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Comparative Study
. 2018 Mar 13;15(3):506.
doi: 10.3390/ijerph15030506.

Acute Stress and Anxiety in Medical Residents on the Emergency Department Duty

Joaquín M González-Cabrera  1 , María Fernández-Prada  2 , Concepción Iribar  3   4 , Rogelio Molina-Ruano  5 , María Salinero-Bachiller  6 , José M Peinado  7   8
Affiliations
Comparative Study

Acute Stress and Anxiety in Medical Residents on the Emergency Department Duty

Joaquín M González-Cabrera et al. Int J Environ Res Public Health. .

Abstract

The objectives of this longitudinal study were to compare salivary cortisol release patterns in medical residents and their self-perceived anxiety levels between a regular working day and a day when on call in the emergency department (ED-duty day) and to determine any differences in cortisol release pattern as a function of years of residency or sex. The study included 35 residents (physicians-in-training) of the Granada University Hospital, Granada, Spain. Acute stress was measured on a regular working day and an ED-duty day, evaluating anxiety-state with the Spanish version of the State-Trait Anxiety Inventory. Physiological stress assessment was based on salivary cortisol levels. Cortisol release concentrations were higher on an ED-duty day than on a regular working day, with a significantly increased area under the curve (AUC) (p < 0.006). This difference slightly attenuated with longer residency experience. No gender difference in anxiety levels was observed (p < 0.001). According to these findings, the hypothalamic-pituitary-adrenal axis activity and anxiety levels of medical residents are higher on an ED-duty day than on a regular working day.

Keywords: Emergency Department-duty day; acute stress; anxiety; cortisol; medical resident.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of salivary cortisol release profiles between regular working day and emergency department (ED)-duty day (n = 35).
Figure 2
Figure 2
Cortisol profile on ED-duty days as a function of year of residency (arithmetic mean (± SEM) in 35 residents). SEM: standard error of the mean; R1: first year of residency; R2: second year of residency; R3: third year of residency.
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