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Risk of nurse burnout can be 'estimated by using saliva samples'

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Nursing staff at risk of burnout can be identified by means of a simple saliva test that measures the hormone cortisol, according to researchers from Austria.

Cortisol is an anti-stress hormone, which activates metabolic break-down processes, thereby, making energy-rich compounds available to the human body.

“Our current data indicate that people at risk of burnout can be identified from a single saliva sample”

Study authors

Its damping effect on the immune system is also used to prevent over-reactions and to suppress inflammation. The hormone is predominantly produced in the early morning on waking.

In healthy people, the cortisol level then falls again over the course of the day until there is practically no measurable cortisol left by the evening.

The picture is very different for those under constant stress, with the body keeping the cortisol level within the measurable range for much longer in order to cope with the prevailing stress.

If the stress then becomes “chronic”, cortisol levels remain high without any normal daily pattern, noted the study authors who were led by researchers from the Medical University of Vienna.

They said their study had now shown that elevated cortisol levels can be detected using a single saliva sample, taken either at midday or in the evening, so that the risk of burnout can be measured.

“People identified as having a high level of work-related stress had noticeably higher cortisol values at midday and in the evening”

Study authors

Their study compared the work-related stress and cortisol levels of burnout patients with those of healthy employees. It included 40 people experiencing burnout and 26 healthy controls.

At baseline, significantly higher levels of salivary cortisol were observed in the burnout group compared to the control group. This was “even more pronounced” in the midday and evening samples than for total morning cortisol secretion, the study authors said in the journal Scientific Reports.

They said: “It was found that people who were identified as having a high level of work-related stress using psychological methods had noticeably higher cortisol values at midday and also in the evening.”

They added that they had also observed an improvement in the “clinical course and cortisol levels” of patients receiving treatment in a special stress clinic that was set up.

“This means that we can use these markers for preventively identifying people who are at greater risk of burnout,” said the researchers.

“Our current data indicate that people at risk of burnout can be identified from a single saliva sample with almost 100% accuracy,” they added.

They said follow-up work now needed to evaluate the findings and develop a valid biochemical testing system for use in everyday clinical practice to identify high-risk candidates for burnout.

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