Vital analysis: field validation of a framework for annotating biological signals of first responders in action

Smartphone-Based Self-Assessment of Stress in Healthy Adult Individuals: A Systematic Review

Background

Stress is a common experience in today’s society. Smartphone ownership is widespread, and smartphones can be used to monitor health and well-being. Smartphone-based self-assessment of stress can be done in naturalistic settings and may potentially reflect real-time stress level.

Objective

The objectives of this systematic review were to evaluate (1) the use of smartphones to measure self-assessed stress in healthy adult individuals, (2) the validity of smartphone-based self-assessed stress compared with validated stress scales, and (3) the association between smartphone-based self-assessed stress and smartphone generated objective data.

Methods

A systematic review of the scientific literature was reported and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The scientific databases PubMed, PsycINFO, Embase, IEEE, and ACM were searched and supplemented by a hand search of reference lists. The databases were searched for original studies involving healthy individuals older than 18 years, measuring self-assessed stress using smartphones.

Results

A total of 35 published articles comprising 1464 individuals were included for review. According to the objectives, (1) study designs were heterogeneous, and smartphone-based self-assessed stress was measured using various methods (e.g., dichotomized questions on stress, yes or no; Likert scales on stress; and questionnaires); (2) the validity of smartphone-based self-assessed stress compared with validated stress scales was investigated in 3 studies, and of these, only 1 study found a moderate statistically significant positive correlation (r=.4; P<.05); and (3) in exploratory analyses, smartphone-based self-assessed stress was found to correlate with some of the reported smartphone generated objective data, including voice features and data on activity and phone usage.

Conclusions

Smartphones are being used to measure self-assessed stress in different contexts. The evidence of the validity of smartphone-based self-assessed stress is limited and should be investigated further. Smartphone generated objective data can potentially be used to monitor, predict, and reduce stress levels.

Are standard heart rate variability measures associated with the self-perception of stress of firefighters in action?

Stress is a major factor for the degradation of cardiac health in first responder professionals such as firefighters. Monitoring stress during real events might be the key for controlling this problem. In this paper we inspect how standard heart rate variability (HRV) measures are associated with the self-perception of stress of firefighters in action, supported by an advanced technological solution to acquire this data. Results obtained from more than 94 hours of annotated ECG recordings of firefighters in action are promising, showing positive association with various standard HRV measures. Given the richness of the gathered data, we have also measured the association of the HRV measures with the stage of a firefighting event (pre, during, post), obtaining some interesting results that hint that the psychological impact of the post-event may be one of the most concerning situations for a firefighter, motivating further studies on this in the future.