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医生职业倦怠中皮质醇对急性心理社会应激的反应性

Cortisol Reactivity to Acute Psychosocial Stress in Physician Burnout.

作者信息

Zuccarella-Hackl Claudia, Princip Mary, Holzgang Sarah A, Sivakumar Sinthujan, Kuenburg Alexa, Pazhenkottil Aju P, Gomez Vieito Diego, von Känel Roland

机构信息

Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Haldenbachstrasse 16/18, CH-8091 Zurich, Switzerland.

Department of Cardiology, University Hospital Zurich, University of Zurich, CH-8091 Zurich, Switzerland.

出版信息

Biomedicines. 2024 Feb 1;12(2):335. doi: 10.3390/biomedicines12020335.

Abstract

BACKGROUND

Physician burnout, characterized by chronic job-related stress leading to emotional exhaustion, depersonalization, and reduced personal accomplishment. This cross-sectional study investigates cortisol reactivity in male physicians with burnout compared to healthy controls during an acute psychosocial stress test.

METHODS

Sixty male physicians (30 burnout, 30 healthy controls) participated between September 2019 and December 2021 to investigate the impact of burnout on cardiovascular health. Salivary cortisol levels were measured before and after a Trier Social Stress Test (TSST). Burnout was assessed with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Covariates included age, BMI, and physical activity. Data were analyzed using repeated measures analysis and area under the curve analysis.

RESULTS

Male physicians with burnout exhibited significantly greater cortisol reactivity during the TSST, notably post-stress to 15 min post-stress. Emotional exhaustion correlated with reduced cortisol increase from pre-stress and smaller post-stress to 15- and 45-min declines.

DISCUSSION

Findings suggest heightened cortisol reactivity in male physicians with burnout, possibly reflecting initial chronic stress stages. This study highlights the necessity for long-term research on cortisol's influence on cardiovascular health and stress responses across diverse groups.

CONCLUSIONS

The findings contribute to comprehending physiological responses in burnout-afflicted physicians, emphasizing cortisol reactivity's pivotal role in stress-related research and its potential health implications, particularly within the burnout context.

摘要

背景

医生职业倦怠的特征是与工作相关的慢性压力导致情绪耗竭、去个性化和个人成就感降低。这项横断面研究调查了在急性心理社会压力测试期间,患有职业倦怠的男性医生与健康对照组相比的皮质醇反应性。

方法

2019年9月至2021年12月期间,60名男性医生(30名职业倦怠者,30名健康对照者)参与研究,以调查职业倦怠对心血管健康的影响。在进行特里尔社会压力测试(TSST)之前和之后测量唾液皮质醇水平。使用马氏职业倦怠量表-人类服务调查(MBI-HSS)评估职业倦怠。协变量包括年龄、体重指数和身体活动。使用重复测量分析和曲线下面积分析对数据进行分析。

结果

患有职业倦怠的男性医生在TSST期间表现出明显更高的皮质醇反应性,尤其是在压力后到压力后15分钟。情绪耗竭与压力前皮质醇增加减少以及压力后到15分钟和45分钟时皮质醇下降较小相关。

讨论

研究结果表明,患有职业倦怠的男性医生的皮质醇反应性增强,这可能反映了最初的慢性压力阶段。这项研究强调了对皮质醇对不同群体心血管健康和应激反应影响进行长期研究的必要性。

结论

这些发现有助于理解受职业倦怠影响的医生的生理反应,强调皮质醇反应性在与压力相关研究中的关键作用及其潜在的健康影响,特别是在职业倦怠背景下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef00/10886584/d4a82f7f5a09/biomedicines-12-00335-g001.jpg

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