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Intervenção do biofeedback baseado na variabilidade da frequência cardíaca para o stress e a ansiedade na transição clínica dos estudantes de medicina dentária
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Introdução: A transição para a prática clínica em Medicina Dentária consistiu um período exigente, associado ao aumento dos níveis de stress e ansiedade. O Heart Rate Variability Biofeedback (HRV-BFB) constitui uma abordagem promissora de autorregulação autonómica.
Objetivos: Avaliar a eficácia de um programa de HRV-BFB no stress percebido (PSS10), ansiedade-estado (STAI-Y1), distress psicológico (K10) e indicadores fisiológicos da HRV, em estudantes do 4.° ano de Medicina Dentária.
Metodologia: Ensaio clínico randomizado, incluindo 72 estudantes do 4.° ano do Mestrado Integrado em Medicina Dentária da Egas Moniz School of Health and Science, distribuídos aleatoriamente por grupo experimental (n=36) e grupo de controlo (n=36). O grupo experimental realizou 10 sessões bissemanais de 10 minutos de HRV-BFB, ao longo de 5 semanas. Foram avaliadas as variáveis psicológicas em ambos os grupos, em 3 momentos (pré, pós e follow-up), bem como a evolução de indicadores fisiológicos da HRV no grupo experimental, através de análises estatísticas descritivas e inferenciais.
Resultados: A MANOVA revelou um efeito significativo da interação tempo × grupo (p=.007). As ANOVAs evidenciaram interações tempo × grupo significativas para PSS10 (p=.017), STAI-Y1 (p=.011) e K10 (p=.026). As comparações post-hoc indicaram uma redução significativa da PSS10 entre o pré e o pós-intervenção no grupo HRV-BFB, bem como aumentos significativos da STAI-Y1 no grupo controlo entre o pré e o pós-intervenção e entre o pré e o follow-up. Ao nível fisiológico, observou-se no grupo experimental, um aumento do RMSSD (p=.004) e da potência LF (p=.003), com estabilidade da MeanHR e HF, bem como uma tendência para diminuição do SNSi e do rácio LF/HF.
Conclusão: O HRV-BFB poderá contribuir para uma adaptação autonómica progressiva, reforçando a modulação parassimpática e melhorando o bem-estar psicológico, constituindo uma estratégia viável para a promoção da saúde mental durante a transição clínica.
Introduction: The transition to clinical practice in Dentistry constituted a demanding period, associated with increased levels of stress and anxiety. Heart Rate Variability Biofeedback (HRV-BFB) constitutes a promising approach to autonomic self-regulation. Objectives: To evaluate the effectiveness of an HRV-BFB program on perceived stress (PSS10), state anxiety (STAI-Y1), psychological distress (K10) and physiological indicators of HRV, in 4th-year Dental Students. Methods: Randomized clinical trial was conducted including 72 4th-year Integrated Master’s students in Dentistry from Egas Moniz School of Health and Science, randomly allocated to an experimental group (n=36) and a control group (n=36). The experimental group completed 10 biweekly 10-minute HRV-BFB sessions over 5 weeks. Psychological variables were assessed in both groups at three time points (pre, post, and follow-up), as well as the evolution of physiological HRV indicators in the experimental group, through descriptive and inferential statistics. Results: MANOVA revealed a significant time × group interaction effect (p=.007). ANOVAs showed significant time × group interactions for PSS10 (p=.017), STAI-Y1 (p=.011), and K10 (p=.026). Post-hoc comparisons indicated a significant reduction in PSS10 between pre- and post-intervention in the HRVBFB group, as well as significant increases in STAI-Y1 in the control group between pre- and post-intervention and between pre-intervention and follow-up. At the physiological level, the group experimental showed increase in RMSSD (p=.004) and LF power (p=.003), with stability in MeanHR and HF, as well as a tendency towards a decrease in SNSi and the LF/HF ratio. Conclusion: HRV-BFB may contributes to progressive autonomic adaptation, reinforcing parasympathetic modulation and improving psychological well-being, constituting a viable strategy for the promotion of mental health during the clinical transition.
Introduction: The transition to clinical practice in Dentistry constituted a demanding period, associated with increased levels of stress and anxiety. Heart Rate Variability Biofeedback (HRV-BFB) constitutes a promising approach to autonomic self-regulation. Objectives: To evaluate the effectiveness of an HRV-BFB program on perceived stress (PSS10), state anxiety (STAI-Y1), psychological distress (K10) and physiological indicators of HRV, in 4th-year Dental Students. Methods: Randomized clinical trial was conducted including 72 4th-year Integrated Master’s students in Dentistry from Egas Moniz School of Health and Science, randomly allocated to an experimental group (n=36) and a control group (n=36). The experimental group completed 10 biweekly 10-minute HRV-BFB sessions over 5 weeks. Psychological variables were assessed in both groups at three time points (pre, post, and follow-up), as well as the evolution of physiological HRV indicators in the experimental group, through descriptive and inferential statistics. Results: MANOVA revealed a significant time × group interaction effect (p=.007). ANOVAs showed significant time × group interactions for PSS10 (p=.017), STAI-Y1 (p=.011), and K10 (p=.026). Post-hoc comparisons indicated a significant reduction in PSS10 between pre- and post-intervention in the HRVBFB group, as well as significant increases in STAI-Y1 in the control group between pre- and post-intervention and between pre-intervention and follow-up. At the physiological level, the group experimental showed increase in RMSSD (p=.004) and LF power (p=.003), with stability in MeanHR and HF, as well as a tendency towards a decrease in SNSi and the LF/HF ratio. Conclusion: HRV-BFB may contributes to progressive autonomic adaptation, reinforcing parasympathetic modulation and improving psychological well-being, constituting a viable strategy for the promotion of mental health during the clinical transition.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Stress Ansiedade VFC Biofeedback Alunos de medicina dentária