Evaluation of stress and resilience quantification among university students using heart rate variability

Abstract

Malaysia has recently been rocked by the news on the 1708 suicide cases from January 2019 to May 2021. The ongoing neglect of adolescents’ mental health is taking its toll as 51% of the total suicide cases are made up of teenagers between 15 to 18 years old. It is also reported that young people especially university students are affected by Covid-19 prolonged lockdown had the tendency of experiencing mental exhaustion. Notable causes for mental health problems are improper stress management and the lack of psychological resilience. Previously, stress and resilience levels were evaluated using questionnaires. Although questionnaires provide a fair result, there are arguments about their validity due to the existence of bias. The invention of multiple Heart Rate Variability (HRV) devices has made it possible to nullify the bias effect but it is under utilised. Therefore, this study proposed to investigate the effect of HRV through a slow breathing technique. The goal of this study is to improve stress and psychological resilience levels among university students. The methodology involves two stages of data collection: two questionnaires namely Depression, Anxiety, and Stress Scale-21 Items (DASS-21) and Brief Resilience Scale (BRS) were distributed to 240 engineering students; two experiments involving 70 students were conducted to examine the stress and resilience levels. The students were picked as the subjects for each experiment according to their scores obtained from the two questionnaires. The changes of the subjects’ heart rhythm pattern and coherence scores, before and after the intervention were observed using the HeartMath EmWave device. The analysis demonstrated that the proposed HRV using a slow breathing technique as an intervention had contributed a positive impact in managing stress and improving psychological resilience. After implementing the intervention, the total average coherence score increased significantly by 74.3% for Experiment 1 and 52% for Experiment 2. The findings from HeartMath emWave were further analysed using Kubios HRV software. The analyses from the software showed that human nervous system can be manipulated by a suitable intervention. The mean Stress Index, which is heavily linked to Sympathetic Nervous System activities, managed to reduce by 65% and 56.2% with respect to Experiment 1 and Experiment 2. The results from both experiments also provided fruitful insight into the relationship between HRV, stress, and resilience quantification. This study shows that HRV devices and variables are effective in managing stress and improving resilience.