Assessment of the Level of Burnout in Several Medical Fields by Studying the Diurnal Profile of Salivary Cortisol

Background: Occupational stress afflicts not only job performance, but also the physical status and the health of the working human being. Thus, methods to analyze the level of stress and burnout by laboratory measurements and different types of questionnaires were developed during the last years.
Aim: To determine the relationship between salivary cortisol variations and the individual self evaluation performed by physicians in several medical fields: general surgery, intensive care, internal medicine.
Material and method: A self assessment survey was undertaken by physicians in three specialties, investigating the place doctors find themselves in the collectivity, their integration and interpersonal relationships – all contributing to a burn-out potential inventory score, the BPI. The BPI score was correlated with the cortisol level found in 3 samples of saliva collected at awakening, immediately after the maximum stress of the day and at night, before sleeping.
Results: We found significant variations of the cortisol level between the early morning salivary level at awakening and the climax of the stress. There was a linear correlation between the maximal cortisol level and the BPI score.
Conclusion: Salivary cortisol, well correlated with serum levels is a consistent marker of the stress and the intensity of the reactivity to stress. Thus we promote it as a feasible, accessible and low cost measurement of the reactivity to stress, both for the individual and the professional group.

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