ANALYSIS OF STRESS RESISTANCE AND ADAPTIVE POTENTIAL OF STUDENTS OF THE INITIAL COURSES OF THE MEDICAL UNIVERSITY

Abstract

Keywords

Relevance: The Bayevsky index or stress index is a parameter characterizing the degree of tension of the neurohumoral mechanisms of regulation of heart rhythm, i.e. the degree of predominance of sympathetic or parasympathetic nervous systems. In a calm state, the rhythm of the heart is mainly regulated by pacemakers (pacemaker cells), the influence of sympathetic and parasympathetic ganglia is also added here, as well as the level of certain hormones has its effect. With this type of influence, the heart rate is not strictly periodic and can change in waves [1]. At the same time, the Bayevsky index remains low. In case of stress reactions, the control of the heart rate is taken over by the brain centers - the brainstem and the cerebral cortex. And already with such a highly organized control, the rhythm changes to a more rigid one, i.e. periodic and correct, and the time between adjacent beats is the same. At the same time, the Bayevsky index increases [2]. 

The Bayevsky index is calculated based on the analysis of heart rate variability (HRV), which reflects fluctuations in the intervals between adjacent heartbeats. Heart rate variability is a powerful tool for assessing the effect of the autonomic nervous system on heart function [3]. With the help of the Bayevsky index, it is possible to determine, among other things, the level of stress and resistance to it. High index values may indicate increased stress or reduced adaptation of the body to stress [4].

The relevance of the Bayevsky index study to assess the level of stress and resistance to it in 1st and 2nd year students of a medical university is due to a number of factors. Students of medical universities from their first years face a high academic load, emotional stress and the need to adapt to a new social and educational environment. These factors can lead to the development of stress and a decrease in educational motivation, which, in turn, negatively affects the educational process and can contribute to the emergence of health-saving problems [2].

The use of the Bayevsky index as a tool for assessing the stress level and adaptive capabilities of students allows us to obtain objective data on the state of their autonomic nervous system and its ability to cope with stress [5]. This research can contribute to the development of effective strategies to improve students' adaptation to the conditions of the educational process, reduce stress levels and prevent its negative effects on health and educational activities.

Objective: to assess the stress resistance and adaptive potential of the students of the initial courses of the medical university.

Research material and methods: 128 students aged 17 to 23 years took part in the study conducted at the Department of Normal Physiology of N. N. Burdenko VSMU: 1 group consisted of 1st year students, 2 group – 2nd year students. In accordance with the principles of the Helsinki Declaration of the World Medical Association, written informed consent was received from all participants to participate in the study.

The study began with preliminary data collection via a QR code leading to a Google form that included questions about personal information and health indicators collected from the Health app. The exclusion of participants was based on the presence of cardiovascular, respiratory and nervous diseases, as well as taking medications. Further, using variational cardiointervalometry on the device "Psychophysiological testing Device UPFT-1/30 – "Psychophysiologist", key parameters for assessing stress and adaptation, including the Bayevsky index, were measured [6]. The data obtained served as the basis for the creation of a database on the assessment of stress levels and adaptive capabilities of participants.

The statistical analysis was carried out using the StatTech v. 4.0.6 program (developed by Stattech LLC, Russia) [7]. 

The results obtained and their discussion: We analyzed the indicator "Bayevsky Index" depending on the indicator “Course".                                                                                                          

When evaluating the Baevsky index index depending on the exchange rate, we identified statistically significant differences (p = 0.036). We found that the normal values of the Bayevsky index (i.e. 70-150 y.f) were detected in 65% of 1st year students and 77.9% of 2nd year students, respectively. Moderate voltage of regulatory systems (i.e. 150-300 cu) was found in 10% of 1st year students and 8.8% of 2nd year students, respectively. Pronounced voltage of regulatory systems (i.e. 300-600 cu) was found in 25% of 1st year students and 8.8% of 2nd year students, respectively. And finally, overvoltage (i.e. 600+ units) were found only in 4.4% of 2nd year students.

Statistically confirmed differences in the values of the Bayevsky index between students of the first and second years of medical school indicate a possible adaptation of students to academic stress and academic workload over time. The increase in the number of students with index values within the normal range (70-150 units) in the second year indicates a potential improvement in the function of the autonomic nervous system and strengthening stress resistance. Reducing the percentage of students with high and moderate stress levels in the second year suggests a positive impact of adaptation. However, the detection of overstrain in a limited number of second-year students highlights the need for an individual approach to support students facing difficulties adapting to their studies [8].

Next, the analysis of the "Bayevsky Index" indicator was carried out depending on the “motor activity” indicator in order to see how and in what amount motor activity affects the Bayevsky index (Fig.1).

Figure 1 – Analysis of the "Bayevsky Index" indicator depending on the "Motor activity” indicator

According to the data obtained, when evaluating the Baevsky index index depending on motor activity, significant differences were found (p = 0.012). It was found that the normal values of the Bayevsky Index (i.e. 70-150 y.f) were detected with low physical activity (i.e. at <5000 steps per day) in 33% of students, with moderate physical activity (i.e. at 5000-10000 steps per day) in 81.2% of students, with high physical activity (i.e. at 1000+ steps per day) in 63.3% of students. Moderate voltage of regulatory systems (i.e. 150-300 units) were found with low physical activity in 33% of students, with moderate physical activity in 4.7% of students, with high physical activity in 12.2% of students. Pronounced tension of regulatory systems (i.e. 300-600 cu) was found with low physical activity in 33% of students, with moderate physical activity in 9.4% of students, with high physical activity in 24.5% of students. And finally, overstrain (i.e. 600+ units) was found in only 4.7% of students with moderate workload.

The analysis of data on the Bayevsky Index, based on the level of physical activity of students, revealed the importance of moderate activity for the effective functioning of the autonomic nervous system. It is observed that students who lead a moderate lifestyle (from 5,000 to 10,000 steps per day) demonstrate optimal index values, which indicates their successful adaptation to stress and stress. In contrast, both low and excessive physical activity are associated with increased stress levels of regulatory systems, which may indicate a risk of overstrain or ineffective adaptation. The findings emphasize the need to adjust the level of physical activity in order to facilitate better adaptation of students to academic requirements and reduce stress [3, 8].

Conclusions: 1. Statistically significant differences in the Bayevsky index between 1st and 2nd years indicate an increase in the level of adaptation of students to learning stress over time. 2. Moderate physical activity promotes optimal regulation of the autonomic nervous system and adaptation to stress, while extreme levels of activity worsen adaptation. Based on the data obtained, it is possible to develop recommendations for correcting the educational load and methods of psychological support.