Experience and endocrine stress responses in neonatal and pediatric critical care nurses and physicians.

Details

Serval ID
serval:BIB_DFA064F03613
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Experience and endocrine stress responses in neonatal and pediatric critical care nurses and physicians.
Journal
Critical Care Medicine
Author(s)
Fischer J.E., Calame A., Dettling A.C., Zeier H., Fanconi S.
ISSN
0090-3493
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
28
Number
9
Pages
3281-3288
Language
english
Abstract
OBJECTIVE: Critical care is a working environment with frequent exposure to stressful events. High levels of psychological stress have been associated with increased prevalence of burnout. Psychological distress acts as a potent trigger of cortisol secretions. We attempted to objectify endocrine stress reactivity. DESIGN: Observational cohort study during two 12-day periods in successive years. SETTING: A tertiary multidisciplinary neonatal and pediatric intensive care unit (33 beds). SUBJECTS: One hundred and twelve nurses and 27 physicians (94% accrual rate). INTERVENTIONS AND MEASUREMENTS: Cortisol determined from salivary samples collected every 2 hrs and after stressful events. Participants recorded the subjective perception of stress with every sample. Endocrine reactions were defined as transient surges in cortisol of >50% and 2.5 nmol/L over the baseline. MAIN RESULTS: During 7,145 working hours, we observed 474 (12.5%) endocrine reactions from 3,781 samples. The mean cortisol increase amounted to 10.6 nmol/L (219%). The mean occurrence rate of endocrine reactions per subject and sample was 0.159 (range, 0-0.43). Although the mean raw cortisol levels were lower in experienced team members (>3 yrs of intensive care vs. <3 yrs, 4.1 vs. 4.95 nmol/L, p < .001), professional experience failed to attenuate the frequency and magnitude of endocrine reactions, except for the subgroup of nurses and physicians with >8 yrs of intensive care experience. A high proportion (71.3%) of endocrine reactions occurred without conscious perception of stress. Unawareness of stress was higher in intensive care nurses (75.1%) than in intermediate care nurses (51.8%, p < .01). CONCLUSIONS: Stress-related cortisol surges occur frequently in neonatal and pediatric critical care staff. Cortisol increases are independent of subjective stress perception. Professional experience does not abate the endocrine stress reactivity.
Keywords
Adult, Arousal/physiology, Awareness, Cohort Studies, Female, Humans, Hydrocortisone/blood, Intensive Care Units, Neonatal, Intensive Care Units, Pediatric, Male, Nurses/psychology, Patient Care Team, Physicians/psychology, Prospective Studies, Stress, Psychological/complications
Pubmed
Web of science
Create date
25/01/2008 10:06
Last modification date
20/08/2019 16:04
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