*Proceedings*  **Design of a System to Implement Occupational Stress Studies Trough Wearables Devices and Assessment Tests †**

**Patricia Concheiro-Moscoso 1,\*, María del Carmen Miranda-Duro 1, Carlota Fraga 1, Cristina Queirós 2, António José Pereira da Silva Marques 3 and Betania Groba 1** 


Published: 20 August 2020

**Abstract: Introduction**: Stress at work is a factor that has repercussions on both a personal and health level, as well as on productivity at work. **Objective**: To establish if the wearables are devices capable of determining the level of labor stress of working people in a research center. **Methodology:** This pilot study followed up different variables during 6 months on 11 participants of a research center. In the study, wearables Xiaomi MiB and 3 were used, which recorded and continuously monitored the physical activity and sleep of the participants. On the other hand, different specific evaluation tests were used to measure work stress, quality of life and sleep quality. **Results**: The data obtained from the tests and the wearables show that men feel slightly more stressed and sleep worse than women; however, men spend more time sitting and walking than women. **Conclusions:** It is considered important to replicate the study in larger and more heterogeneous cohorts.

**Keywords:** wearables; work stress; quality of life

#### **1. Introduction**

Work stress is a phenomenon that has been gaining in importance in the recent years. It is defined as "a harmful reaction that people have to cope with the pressures and undue demands placed on them at work" [1]. It has a high impact and repercussions on personal and health levels, as well as on productivity at work [2]. When the occupational stress situation maintenances and increases gradually over time, it could be Burnout [3]. This syndrome is defined as "a prolonged response to chronic emotional and interpersonal stressors at work, and is integrated by the dimensions of burnout, cynicism and inefficiency" [3]. The Burnout has a negative influence in the employment and employees' psychological welfare [4].

Some researches on the stress detection reported to the need for improvements the measurement of daily stressors and in the design of studies with the aim of knowing the influence that the different stress process have in the quality of life [5]. So, in this direction, wearable devices as phones, activity trackers, or sensors could become the main tools for the continuous and real-time monitoring of different parameters in order to contribute to health processes and make a relevant contribution to research [6]. In addition, these technological devices can measure physical activity and sleep quality to relate to possible patterns of behavior when exposed to significant stress situations. Some studies, such as Liao et al. (2005), Mozos et al. (2016) and Han et al. (2017), monitored stress in real time through combination of sensors systems to detect stressful situations [7].

This study provides to a new form to capture stress signals by using a smart wristband. Therefore, the aim of this research was to stablish if these wearables are devices capable of determining the level of occupational stress of workers in a research center in Galicia.

#### **2. Methods**

#### *2.1. Study Design*

This pilot study was conducted in a research center during 6 months. It included 11 participants based on the inclusion criteria. The inclusion of participants, who were working in an administrative management department from a research center, is highlighted. Prior to participation, informed consent was obtained from all research volunteers. The study protocol was approved by the Autonomic Research Ethics of A Coruña-Ferrol (2019/249).

#### *2.2. Measures*

#### 2.2.1. Assessment Tools

All tools were self-administrated, coded and managed through Consortium Research Electronic Data Capture (REDCAP) software. The tools were designed, configured and assigned to each of participants via REDCAP. Moreover, the researchers followed up on questionnaires that were filled in by the participants during the study.

The sociodemographic questionnaire was self-administrated at the start of the study. Perceived Stress Scale v10, Pittsburgh Sleep Quality Index scale, EuroQol-5D-5L scale were covered at the start and the end of the research.

Weekly questionnaire was composed by 7 questions about stress, work engagement and frustration; 3 questions were daily self-administrated and 4 questions were weekly self-administrated.

#### 2.2.2. Wearables Devices

The participants wore Xiaomi Mi Band 3 during 6 months. The activity, sleep and heart rate data were extracted by automatic data acquisition system of TALIONIS group, which was located in the work environment of participants.

#### **3. Results**

A total of 11 workers participated in this study, who were mostly women (63.63%). There were no significant differences between start and final measurements of participants.

The measures associated with health-related quality of life show that some participants reported to slight and moderate problems in the dimensions "pain/discomfort" (n = 2) and anxiety/depression (n = 3), specifically at the beginning of the study. In both evaluations, the average score of perceived health status were high (EI = 84.56 (±8.13); EF = 88.38 (±9.91)). PSS-10 results show that the men (Total score = 11.25) exhibited higher levels of stress than women (Total score = 9.71). This is opposed to weekly questionnaire, which shows that women (total score for women = 15.57; total score for man = 14.56) had higher level of stress.

Averages scores of PSQI show that participants had slight difficulties to fall asleep and low sleep quality (EI = 4.89 (±2.62); EF = 4.38 (±1.85)). By contrast, wearables reported that participants attained optimal sleep habits. Data from wearables Xiaomi Mi Band 3 show that men were sitting (7.35 h) and walking (2.22 h) more time than women (6.34 h; 1.64 h). However, the women slept for more time (8.15 h) than men (7.90 h).

#### **4. Discussion and Conclusions**

The aim of this proposal was to establish whether these wearables are devices capable of determining the level of occupational stress of workers. Furthermore, it was determined that the level of occupational stress and quality of life of a group of working people. EQ 5D-5L data show that there were no statically differences associated to sex; this matter is supported by other studies [8]. In general, the participants presented high levels of perceived health status. Men reported more stress than women; in contrast, scientific evidence has reported that the female sex had the highest levels of stress because social, psychological and biological consequences [9]. On the other hand, men showed fewer sleep hours than women; this aspect differs from others studies whose data indicated that women had more sleep problems than men [10]. In conclusion, it is necessary to develop studies with larger sample and with other working environments.

**Author Contributions:** Conceptualization, methodology, formal analysis and writing P.C.-M., M.C.M.-D., C.F. and B.G.; review, editing, visualization and supervision C.Q., A.J.P.S.M. and B.G.; and funding acquisition, M.C.M.-D. and P.C.-M. All authors have read and agreed to the published version of the manuscript.

**Funding:** The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: All the economic costs involved in the study will be borne by the research team. This work was supported in part by some grants from the European Social Fund 2014-2020. CITIC (Research Centre of the Galician University System) and the Galician University System (SUG) obtained funds through Regional Development Fund (ERDF) with 80%, Operational Programme ERDF Galicia 2014-2020 and the remaining 20% by the Secretaría Xeral de Universidades of the Galician University System (SUG). Specifically, the author PCM obtained a scholarship (Ref.ED481A-2019/069) and the author M.C.M.D. (Ref.ED481A 2018/205) to develop the PhD thesis. On the other hand, the diffusion and publication of this research was funded by the CITIC, Research Centre of the Galician University System with the support previously mentioned (Ref ED431G2019/01).

**Acknowledgments:** Financial support from the Xunta de Galicia and the European Union (European Social Fund—ESF), is gratefully acknowledged.

**Conflicts of Interest:** The authors declare no conflict of interest.

#### **References**


*Proceedings* **2020**, *54*, 19


© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

### *Proceedings*  **Virtual Reality Game Analysis for People with Functional Diversity: An Inclusive Perspective †**

#### **María del Carmen Miranda-Duro \*, Patricia Concheiro-Moscoso, Javier Lagares Viqueira, Laura Nieto-Riveiro, Nereida Canosa Domínguez and Thais Pousada García**

TALIONIS Group, CITIC, Oza, Universidade da Coruña, 15071 A Coruña, Spain; patricia.concheiro@udc.es (P.C.-M.); javier.lagares@udc.es (J.L.V.); laura.nieto@udc.es (L.N.-R.); nereida.canosa@udc.es (N.C.D.); thais.pousada.garcia@udc.es (T.P.G.)

**\*** Correspondence: carmen.miranda@udc.es

† Presented at the 3rd XoveTIC Conference, A Coruña, Spain, 8–9 October 2020.

Published: 20 August 2020

**Abstract:** Virtual reality (VR) allows us to simulate everyday life environments with realism and in an immersive environment, with the use of the appropriate hardware. People with functional diversity, either because of environmental barriers or because of their reduced mobility, have fewer opportunities to participate in different daily activities or risk situations outdoors. Therefore, VR can be a technological resource for these people to access, try out, and experience different environments and scenarios, offering new participation experiences. Therefore, the aim of this proposal is to analyze the properties and determine the possibilities of the virtual reality applications available on commercial platforms for use in the practice of rehabilitation and intervention aimed at people with functional diversity. This is a transversal, descriptive study that has focused on the analysis of the 40 applications from the STEAM Virtual Reality and VIVE platforms for High Tech Computer Corporation (HTC). After analysis, it has been observed that there are no applications available that are fully accessible and with a minimum degree of usability for use by people with functional diversity.

**Keywords:** virtual reality; functional diversity; accessibility

#### **1. Introduction**

Virtual reality (VR) allows us to simulate everyday life environments with realism and in an immersive environment, with the use of the appropriate hardware. These virtual spaces allow for the reproduction of everyday situations, such as shopping, attending a concert, or going on a medical visit, but also, other experiences that are less frequent, such as exposure to risk events, adventure experiences, or stimuli that can simulate "phobias" for their approach. People with functional diversity, either because of environmental barriers or because of their reduced mobility, have fewer opportunities to participate in different daily activities or risk situations outdoors. Therefore, VR can be a technological resource for these people to access and try out different environments and scenarios, offering new experiences of participation. Furthermore, the possibility of adapting and customizing these virtual contents gives them added value, optimizing their applicability in a therapeutic intervention [1,2].

The aim of this proposal is to analyze the properties and determine the possibilities of VR apps available on commercial platforms for use in the practice of rehabilitation and intervention aimed at people with functional diversity. As a specific objective, it is proposed that the content of the apps must be related to different activities in people's daily lives, such as simulations of a job or activities such as cooking.

#### **2. Material and Methods**

The present study was carried out between February and May. The apps included in the analysis of the present study met the inclusion and exclusion previously defined (see Table 1).

The present study consists of a transversal, descriptive study that has focused on the analysis of the different apps included. This process has been carried out on the basis of a checklist of our own elaboration through which different characteristics were analyzed, such as language options; age for use; type of activity (observation or interaction); purpose; duration; physical and cognitive, comprehension or usability implications; game mode (individual or multiplayer); level of accessibility, and cost.

**Table 1.** Inclusion and exclusion criteria of virtual reality app analyzed.


#### **3. Results**

A total of 40 VR apps were included in the analysis of the present study. From Viveport were Camila, Let Hawaii Happen, Lifelique VR Museum, BallomBon Cashmere, Ikea VR Pancake Kitchen, The Stanford Ocean Acidification Experience, Richie Experience, Sim City, The Blu: Whale Encounter, VR Bowls, Engage, ISS 360º Tour with Tim Peake, Crossing the Road with Safety, Cmoar VR Cinema, Cabinet Model Room, The VR Museum of Fine Art, Underwater Mermaid, Clash of Chefs VR—Early Access, Bartender VR Simulator, Manifest Dream, VR Paris Bus Tour—France, Museum of Other Realities, 3D Organon VR Anatomy, OhShape, Ultimate Fishing Simulator, Mona Lisa: Beyond the Glass, First Person Tennis—The Real Tennis Simulator, Virtual Vacations, Blueplanet VR, Conductor, Paper Fire Rookie, and Healthy Badminton 2019 [3]. From the Steam platform, we included BoxVR, Tiny Town VR, Budget Cuts, Thief Simulator, Surgeon Simulator: Experience Reality, Ocean Rift, and Minigolf VR [4].

The most common language was English (92.5%), while the 52.5% of them were only in English, followed by Spanish (30%)—but none of them were only in Spanish—and Chinese (27.5%), while 7.5% were only in Chinese. The languages included in the apps were English, Spanish, Chinese, Korean, French, German, Italian, Japanese, Korean, Polish, Portuguese, Russian, Turkish, and Dutch. However, no app specified the appropriate age for use. In addition, related to the type of activity, 30% of the 40 apps were only for observational mode, while the rest were available in an observation and interaction mode with the VR scenario.

Among the different purposes that the different apps had, it is worth mentioning some of them, for example story-telling; vacation simulator; education (i.e., anatomy) and learning cultural aspects (i.e., visiting museums or cities); creating dresses; games such as blow up balloons; activities such as cooking; observation of oceans or landscapes; job simulator (i.e., office job, waiter, surgeon); a city simulator; playing sports (i.e., bowls, golf, tennis, badminton, boxing); organization of classes, meetings and others; space simulator in the role of an astronaut; crossing the road with safety; leisure activities such as cinema, room design, fishing, firefighting, and a thief simulator. The duration of the experience in each app was specified only in five of them and ranged from minimum 2 min to 2 hours maximum, depending on the type of activity. In addition, 82.5% are to be enjoyed individually, while the rest allows for a multi-player experience.

With regards to accessibility, 37.5% are required to be used standing up, while 5% are performed sitting down. However, 57.5% can be used both standing and sitting. In this line, 45% are free, while the rest range from EUR 0.99 to EUR 27.99.

#### **4. Discussion and Conclusions**

The aim of this proposal is to analyze the properties and determine the possibilities of VR apps available on commercial platforms for use in the practice of rehabilitation and intervention aimed at people with functional diversity. Therefore, it should be noted that the purpose of the apps mainly does not include in leisure activities, clothing, food, social participation, education, work, and play. Activities such as personal care, grooming, or others such as money management are also not included.

In the same way, the authors have found it difficult to classify the different apps as "easy", "difficult", or "intermediate" taking into account what is involved at the physical, cognitive or understanding level due to basic limitations, such as language or the controls themselves that are used for virtual reality experiences. Thus, there was no app specifically designed and created for people with functional diversity, but which also met the accessibility requirements defined by Web Content Accessibility Guidelines 2.1 [5].

In conclusion, after the analysis was carried out, it has been observed that there are no applications available that are fully accessible and with a minimum degree of usability for use by people with functional diversity. In addition, there is a language handicap, since they are mostly only available in English. The way of interacting with the virtual environment can also generate problems, since the use of the controls and the activation of different buttons complicates and limits the complex handling in case the person has reduced mobility. Given this lack of adequate resources and the relevance that VR can have in therapeutic processes, the need to create virtual reality scenarios adapted and suitable for people with functional diversity is detected.

**Author Contributions:** Conceptualization, methodology, formal analysis, and writing M.d.C.M.-D., P.C.-M., and J.L.V.; review, editing, visualization, and supervision, L.N.-R, N.C.D., and T.P.G.; funding acquisition, M.d.C.M.-D. and P.C.-M. All authors have read and agreed to the published version of the manuscript.

**Funding:** This work was supported in part by some grants from the European Social Fund 2014-2020. CITIC (Research Centre of the Galician University System) and the Galician University System (SUG) obtained funds through Regional Development Fund (ERDF) with 80%, Operational Programme ERDF Galicia 2014-2020 and the remaining 20% by the Secretaría Xeral de Universidades of the Galician University System (SUG). Specifically, the author MCMD obtained a scholarship (Ref. ED481A 2018/205) and the author PCM (Ref. ED481A-2019/069) to develop the PhD thesis. On the other hand, the diffusion and publication of this research was funded by the CITIC, Research Centre of the Galician University System with the support previously mentioned (Ref ED431G 2019/01).

**Acknowledgments:** Financial support from the Xunta de Galicia and the European Union (European Social Fund—ESF), is gratefully acknowledged.

**Conflicts of Interest:** The authors declare no conflict of interest.

#### **References**


© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
