P261 Psychosocial work stressors and salivary cortisol levels: a study among resident physicians

Abstract

Introduction Resident physicians face stressors that include work overload, role conflict, lack of support, and family-work conflicts. The study aimed at assessing the psychosocial work environment of resident physicians and its relation to salivary cortisol levels. Methods Eighty-one resident physicians (44 males, 37 females) at Suez Canal university hospital in Ismailia city, Egypt; completed the Copenhagen Psychosocial Questionnaire (COPSOQ) short form to assess psychosocial work environment and related stress. Salivary samples were collected at the start and end of the 8-hour morning work. An enzyme immunoassay test method was used to determine the salivary cortisol concentration (ng/ml). Residents were categorised into high-risk and low-risk groups; (60 & 21 residents respectively). Results On the COPSOQ positive domains, low-risk resident physicians had higher scores on; commitment to the workplace, predictability, leadership quality, and social support from superiors, with no statistically significant difference between groups. The morning cortisol level was significantly (p = 0.01) lower in high-risk residents (mean 25.51 ± 3.9 ng/ml) than in low-risk (mean 28.52 ± 4.78 ng/ml) residents. Also female residents had a lower level of morning cortisol (26.73 ± 4.73 ng/ml) as compared to males (28.59 ± 4.65 ng/ml); with no statistically significant difference (p = 0.08). Morning cortisol level was negatively correlated with quantitative work demands score (r = −0.31, p = 0.01). Work environment domain with “quantitative work demands” showed the best fitting model (R2 = 0.32) for prediction of morning salivary cortisol level change (p = 0.01). There was no difference between the two groups in afternoon salivary cortisol level Conclusions Morning salivary cortisol concentration is better correlated with psychosocial factors and quantitative work demands and reflects the psychosocial risk at work. There is a possibility of using a single morning salivary cortisol sample to reflect self-perceived stress at work. More studies are needed to assess the different aspects of workplace organisation and climate among HCWs.