Stress among nurses: an examination of salivary cortisol levels on work and day off

Abstract

The present study evaluates the use of salivary cortisol concentration as a physiological index of the stress level among nurses on their work day and day off and correlates it with the questionnaire used to measure occupational stress in nurses (Inventário de Estresse em Enfermeiros - IEE). This is a comparative, cross-sectional descriptive study in which sociodemographic data, IEE results and salivary cortisol levels were used. Fifty-seven nurses participated in the study (80.7% females and a mean age of 37.1 years old). The IEE average score was 124.5. The average cortisol level was 564.1 ng/m on work day and 354.1 ng/mL on day off. Nurses who had double workdays presented high values of salivary cortisol during the work day (638.1 ng/mL). In conclusion, salivary cortisol identified the nurses’ stress level, and differences were found between a work day and day off. On the nurses’ day off, their salivary cortisol levels and stress scores were lower.

Association between shift work, salivary cortisol levels, stress and fatigue in nurses: integrative review

“…Concerning occupational stress, cortisol secretion and work shifts, the results were likewise inconclusive, whereas a study showed that salivary cortisol levels in workers presented typical secretion patterns, regardless of the work shift 7 , while, in other two studies, professionals working the night shift presented alterations on daily secretion of cortisol, though of no statistical relevance. 19,28 No articles were found which concomitantly evaluated fatigue, stress and salivary cortisol levels in nurses.…”

“…However, physical or psychological stress agents, many pharmaceuticals, as well as genetic and sociodemographic factors are able to alter cortisol secretion rhythm, either stimulating or suppressing the HHA axis 3,4 . The use of saliva as a diagnosis fluid is a relatively new practice and, although many biomarkers can be analyzed, including heavy metals, enzymes and DNA, measuring cortisol levels as a neurobiological stress and fatigue marker has proven itself promising, with plenty of available commercial tests [5][6][7] . Salivary cortisol is the free and biologically active form of this hormone, and sample collection is simple, safe and non-invasive, as it can be made even in the participant's workplace.…”

“…Sample collection protocols in the selected studies varied from one to three days, and in only one study cortisol levels upon awakening were analyzed. 7 Among the selected articles, only one of them analyzed saliva samples collected in two different days (workday and leave), whereas two studies analyzed samples provided in a single day.…”

“…[29][30][31][32][33] In addition, there was no consensus regarding the evaluation of cortisol secretion, so two studies chose to analyze it in predetermined occasions 19,28 and two used standard indexes of cortisol secretion such as CAR and the area under the curve (AUC). 7 Another possible explanation for data inconsistency is the low sample number of the studies. The authors reported taking plentiful exclusion criteria, sample losses due to insufficient saliva There was no relevant relation -Salivary cortisol levels were not statistically related to the workers' work schedules.…”

Relaxation and Guided Imagery for Parents of Offspring with Developmental Disabilities

“…A stressor such as the number of work days compared to vacation days is associated with an increase in the production of the stress hormone cortisol in humans [4]. Stress has also been associated with fatal diseases such as cancer [5].…”