Ibar Carolina, Fortuna Federico, Gonzalez Diego, Jamardo Juan, Jacobsen Dario, Pugliese Lucas, Giraudo Laura, Ceres Veronica, Mendoza Cynthia, Repetto Esteban M, Reboredo Graciela, Iglesias Silvia, Azzara Sergio, Berg Gabriela, Zopatti Damian, Fabre Bibiana
Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Residencia en Bioquímica Clínica, Argentina; Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Cátedra de Bioquímica Clínica I, Buenos Aires, Argentina.
Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Residencia en Bioquímica Clínica, Argentina.
Psychoneuroendocrinology. 2021 Jun;128:105213. doi: 10.1016/j.psyneuen.2021.105213. Epub 2021 Apr 1.
In the critical context of COVID-19 pandemic, healthcare workers are on the front line, participating directly in the care, diagnosis, and treatment of patients with COVID-19. This exposes them to a higher risk of developing chronic stress, psychological distress, and any other mental health symptoms.
to evaluate stress and burnout in a health workers population and, in addition, to measure hair cortisol concentration as a current biomarker of stress.
234 health workers from Hospital de Clínicas "José de San Martín", Buenos Aires University, were included in this study. In this population hair samples were obtained from the posterior vertex as close to the scalp as possible and the individuals completed the following surveys: perceived stress, social support, burnout scale, life event scale, and sociodemographic data. Hair cortisol was measured by an automated chemiluminescent method. The studied population was divided into three groups considering those individuals below the healthy reference sample range (< 40 pg/mg hair), within the healthy reference range (40-128 pg/mg hair) and above the reference range (> 128 pg/mg hair). This study used a transversal and observational design.
Our results show that 40% of the studied population presented hair cortisol values outside of the healthy reference range. In the whole studied population, a direct correlation was found between hair cortisol concentration and perceived stress as well as between hair cortisol concentration and the emotional exhaustion component of burnout (r = 0.142, p = 0.030; r = 0.143, p = 0.029, respectively). 12% of the studied population showed Burnout (52% doctors and residents, 19% nurses, 19% administrative personnel). Higher values in hair cortisol levels were found in the group with burnout versus individuals without burnout (p = 0.034). Finally, a mediation analysis was performed, finding that depersonalization is a mediating variable in the relationship between self-perceived stress and hair cortisol level (F = 4.86, p = 0.0086; indirect effect IC: 0.0987-1.8840).
This is the first study in which a stress biomarker such as hair cortisol is evaluated in this population and in this context. Healthcare workers are subjected to increased levels of stress and burnout. High depersonalization, emotional exhaustion, and decreased personal sense of accomplishment characterize this population. It is the responsibility of the health authorities to implement strategies to manage this psychological emergency.
在新冠疫情的危急背景下，医护人员处于前线，直接参与新冠患者的护理、诊断和治疗。这使他们面临更高的患慢性压力、心理困扰及其他心理健康症状的风险。
评估医护人员群体中的压力和职业倦怠，此外，测量头发皮质醇浓度作为当前压力的生物标志物。
本研究纳入了布宜诺斯艾利斯大学“何塞·德·圣马丁”临床医院的234名医护人员。在该群体中，尽可能靠近头皮从头顶后部采集头发样本，个体完成以下调查：感知压力、社会支持、职业倦怠量表、生活事件量表和社会人口统计学数据。头发皮质醇通过自动化学发光法测量。根据个体头发皮质醇水平低于健康参考样本范围（<40 pg/mg头发）、处于健康参考范围（40 - 128 pg/mg头发）和高于参考范围（>128 pg/mg头发），将研究人群分为三组。本研究采用横断面观察设计。
我们的结果显示，40%的研究人群头发皮质醇值超出健康参考范围。在整个研究人群中，发现头发皮质醇浓度与感知压力之间以及头发皮质醇浓度与职业倦怠的情感耗竭成分之间存在直接相关性（分别为r = 0.142，p = 0.030；r = 0.143，p = 0.029）。12%的研究人群表现出职业倦怠（52%为医生和住院医师，19%为护士，19%为行政人员）。与无职业倦怠的个体相比，职业倦怠组的头发皮质醇水平更高（p = 0.034）。最后，进行了中介分析，发现去个性化是自我感知压力与头发皮质醇水平之间关系的中介变量（F = 4.86，p = 0.0086；间接效应IC：0.0987 - 1.8840）。
这是首次在该人群和此背景下评估头发皮质醇这种压力生物标志物的研究。医护人员承受着增加的压力和职业倦怠水平。该人群的特征是高度去个性化、情感耗竭和个人成就感降低。卫生当局有责任实施策略来应对这一心理紧急情况。
