Heming Meike, Angerer Peter, Apolinário-Hagen Jennifer, Nater Urs Markus, Skoluda Nadine, Weber Jeannette
Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Department of Clinical Psychology and Health Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria.
J Occup Med Toxicol. 2023 May 30;18(1):7. doi: 10.1186/s12995-023-00373-7.
Medical students often experience high levels of stress due to adverse study conditions, which may have adverse health consequences. Hair cortisol concentration (HCC) has been described as a physiological marker for chronic stress and might thus help to identify students under stress and examine the study conditions being responsible for long-term physiological stress responses. This study therefore investigated the association between study conditions and HCC in a sample of medical students.
Fifty-five students from a medical school in Germany completed a paper-based questionnaire and had hair samples collected between May 2020 and July 2021. Study conditions were assessed with student versions of questionnaires based on the Job-Demand-Control-Support model (StrukStud, 25 items) and Effort-Reward Imbalance model (Student ERI, nine items). HCC of two centimeters closest to the scalp were determined by a cortisol luminescence immunoassay. Linear multiple regression analyses were performed to examine associations between study conditions and HCC.
Demands (B = 0.23, p = 0.002), effort (B = 0.12, p = 0.029) and the effort-reward-ratio (B = 0.28, p = 0.007) were positively associated with HCC in separate regression analyses, adjusted for age and sex. Only the association between demands and HCC remained significant when all components of the respective questionnaire were considered in the same model (B = 0.22, p = 0.003).
The results suggest that adverse study conditions may be associated with activation of the hypothalamic-pituitary-adrenal axis stress response as reflected by increased HCC. Longitudinal research is needed to confirm these cross-sectional results and examine effects of more prolonged stress due to adverse study conditions.
由于不良的学习条件，医学生经常经历高水平的压力，这可能会对健康产生不良后果。头发皮质醇浓度（HCC）已被描述为慢性压力的生理标志物，因此可能有助于识别处于压力下的学生，并检查导致长期生理应激反应的学习条件。因此，本研究调查了医学生样本中学习条件与HCC之间的关联。
来自德国一所医学院的55名学生完成了一份纸质问卷，并在2020年5月至2021年7月期间采集了头发样本。基于工作需求-控制-支持模型（StrukStud，25项）和努力-回报失衡模型（学生ERI，9项）的学生版问卷对学习条件进行了评估。通过皮质醇发光免疫测定法测定最接近头皮的两厘米头发的HCC。进行线性多元回归分析以检查学习条件与HCC之间的关联。
在调整年龄和性别的单独回归分析中，需求（B = 0.23，p = 0.002）、努力（B = 0.12，p = 0.029）和努力-回报比（B = 0.28，p = 0.007）与HCC呈正相关。当在同一模型中考虑各自问卷的所有组成部分时，只有需求与HCC之间的关联仍然显著（B = 0.22，p = 0.003）。
结果表明，不良的学习条件可能与下丘脑-垂体-肾上腺轴应激反应的激活有关，这表现为HCC升高。需要进行纵向研究以证实这些横断面结果，并检查由于不良学习条件导致的更长时间压力的影响。
