Objective assessment of mental stress in individuals with different levels of effort reward imbalance or overcommitment using heart rate variability: a systematic review.

backgroundWorkloads are increasing and could cause mental stress, e.g., in the form of subjective effort reward imbalance (ERI) and overcommitment (OC). The heart rate variability (HRV) is a valid method for objective monitoring of workload. The aim of this project is to systematically evaluate the literature on HRV as an objective indicator for mental stress in individuals with different levels of ERI or OC.

methodsA systematic literature review examining HRV of employees in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting systematic reviews was performed. Electronic databases used were PubMed, Ovid, Cochrane Libary, Scopus and Web of Science, PsyInfo, Psyndex, and Livio. Only articles from 2005 to 2021 were included. Inclusion criteria were case-control studies, intervention studies, cross-sectional studies, or longitudinal studies with different levels of ERI and/or OC, >10 participants in each group, measurement of 24h HRV by using Holter ECG or chest belt, and full-text in English or German language. The methodological quality was evaluated by using a modified STARD for HRV.

resultsFive studies matched the inclusion criteria by using HRV (24-h ECG) with a different HRV analysis at day and night. It showed an adaptation of HRV with higher ERI or OC with reduced parasympathetic HRV parameters, but the studies were not comparable.

conclusionsThere is a need for occupational health studies that examine strains and stress of different employees with predominantly mental stress. The well-established parasympathetic mediated HRV parameters seem to be suitable parameters to objectify the stress.