Self perceived work related stress and the relation with salivary IgA and lysozyme among emergency department nurses

Abstract

Aims: To assess and compare the self perceived work related stress among emergency department (ED) and general ward (GW) nurses, and to investigate its relation with salivary IgA and lysozyme. Methods: One hundred and thirty two of 208 (63.5%) registered female ED and GW nurses participated in the study. A modified mental health professional stress scale (PSS) was used to measure self perceived stress. ELISA methods were used to determine the salivary IgA and lysozyme levels. Results: On PSS, ED nurses had higher scores (mean 1.51) than GW nurses (1.30). The scores of PSS subscales such as organisational structure and processes (OS), lack of resources (RES), and conflict with other professionals (COF) were higher in ED than in GW nurses. ED nurses had lower secretion rates of IgA (geometric mean (GM) 49.1 µg/min) and lysozyme (GM 20.0 µg/min) than GW nurses (68.2 µg/min, 30.5 µg/min). Significant correlations were observed between PSS and log IgA and lysozyme secretion rates. OS, RES, and COF were correlated with log IgA and lysozyme levels. Conclusion: ED nurses, who reported a higher level of professional stress, showed significantly lower secretion rates of salivary IgA and lysozyme compared to GW nurses. Salivary IgA and lysozyme were inversely correlated with self perceived work related stress. As these salivary biomarkers are reflective of the mucosal immunity, results support the inverse relation between stress and mucosal immunity.

Effects of Prolonged Night Shifts on Salivary <i>α</i>-Amylase, Secretory Immunoglobulin, Cortisol, and Chromogranin A Levels in Nurses

“…For example, university students undergoing exams [22] and prisoners [23] have been shown to have decreased levels; similarly, emergency nurses working under high stress conditions have been reported to have low sIgA levels [2]. The sIgA level is also known to decrease in a similar manner in people with a pessimistic outlook on life [24], thus studies are consistent in terms of chronic stress inducing decreased sIgA levels.…”

“…Nevertheless, the long 16 h shift is apt to cause physical and mental exhaustion and disrupt the normal circadian rhythm [1]. Furthermore, many reports have confirmed that prolonged night schedule is highly stressful [2] [3] and associated with higher burnout rates [4] [5] and medical errors, but the precise physiological effects of a 16 h shift remain undetermined. Most assessments of fatigue rely on questionnaires that evaluate subjective fatigue severity while practical, objective evaluations are virtually nonexistent.…”

Biomarkers of Stress in Saliva / Biomarkeri stresa u pljuvački

“…Lysozyme concentration was significantly (p<0,05) lower in the saliva sample taken before the exam in relation to the values obtained after the completion of all exams. Yang et al (17) have shown that the value of salivary lysozymes is related to mental health, which means that the value of salivary lysozyme stands in negative correlation to the level of experienced professional stress in emergency nurses in relation to general nurses.…”

“…Since stress shows the immunosuppressive effect, the level of secretory IgA (10,11,15) and lysozyme (16) release of catecholamine, which is difficult to track in the saliva because of low concentration, rapid degradation and hormone instability in the samples taken. It is also possible to use chromogranin A (CgA) (14,17) and enzyme α-amylase (14, 18) as a response of the sympatho-adrenomedullary system to stress, or as biomarkers of stress, as alternative indices of adrenergic activity, due to their stability in the saliva and reliability of the obtained values.…”

Glucan Supplementation Regulates Secretory Immunity and Stress

“…Several studies repeatedly demonstrated relations between SIgA variations and psychological stress of students (Guo et al, 2002). Levels of SIgA are influenced by additional factors such as amount of water consumption (Backes et al, 2015), physical activity and physical challenge (Cieslak et al, 2003;Dwyer et al, 2010;Gleeson and Pyne, 2000), changes in biorhythms during work shift (Guo et al, 2002;Lac and Chamoux, 2003), time of the season, location, altitude above sea level and most of all by stress related to psychological challenge and persisting physical challenge (Cieslak et al, 2003;Cohen et al, 2001;Gleeson and Pyne, 2000;Guo et al, 2002;Hunter et al, 2011;Kidd et al, 2011;Powell et al, 2015;Yang et al, 2002). Two major branches of stress induction include autonomous nervous system and hypothalamus-adrenal gland-pituitary axis.…”