraduates. Analyses of physiological values collected during the cold pressor task indicated greater cardiac hyperactivity for medical students than for undergraduates. The present study supports previous research linking medical school burnout to hemodynamic and autonomic functioning, suggests biomarkers for medical school burnout, and provides evidence that burnout may be implicated as a physiological risk factor in medical students. Study limitations and potential intervention avenues are discussed.

4. Discussion

This study evaluated novel relationships between burnout and cardiovascular and autonomic nervous systemfunctioning inmedical and premedical student samples. As expected, graduate medical students suffer from higher burnout than premedical undergraduates. Furthermore, the associations between school burnout and indices of poorer cardiovascular functioning were stronger for the graduate medical students than the premedical undergraduates. In particular, we observed that school burnout was associated with decreased markers of vagal activity (pNN50, RMSSD) and increased markers of sympathetic tone (LFnu, LFSBP) to a greater degree in graduate medical students. Thus the novel findings of the present study include identifying potential biomarkers of school burnout which provide initial evidence to suggestthat school burnout, especially in the medical student population, may be cardiotoxic and hence may predispose individuals with high school burnout scores to cardiovascular disease.