Abstract
Background: Professional caregivers in youth residential care institutions experience frequent verbal and physical aggression as well as multiple stressors as part of their everyday work, leading to high levels of burnout and staff turnover. Resilience might buffer against psychophysiological stress response and therefore be crucial for well-being in professional caregivers.Objectives: We aimed to investigate if measures related to resilience [sense of coherence (SoC), self-efficacy and self-care] and attachment security of caregivers were cross-sectionally associated with stress markers in hair samples [cortisol and dehydroepiandrosterone (DHEA)].Method: Participants (n = 134; 64.2% women) reported on individual resilience measures and provided hair samples for cortisol and DHEA assays. Attachment was assessed in a subsample using the Adult Attachment Projective Picture System (AAP, n = 69). Linear regression models were fitted to estimate the association between resilience measures and the Cortisol:DHEA ratio, cortisol and DHEA, controlling for gender and age.Results: SoC was associated with a lower Cortisol:DHEA ratio (β = −0.36, p < 0.001), driven by a positive association between SoC and DHEA levels (β = 0.28, p = 0.002). Self-care was also associated with lower Cortisol:DHEA ratios (β = −0.24, p = 0.005), due to self-care being associated with higher DHEA (β = 0.21, p = 0.016). HPA-axis measures were not associated with self-efficacy nor with attachment patterns in a subsample.Conclusions: Our findings imply that youth residential care institutions might benefit from programs focusing on enhancing SoC and self-care practices. Fostering a meaningful, comprehensible and manageable professional climate in caregiving environments and implementing self-care in routine practices might enhance not only well-being but also physical health of professional caregivers and in this way buffer adverse health effects of chronic stressors.
Highlights
Professional caregivers in child welfare institutions experience multiple stressors, including frequent episodes of verbal and physical aggression and are faced with complex mental health issues of often highly traumatized clients as part of their everyday work, leading to high levels of burnout, staff turnover, and compassion fatigue [1,2,3]
Selfcare was negatively associated with the Cortisol:DHEA ratio (β = −0.24), largely to due to its positive association with DHEA (β = 0.21)
This is in line with findings of a study in 32 non-clinical adults that indicated resilience to be related to lower Cortisol:DHEA ratio in hair samples, due to a significant positive association with DHEA-S [64], a sulfate of DHEA, which in its function is closely related to its predecessor [54]
Summary
Professional caregivers in child welfare institutions experience multiple stressors, including frequent episodes of verbal and physical aggression and are faced with complex mental health issues of often highly traumatized clients as part of their everyday work, leading to high levels of burnout, staff turnover, and compassion fatigue [1,2,3]. Professional caregivers in youth residential care are exposed to chronic stressors and aggression resulting from their work with a highly troubled clientele. Professional caregivers in youth residential care institutions experience frequent verbal and physical aggression as well as multiple stressors as part of their everyday work, leading to high levels of burnout and staff turnover. Resilience might buffer against psychophysiological stress response and be crucial for well-being in professional caregivers
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