DOI QR코드

DOI QR Code

An Exploratory Study on Occupational Stress and Anxiety Through Salivary Cortisol and Self-Report Scale in Korean Nurses on Shift and Regular Work

근무형태별 간호사의 스트레스와 불안 조사: 타액 코티솔과 자가보고 척도를 이용한 탐색적 연구

  • Received : 2017.06.09
  • Accepted : 2017.08.16
  • Published : 2017.08.31

Abstract

Purpose: The purpose of the study was to compare salivary cortisol levels, self-reported occupational stress, and anxiety before duty to those after duty in the shift and regular work nurses, and the relationships among them. Methods: Thirty nurses working in a tertiary hospital participated in the study. Salivary specimens were collected before and after daytime duty for 2 days. The occupational stress and state anxiety were also evaluated using self-report questionnaires. Results: The average level of salivary cortisol was $0.40{\mu}g/dL$ before duty and $0.20{\mu}g/dL$ after duty in Korean nurses. Overall levels of salivary cortisol, self-reported occupational stress, and anxiety were higher in shift working nurses than regular working nurses. In shift working nurses, the salivary cortisol gap between before and after duty was attenuated on the first day of daytime duty. Significant positive correlation was found between the level of cortisol before duty and anxiety after duty. Conclusion: Strategies to alleviate occupational stress and anxiety are needed for shift working nurses, especially for those with elevated levels of cortisol. It seems to require 3days to recover from attenuated cortisol rhythm during nighttime duty in shift working nurses.

Keywords

References

  1. Yoon SH. The effects of organizational managerial characteristics and job characteristics on job sress and job effectiveness: A survey on clinical nurses. Korean Journal of Industrial and Oranizational Psychology. 2004;17(3):451-466.
  2. Choi EJ, Park JW, Cho ML. Factors influencing turnover intention of nurses after evaluation for certification at geriatric hospitals: Focused on job stress and burnout. Journal of the Korean Academia-Industrial Cooperation Society. 2016;17(3):438-449.
  3. Yang YS, Kang YH. ICU new nurses' job stress, job satisfaction, organizational commitment and turnover intention. Nursing Science. 2013;25(2):47-58.
  4. Cho HK, Lee TY, Kim CW. Hospital nurse turnover rate and structural characteristics of hospital. Journal of Academia-industrial Technology. 2015;16(1): 453-461.
  5. Kim DS, Chung YS, Park SK. Relationship between the stress hormone, salivary cortisol level and stress score by self-report measurement. The Korean Journal of Health Psychology. 2004;9(3):633-645.
  6. Rocha MCP, Figueiredo de Martino MM, Grassi-Kassisse DM, Luiz de Souza A. Stress among nurses: an examination of salivary cortisol levels on work and day off. Universidad de Sao Paulo Escola de Enfermagem. 2013;47(5):1194-1201. http://dx.doi.org/10.1590/s0080-623420130000500025
  7. Niu SF, Chung MH, Chu H, Tsai JC, Lin CC, Liao YM, et al. Differences in cortisol profiles and circadian adjustment time between nurses working night shifts and regular day shifts: A prospective longitudinal study. International Journal of Nursing Studies. 2015;52(7):1193-1201. http://dx.doi.org/10.1016/j.ijnurstu.2015.04.001
  8. Tahghighi M, Rees CS, Brown JA, Breen LJ, Hegney D. What is the impact of shift work on the psychological functioning and resilience of nurses? An integrative review. Journal of Advanced Nursing. 2017;73(9): 2065-2083. http://dx.doi.org/10.1111/jan.13283
  9. Lee JH, Kim CY. The effects of stress on salivary cortisol level of some of the dental hygienists. Journal of Dental Hygiene Science. 2012;21(1):65-70.
  10. Yoshida Y, Mogi A, Yamada T, Aisu N, Matsuoka T, Kojima D, et al. Subjective and objective assessment of oxaliplatin-induced peripheral neuropathy. SpringerPlus. 2015;4:822-826. http://dx.doi.org/10.1186/s40064-015-1646-7
  11. Enderlin CA, Coleman EA, Cole C, Richards KC, Kennedy RL, Goodwin JA, et al. Subjective sleep quality, objective sleep characteristics, insomnia symptom severity, and daytime sleepiness in women aged 50 and older with nonmetastatic breast cancer. Oncology Nursing Forum. 2011;38(4):E314-325. http://dx.doi.org/10.1188/11.onf.e314-e325
  12. Baba M, Ohkura M, Koga K, Nishiuchi K, Herrera LR, Matsuse R, et al. Analysis of salivary cortisol levels to determine the association between depression level and differences in circadian rhythms of shift-working nurses. Journal of Occupational Health. 2015;57(3):237-244. http://dx.doi.org/10.1539/joh.14-0079-OA
  13. Kang JH, Han SJ. A study of intensive care unit nurses' understanding of the meaning of death, death anxiety, death concern and respect for life. Korean Journal of Hospice and Palliative Care. 2013;16(2):80-89. https://doi.org/10.14475/kjhpc.2013.16.2.080
  14. Kim WS, Cho HH, Kwon S. The influence of terminal care performance, death anxiety and self-esteem on terminal care stress of geriatric hospital nurses. Korean Journal of Hospice and Palliative Care. 2016;19(2):154-162. https://doi.org/10.14475/kjhpc.2016.19.2.154
  15. Fujimaru C, Okamura H, Kawasaki M, Kakuma T, Yoshii C, Matsuishi T. Self-perceived work-related stress and its relation to salivary IgA, cortisol and 3-methoxy-4-hydroxyphenyl glycol levels among neonatal intensive care nurses. Stress and Health. 2012;28(2):171-174. http://dx.doi.org/10.1002/smi.1414
  16. Lee SM. The effect of job characteristics and personal factors on work stress, job satisfaction and turnover intention. Journal of Korean Academy of Nursing. 1995;25(4):790-806.
  17. Han MS, Lee KY. The effect of back massage on degree of pain, state anxiety and quality of sleep of postoperative patients with gastrectomy. Asian Oncology Nursing. 2012;12(1):69-76. https://doi.org/10.5388/aon.2012.12.1.69
  18. Suh M, Lee SO. Exploring subjective stress, sleep and diurnal variation of salivary cortisol in Korean female adults. Journal of Korean Biological Nursing Science. 2016;18(1):9-16. https://doi.org/10.7586/jkbns.2016.18.1.9
  19. Hulme PA, French JA, Agrawal S. Changes in diurnal salivary cortisol levels in response to an acute stressor in healthy young adults. Journal of the American Psychiatric Nurses Association. 2011;17(5):339-349. http://dx.doi.org/10.1177/ 1078390311419352
  20. Samuel LJ, Roth DL, Schwartz BS, Thorpe RJ, Glass TA. Socioeconomic status, race/ethnicity, and diurnal cortisol trajectories in middle-aged and older adults. The Journals of Gerontology Series B, Psychological Sciences and Social Sciences. 2016. Epub 2016/07/22 Forthcoming. http://dx.doi.org/10.1093/geronb/gbw080
  21. Association of American Medical Colleges. Total U.S. medical school enrollment by race/ethnicity and sex, 2013-2014 through 2015-2016. Colleges AoAM, 2016.
  22. Powell DJ, Schlotz W. Daily life stress and the cortisol awakening response: testing the anticipation hypothesis. PloS One. 2012;7(12):e52-67. http://dx.doi.org/10.1371/journal.pone.0052067
  23. Jensen MA, Hansen AM, Kristiansen J, Nabe-Nielsen K, Garde AH. Changes in the diurnal rhythms of cortisol, melatonin, and testosterone after 2, 4, and 7 consecutive night shifts in male police officers. Chronobiology International. 2016;11:1-13. http://dx.doi.org/10.1080/07420528.2016.1212869
  24. Costa G, Anelli MM, Castellini G, Fustinoni S, Neri L. Stress and sleep in nurses employed in " $3{\times}8$" and " $2{\times}12$ " fast rotating shift schedules. Chronobiology International. 2014;31(10):1169-1178. http://dx.doi.org/10.3109/07420528.2014.957309
  25. Lovallo WR, Enoch MA, Sorocco KH, Vincent AS, Acheson A, Cohoon AJ, et al. Joint impact of early life adversity and COMT Val158Met (rs4680) genotypes on the adult cortisol response to psychological stress. Psychosomatic Medicine. 2017;79(6):631-637. http://dx.doi.org/10.1097/psy.0000000000000481
  26. Massar SAA, Liu JCJ, Mohammad NB, Chee MWL. Poor habitual sleep efficiency is associated with increased cardiovascular and cortisol stress reactivity in men. Psychoneuroendocrinology. 2017;81:151-156. http://dx.doi.org/ 10.1016/j.psyneuen.2017.04.013
  27. Wu H, Sun W, Wang L. Factors associated with occupational stress among Chinese female emergency nurses. Emergency Medicine Journal. 2012;29(7):554-558. http://dx.doi.org/10.1136/emj.2010.094391
  28. Lanzenberger R, Wadsak W, Spindelegger C, Mitterhauser M, Akimova E, Mien LK, et al. Cortisol plasma levels in social anxiety disorder patients correlate with serotonin-1A receptor binding in limbic brain regions. The International Journal of Neuropsychopharmacology. 2010;13(9):1129-1143. http://dx.doi.org/10.1017/s1461145710000581
  29. Powers SI, Laurent HK, Gunlicks-Stoessel M, Balaban S, Bent E. Depression and anxiety predict sex-specific cortisol responses to interpersonal stress. Psychoneuroendocrinology. 2016;69:172-179. http://dx.doi.org/10.1016/j.psyneuen.2016.04.007
  30. Schoorl J, Rijn SV, Wied M, van Goozen S, Swaab H. The role of anxiety in cortisol stress response and cortisol recovery in boys with oppositional defiant disorder/conduct disorder. Psychoneuroendocrinology. 2016;73:217-223. http://dx.doi.org/10.1016/j.psyneuen.2016.08.007

Cited by

  1. 한국 간호사의 건강연구에서 야간근무 노출 평가에 대한 고찰 vol.28, pp.4, 2018, https://doi.org/10.15269/jksoeh.2018.28.4.331
  2. Salivary Cortisol, Subjective Stress and Quality of Sleep Among Female Healthcare Professionals vol.13, pp.None, 2017, https://doi.org/10.2147/jmdh.s229396