Stres na delovnem mestu in variabilnost srčne frekvence

Abstract

Stress is a complex psychoneuroendocrinological and immune response of an individual to a stressogenic factor. The most important contemporary stressogenic factors are mental, psychosocial and socio-economic stressors. This especially holds true for occupational stress. Many symptoms, signs and diseases are associated with chronic occupational stress. This article describes different stressogenic factors that lead to occupational stress and two conceptual models of occupational stress (Karasek’s Demand/Control Model and Siegrist’s Effort- Reward Imbalance Model). Reaction to stress can be measured in various ways. This article summarizes the physiology of heart beat regulation and presents heart rate variability as a measurable parameter of stress reaction. Measuring heart rate variability gives us an insight into autonomic modulation of the heart and functioning of the entire autonomic nervous system. The article presents the latest results of larger studies that examined the impact of occupational stress and various work schedules as source of occupational stress on heart rate variability. We described various mechanisms that lead to end-organ damage due to changes in the autonomic nervous system as a result of work stress as well as several measures to reduce the impact of occupational stress on heart rate variability. Subjects exposed to chronic stress have significantly lower heart rate variability compared with subjects unaffected by stress. Researches have shown that reduced heart rate variability reliably predicts mortality among healthy adults, as well as morbidity and mortality in patients after acute myocardial infarction, in patients with chronic heart failure and mortality in patients with chronic kidney disease.