Association between burnout and cortisol secretion, perceived stress, and psychopathology in palliative care unit health professionals

Fernández-Sánchez, José Carlos; Pérez-Mármol, José Manuel; Blásquez, Antonia; Santos-Ruiz, Ana; Peralta-Ramírez, María Isabel

doi:10.1017/s1478951517000244

Cited by 33 publications

(31 citation statements)

References 52 publications

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“…Grossi et al also found higher salivary cortisol levels in participants with burnout than in healthy individuals [36]. A recent study among health professionals working in a palliative care unit to evaluate the association between burnout dimensions and salivary secretion of cortisol showed that the release of cortisol in a one-dimension burnout group was higher than that in the control group for cortisol response upon waking and at bedtime [37]. According to this, we also found higher levels of salivary cortisol in the group of doctors with burnout symptoms in one-dimension:Emotional exhaustion.…”

Section: Discussionmentioning

confidence: 99%

Burnout Syndrome in Physicians—Psychological Assessment and Biomarker Research

2019

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Background and objectives: Burnout is a syndrome typically occurring in work environments with continuous and chronic stress. Physicians are at increased risk for burnout, as a result of 24-h work, delayed work–life balance gratification, and the challenges associated with patient care. The aim of the present study was to evaluate the psychological parameters of burnout symptoms in relation to biomarkers of stress among physicians with different medical specialties. Materials and methods: A total of 303 physicians were contacted as potential participants. A comparison group of 111 individuals working outside medicine was used as a control to verify the results. The physicians were specialists in internal medicine, general surgery, pathology, and primary care. Serum cortisol, salivary cortisol, adrenocorticotropic hormone (ACTH), insulin (IRI), and prolactin levels were analyzed by chemiluminescence enzyme immunoassay (Access 2, Beckman Coulter). Fasting glucose in serum and glycated hemoglobin (HbA1C) in whole blood were measured using the automatic analyzer AU 480 Beckman Coulter system. Symptoms of burnout were measured with the Maslach Burnout Inventory (MBI). Results: The group with burnout presented significantly higher levels of serum and saliva cortisol, ACTH, prolactin, fasting glucose, and HbA1C compared with the control group. The correlation analysis between biomarkers showed a positive correlation with moderate strength between serum and saliva cortisol (r = 0.516, p = 0.01),as well as serum and saliva cortisol with ACTH (r = 0.418; r = 0.412, p = 0.01) and HbA1C (r = 0.382; r = 0.395, p = 0.01). A weak positive correlation was found between serum and saliva cortisol with prolactin (r = 0.236; r = 0.267, p < 0.01) and glucose (r = 0.271; r = 0.297, p < 0.01). In the multiple logistic regression model, saliva cortisol, HbA1C, and age were significantly associated with burnout (chi-square = 16.848, p < 0.032). Conclusion: Our findings demonstrated the interest of exploring biomarkers of stress related to burnout in health professionals.

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Section: Discussionmentioning

confidence: 99%

Burnout Syndrome in Physicians—Psychological Assessment and Biomarker Research

2019

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“…Finally, in a study on 69 health professionals from a palliative care unit, including 32 nursing assistants and 30 nurses that met the burnout criteria with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), the average levels of salivary cortisol in the group with one dimension of burnout (14.17 nmol/L) were higher than non-burnout group (8.83 nmol/L) [56]. High levels of salivary cortisol are also observed in nursing students with high scores of depression, anxiety, and stress [46].…”

Section: Stress-related Cortisol Response In Nursing Studentsmentioning

confidence: 99%

Stress in Nursing University Students and Mental Health

Pulido-Criollo¹,

Cueto‐Escobedo²,

Ruiz³

2018

Health and Academic Achievement

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Stress is a physiological response that impacts the cognitive, emotional, behavioral, and social components. It also involves the adaptation of the organism, the coping resources, and the environment. In young people, stress can be triggered by social interactions or school requirements. This chapter is a narrative review analyzing scientific bibliography from the main databases (NIH, Scielo, Redalyc) that explored the main stressors and their effects on nursing students. These stressors include the care of patients, assignments and workloads, academic evaluations, and negative or hostile social interactions. Data include the deleterious effects of stress in nursing students as anxiety, depression, inhibiting learning, and burnout, which negatively impact their academic development and health. Finally, some interventions to reduce the impact of stress are discussed. Conclusion: Stress responses in nursing students vary in duration and intensity during their academic training; final effects depend on the coping mechanisms, individual resources, and hospital environment. The effects of stress on nursing students impact on academic performance but could also trigger several psychiatric disorders as depression or anxiety, as well as other associated problems such as sleep disorders, alcohol, and psychoactive drug consumption, which in the short and long term may affect the patient care.

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“…Furthermore, burnout is highly comorbid with a myriad of psychiatric disorders including depression [19, 20], anxiety [21], substance abuse [19, 22], and suicidality [12, 23] among healthcare providers. In addition to self-reported health outcomes, burnout is associated with hypothalamus-pituitary-adrenal axis dysregulation [24–26], inflammatory responses [27, 28], and increased allostatic load [29, 30]. It has been reported that individuals with occupational burnout exhibit changes in the brain, such as reduction in gray matter volume of the anterior cingulate, caudate and putamen [31].…”

Section: Introductionmentioning

confidence: 99%

Systematic review of burnout among healthcare providers in sub-Saharan Africa

et al. 2019

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Background Burnout is characterized by physical and emotional exhaustion from long-term exposure to emotionally demanding work. Burnout affects interpersonal skills, job performance, career satisfaction, and psychological health. However, little is known about the burden of burnout among healthcare providers in sub-Saharan Africa. Methods Relevant articles were identified through a systematic review of PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO). Studies were selected for inclusion if they examined a quantitative measure of burnout among healthcare providers in sub-Saharan Africa. Results A total of 65 articles met our inclusion criteria for this systematic review. Previous studies have examined burnout in sub-Saharan Africa among physicians (N = 12 articles), nurses (N = 26), combined populations of healthcare providers (N = 18), midwives (N = 2), and medical or nursing students (N = 7). The majority of studies assessed burnout using the Maslach Burnout Inventory. The highest levels of burnout were reported among nurses, although all healthcare providers showed high burnout. Burnout among healthcare providers is associated with their work environments, interpersonal and professional conflicts, emotional distress, and low social support. Conclusions Available studies on this topic are limited by several methodological challenges. More rigorously designed epidemiologic studies of burnout among healthcare providers are warranted. Health infrastructure improvements will eventually be essential, though difficult to achieve, in under-resourced settings. Programs aimed at raising awareness and coping with burnout symptoms through stress management and resilience enhancement trainings are also needed.

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Association between burnout and cortisol secretion, perceived stress, and psychopathology in palliative care unit health professionals

Cited by 33 publications

References 52 publications

Burnout Syndrome in Physicians—Psychological Assessment and Biomarker Research

Burnout Syndrome in Physicians—Psychological Assessment and Biomarker Research

Stress in Nursing University Students and Mental Health

Systematic review of burnout among healthcare providers in sub-Saharan Africa

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