Bürgin David, Kind Nina, Schröder Martin, Clemens Vera, Fegert Jörg M, Eckert Anne, Buchheim Anna, O'Donovan Aoife, Boonmann Cyril, Schmid Marc
Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland.
Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany.
Front Psychiatry. 2020 Dec 21;11:556486. doi: 10.3389/fpsyt.2020.556486. eCollection 2020.
Professional caregivers in youth residential care institutions experience frequent verbal and physical aggression as well as multiple stressors as part of their everyday work, leading to high levels of burnout and staff turnover. Resilience might buffer against psychophysiological stress response and therefore be crucial for well-being in professional caregivers. We aimed to investigate if measures related to resilience [sense of coherence (SoC), self-efficacy and self-care] and attachment security of caregivers were cross-sectionally associated with stress markers in hair samples [cortisol and dehydroepiandrosterone (DHEA)]. Participants ( = 134; 64.2% women) reported on individual resilience measures and provided hair samples for cortisol and DHEA assays. Attachment was assessed in a subsample using the Adult Attachment Projective Picture System (AAP, = 69). Linear regression models were fitted to estimate the association between resilience measures and the Cortisol:DHEA ratio, cortisol and DHEA, controlling for gender and age. SoC was associated with a lower Cortisol:DHEA ratio (β = -0.36, < 0.001), driven by a positive association between SoC and DHEA levels (β = 0.28, = 0.002). Self-care was also associated with lower Cortisol:DHEA ratios (β = -0.24, = 0.005), due to self-care being associated with higher DHEA (β = 0.21, = 0.016). HPA-axis measures were not associated with self-efficacy nor with attachment patterns in a subsample. Our findings imply that youth residential care institutions might benefit from programs focusing on enhancing SoC and self-care practices. Fostering a meaningful, comprehensible and manageable professional climate in caregiving environments and implementing self-care in routine practices might enhance not only well-being but also physical health of professional caregivers and in this way buffer adverse health effects of chronic stressors.
青少年寄宿护理机构中的专业护理人员在日常工作中经常遭受言语和身体攻击以及多种压力源,导致高水平的职业倦怠和员工流失。心理韧性可能缓冲心理生理应激反应,因此对专业护理人员的幸福感至关重要。我们旨在调查与护理人员的心理韧性[连贯感(SoC)、自我效能感和自我护理]以及依恋安全性相关的措施是否与头发样本中的应激标志物[皮质醇和脱氢表雄酮(DHEA)]存在横断面关联。参与者(n = 134;64.2%为女性)报告了个人心理韧性措施,并提供头发样本用于皮质醇和DHEA检测。使用成人依恋投射图片系统(AAP,n = 69)在一个子样本中评估依恋情况。拟合线性回归模型以估计心理韧性措施与皮质醇:DHEA比值、皮质醇和DHEA之间的关联,并控制性别和年龄。SoC与较低的皮质醇:DHEA比值相关(β = -0.36,p < 0.001),这是由SoC与DHEA水平之间的正相关驱动的(β = 0.28,p = 0.002)。自我护理也与较低的皮质醇:DHEA比值相关(β = -0.24,p = 0.005),因为自我护理与较高的DHEA相关(β = 0.21,p = 0.016)。在一个子样本中,下丘脑-垂体-肾上腺(HPA)轴指标与自我效能感和依恋模式均无关联。我们的研究结果表明,青少年寄宿护理机构可能会从专注于增强SoC和自我护理实践的项目中受益。在护理环境中营造一个有意义、可理解和可管理的专业氛围,并在日常实践中实施自我护理,可能不仅会提高专业护理人员的幸福感,还会改善他们的身体健康,从而缓冲慢性压力源对健康的不利影响。