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Biomarkers and burnout syndrome in university health care students.

Abstract

El objetivo de esta revisión fue sintetizar la información publicada en los últimos 10 años  acerca de los biomarcadores de estrés empleados para medir esta condición en los estudiantes de ciencias de la salud y su relación con las escalas de estrés subjetivo agudo y crónico. Se realizaron búsquedas sistemáticas en Pubmed, Science Direct, Scopus y Lilacs, encontrado 112 artículos, de los cuales se incluyeron 17 que cumplieron con los criterios de inclusión. Los resultados muestran que el cortisol sérico y salival fue el biomarcador más utilizado y las escalas STAI, VASS y la escala de sucesos estresantes, son las que mejor se relacionan con niveles de cortisol en los estudios incluidos en esta revisión. Sim embargo consideramos que la información obtenida no es suficiente para establecer una correlación significativa entre los niveles de biomarcadores de estrés  y de estrés percibido medido por escalas autoreferidas.

Keywords

estudiantes de ciencias de la salud, síndrome de burnout, biomarcadores, estrés

PDF (Español)

References

  1. Aguilar Cordero, M. J., Sánchez López, A. M., Mur Villar, N., García García, I., Rodríguez López, M. A., Ortegón Piñero, A., & Cortes Castell, E. (2014). Cortisol salival como indicador de estrés fisiológico en niños y adultos; revisión sistemática. Nutricion Hospitalaria, 29(5), 960–968. https://doi.org/10.3305/nh.2014.29.5.7273
  2. Amir, M., Dahye, K., Duane, C., & Wendy L, W. (2018). Medical Student and Resident Burnout: A Review of Causes, Effects, and Prevention. Journal of Family Medicine and Disease Prevention, 4(4), 10–17. https://doi.org/10.23937/2469-5793/1510094 DOI: https://doi.org/10.23937/2469-5793/1510094
  3. Bautista, L. E., Bajwa, P. K., Shafer, M. M., Malecki, K. M. C., McWilliams, C. A., & Palloni, A. (2019). The relationship between chronic stress, hair cortisol and hypertension. International Journal of Cardiology: Hypertension, 2(May), 100012. https://doi.org/10.1016/j.ijchy.2019.100012 DOI: https://doi.org/10.1016/j.ijchy.2019.100012
  4. Berrío, N., & Mazo, R. (2010). Estrés Académico. European Journal of Education and Psychology, 3(1), 75–87.
  5. Cabello Velez N, & Santiago Hernández G. (2016). Elementos históricos y conceptuales del Síndrome de Burnout. Arch Med Familiar [Internet]. 2016 [citado 14 Jun 2019]; 18(3): 51-53. 18(3), 51–53. https://www.medigraphic.com/pdfs/medfam/amf-2016/amf163a.pdf
  6. Casillas, A. (2015). Determinación Urinaria De Cortisol Y Aplicación De
  7. Una Escala De Ansiedad En Sujetos Sometidos A Estrés Quirúrgico [Tesis doctoral, Universidad Veracruzana]. Red De Repositorios Latinoamericanos.https://repositorioslatinoamericanos.uchile.cl/handle/2250/688596
  8. Conchado Martínez, J., Alvarez Ochoa, R., Cordero Cordero, G., Gutiérrez Ortega, F., & Terán Palacios, F. (2018). Estrés académico y valores de cortisol en estudiantes de medicina. Revista Científica y Tecnológica UPSE, 5(1), 77–82. https://doi.org/10.26423/rctu.v5i1.322 DOI: https://doi.org/10.26423/rctu.v5i1.322
  9. Cortés Romero, C. E., Noriega, A. E., Ruiz, J. C., Soto Rodríguez, G., Bilbao Reboredo, T., & Vélez Pliego, M. (2018). Estrés y cortisol: implicaciones en la ingesta de alimento. Rev. Cuba. Investig. Bioméd, 37(3), 1–15. http://scielo.sld.cu/pdf/ibi/v37n3/ibi13318.pdf
  10. De Lima, P. O., Nani, B. D., Rolim, G. S., Groppo, F. C., Franz-Montan, M., Alves De Moraes, A. B., Cogo-Müller, K., & Marcondes, F. K. (2020). Effects of academic stress on the levels of oral volatile sulfur compounds, halitosis-related bacteria and stress biomarkers of healthy female undergraduate students. Journal of Breath Research, 14(3). https://doi.org/10.1088/1752-7163/ab944d DOI: https://doi.org/10.1088/1752-7163/ab944d
  11. Deinzer, R., Kiupel, S., & Weik, U. (2019). Endocrine and psychological stress response in simulated doctor-patient interactions in medical education. Psychoneuroendocrinology, 105, 172–177. https://doi.org/10.1016/j.psyneuen.2018.09.028 DOI: https://doi.org/10.1016/j.psyneuen.2018.09.028
  12. DeMaria, S., Silverman, E. R., Lapidus, K. A. B., Williams, C. H., Spivack, J., Levine, A., & Goldberg, A. (2016). The impact of simulated patient death on medical students' stress response and learning of ACLS. Med Teach, 38(7), 730–737. https://dx.doi.org/10.3109/0142159X.2016.1150986 DOI: https://doi.org/10.3109/0142159X.2016.1150986
  13. Deneva T, Ianakiev Y, K. D. (2019). Burnout Syndrome in Physicians — Psychological. Medicina (Kaunas), 1–11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571619/
  14. Fogelman, N., & Canli, T. (2018). Early life stress and cortisol: A meta-analysis. Hormones and Behavior, 98(November 2017), 63–76. https://doi.org/10.1016/j.yhbeh.2017.12.014 DOI: https://doi.org/10.1016/j.yhbeh.2017.12.014
  15. Gebhart, V., Buchberger, W., Klotz, I., Neururer, S., Rungg, C., Tucek, G., Zenzmaier, C., & Perkhofer, S. (2020). Distraction-focused interventions on examination stress in nursing students: Effects on psychological stress and biomarker levels. A randomized controlled trial. Int J Nurs Pract, 26(1), e12788–e12788. https://dx.doi.org/10.1111/ijn.12788 DOI: https://doi.org/10.1111/ijn.12788
  16. Goiato, M. C., Da Silva, E. V. F., Cândido, N. B., Nóbrega, A. S., De Medeiros, R. A., Sumida, D. H., Chiba, F. Y., & Dos Santos, D. M. (2019). Evaluation of the level of cortisol, capillary blood glucose, and blood pressure in response to anxiety of patients rehabilitated with complete dentures. BMC Oral Health, 19(1), 1–7. https://doi.org/10.1186/s12903-019-0763-z DOI: https://doi.org/10.1186/s12903-019-0763-z
  17. Haleem, D. J., Inam, Q.-U.-A., Haider, S., Perveen, T., & Haleem, M. A. (2015). Serum leptin and cortisol, related to acutely perceived academic examination stress and performance in female university students. Appl Psychophysiol Biofeedback, 40(4), 305–312. https://dx.doi.org/10.1007/s10484-015-9301-1 DOI: https://doi.org/10.1007/s10484-015-9301-1
  18. Iglesias, S. L., Azzara, S. H., Gonzalez, D., Ibar, C., Jamardo, J., Berg, G. A., Bargiela, M. del M., & Fabre, B. (2018). Programa para mejorar el afrontamiento del estrés de los estudiantes, los docentes y los no docentes de la Facultad de Farmacia y Bioquímica de la Universidad de Buenos Aires TT - Stress management program for students, teachers and non-teachers of the F. Ansiedad estrés, 24(2/3), 105–111. https://www.elsevier.es/es-revista-ansiedad-estres-242-articulo-programa-mejorar-el-afrontamiento-del-S1134793718300678 DOI: https://doi.org/10.1016/j.anyes.2018.07.003
  19. Juvinao, K. M., Santos, L. D., Montoya, L. V., Ricardo, J. H., Fortich Mesa, N., & Olier-Castillo, D. (2019). Niveles de citocinas ( IL 1 β , IL 6 y TNF -α ) en estudiantes con estrés académico. Salud UNINORTE, 35(1), 29–40. DOI: https://doi.org/10.14482/sun.35.1.575.1
  20. Karlen, J., Ludvigsson, J., Frostell, A., Theodorsson, E., & Faresjö, T. (2011). Cortisol in hair measured in young adults - A biomarker of major life stressors? BMC Clinical Pathology, 11(1), 12. https://doi.org/10.1186/1472-6890-11-12 DOI: https://doi.org/10.1186/1472-6890-11-12
  21. Katsuura, S., Kuwano, Y., Yamagishi, N., Kurokawa, K., Kajita, K., Akaike, Y., Nishida, K., Masuda, K., Tanahashi, T., & Rokutan, K. (2012). MicroRNAs miR-144/144* and miR-16 in peripheral blood are potential biomarkers for naturalistic stress in healthy Japanese medical students. Neuroscience Letters, 516(1), 79–84. http://10.0.3.248/j.neulet.2012.03.062 DOI: https://doi.org/10.1016/j.neulet.2012.03.062
  22. Koumantarou Malisiova, E., Mourikis, I., Darviri, C., Nicolaides, N. C., Zervas, I. M., Papageorgiou, C., & Chrousos, G. P. (2021). Hair cortisol concentrations in mental disorders: A systematic review. Physiology and Behavior, 229(November), 113244. https://doi.org/10.1016/j.physbeh.2020.113244 DOI: https://doi.org/10.1016/j.physbeh.2020.113244
  23. Linnen, A. M., Ellenbogen, M. A., Cardoso, C., & Joober, R. (2012). Intranasal oxytocin and salivary cortisol concentrations during social rejection in university students. Stress, 15(4), 393–402. https://doi.org/10.3109/10253890.2011.631154 DOI: https://doi.org/10.3109/10253890.2011.631154
  24. Maduka, I. C., Neboh, E. E., & Ufelle, S. A. (2015). The relationship between serum cortisol, adrenaline, blood glucose and lipid profile of undergraduate students under examination stress. African Health Sciences, 15(1), 131–136. https://doi.org/10.4314/ahs.v15i1.18 DOI: https://doi.org/10.4314/ahs.v15i1.18
  25. Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99–113. https://doi.org/10.1002/job.4030020205 DOI: https://doi.org/10.1002/job.4030020205
  26. McGuire, K., & Lorenz, R. (2018). Effect of Simulation on Learner Stress as Measured by Cortisol: An Integrative Review. Nurse Educator, 43(1), 45–49. https://doi.org/10.1097/NNE.0000000000000393 DOI: https://doi.org/10.1097/NNE.0000000000000393
  27. Mills, B., Carter, O., Rudd, C., Claxton, L., & O’Brien, R. (2016). An experimental investigation into the extent social evaluation anxiety impairs performance in simulation-based learning environments amongst final-year undergraduate nursing students. Nurse Education Today, 45, 9–15. https://doi.org/10.1016/j.nedt.2016.06.006 DOI: https://doi.org/10.1016/j.nedt.2016.06.006
  28. Myint, K., Jayakumar, R., Hoe, S.-Z., Kanthimathi, M. S., & Lam, S.-K. (2017). Cortisol, β-endorphin and oxidative stress markers in healthy medical students in response to examination stress. Biomedical Research (India), 28(8), 3774–3779. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019646716&partnerID=40&md5=93a4f4b7b02d638b6cfbd4ef53cca83c
  29. Nani, B. D., De Lima, P. O., Marcondes, F. K., Groppo, F. C., Rolim, G. S., De Moraes, A. B. A., Cogo-Müller, K., & Franz-Montan, M. (2017). Changes in salivary microbiota increase volatile sulfur compounds production in healthy male subjects with academic-related chronic stress. PLoS ONE, 12(3), 1–15. https://doi.org/10.1371/journal.pone.0173686 DOI: https://doi.org/10.1371/journal.pone.0173686
  30. Ng, V., Koh, D., Mok, B., Lim, L. P., Yang, Y., & Chia, S. E. (2004). Stressful life events of dental students and salivary immunoglobulin A. Int J Immunopathol Pharmacol, 17(2 Suppl), 49–56. https://pesquisa.bvsalud.org/portal/resource/es/mdl-15345192 DOI: https://doi.org/10.1177/03946320040170S209
  31. Noriega, A. E. (2021). Introducción. 40(4), 1–15. DOI: https://doi.org/10.29192/claeh.40.1.1
  32. Oberle, E., & Schonert-Reichl, K. A. (2016). Stress contagion in the classroom? The link between classroom teacher burnout and morning cortisol in elementary school students. Social Science and Medicine, 159, 30–37. https://doi.org/10.1016/j.socscimed.2016.04.031 DOI: https://doi.org/10.1016/j.socscimed.2016.04.031
  33. Organización de la Salud (28 de mayo de 2019). Burn-out an "occupational phenomenon": International Classification of Diseases. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
  34. Oosterholt, B. G., Maes, J. H. R., Van der Linden, D., Verbraak, M. J. P. M., & Kompier, M. A. J. (2015). Burnout and cortisol: Evidence for a lower cortisol awakening response in both clinical and non-clinical burnout. Journal of Psychosomatic Research, 78(5), 445–451. https://doi.org/10.1016/j.jpsychores.2014.11.003 DOI: https://doi.org/10.1016/j.jpsychores.2014.11.003
  35. Oswald, B. B., Ward, R. M., Glazer, S., Sternasty, K., Day, K., & Speed, S. (2021). Baseline cortisol predicts drunkorexia in female but not male college students. Journal of American College Health, 69(6), 625–632. https://doi.org/10.1080/07448481.2019.1705834 DOI: https://doi.org/10.1080/07448481.2019.1705834
  36. Pani, S. C., Al Askar, A. M., Al Mohrij, S. I., & Al Ohali, T. A. (2011). Evaluation of stress in final-year Saudi dental students using salivary cortisol as a biomarker. J Dent Educ, 75(3), 377–384. https://pesquisa.bvsalud.org/portal/resource/es/mdl-21368262 DOI: https://doi.org/10.1002/j.0022-0337.2011.75.3.tb05051.x
  37. Parola, V., Coelho, A., Cardoso, D., Gea-Sanchez, M., Blanco-Blanco, J., & Apóstolo, J. (2016). The prevalence of burnout in health professionals working in palliative care: a systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 14(3), 45–50. https://doi.org/10.11124/JBISRIR-2016-2633 DOI: https://doi.org/10.11124/JBISRIR-2016-2633
  38. Pendry, P., & Vandagriff, J. L. (2019). Animal Visitation Program (AVP) Reduces Cortisol Levels of University Students: A Randomized Controlled Trial. AERA Open, 5(2), 233285841985259. https://doi.org/10.1177/2332858419852592 DOI: https://doi.org/10.1177/2332858419852592
  39. Peters, E. M. J., Müller, Y., Snaga, W., Fliege, H., Reißhauer, A., Schmidt-Rose, T., Max, H., Schweiger, D., Rose, M., & Kruse, J. (2017). Hair and stress: A pilot study of hair and cytokine balance alteration in healthy young women under major exam stress. PLoS ONE, 12(4), 1–21. https://doi.org/10.1371/journal.pone.0175904 DOI: https://doi.org/10.1371/journal.pone.0175904
  40. Rodrigues, H., Cobucci, R., Oliveira, A., Cabral, J. V., Medeiros, L., Gurgel, K., Souza, T., & Gonçalves, A. K. (2018). Burnout syndrome among medical residents: A systematic review and meta-analysis. PLoS ONE, 13(11), 1–17. https://doi.org/10.1371/journal.pone.0206840 DOI: https://doi.org/10.1371/journal.pone.0206840
  41. Saborío Morales, L., & Hidalgo Murillo, L. F. (2015). Síndrome de Burnout. Medicina Legal de Costa Rica, 32(1), 119–124. http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S1409-00152015000100014&lng=en&nrm=iso&tlng=es
  42. Serrano, F. T., Salguero-Sánchez, J., Ayala-Fernández, J., García-Torres, M. F., Meza, J. C., & Mejía, C. R. (2016). Síndrome de Burnout en estudiantes de seis facultades de medicina de Colombia, 2016-1: estudio multicéntrico. Cimel, 21(2), 29–34. https://doi.org/https://doi.org/10.23961/CIMEL.2016.212.642
  43. Shadid, A., Shadid, A. M., Shadid, A., Almutairi, F. E., Almotairi, K. E., Aldarwish, T., Alzamil, O., Alkholaiwi, F., & Khan, S.-U.-D. (2020). Stress, Burnout, and Associated Risk Factors in Medical Students. Cureus, 12(1), 1–11. https://doi.org/10.7759/cureus.6633 DOI: https://doi.org/10.7759/cureus.6633
  44. Stegers-Jager, K. M., Savas, M., van der Waal, J., van Rossum, E. F. C., & Woltman, A. M. (2020). Gender-specific effects of raising Year-1 standards on medical students’ academic performance and stress levels. Medical Education, 54(6), 538–546. https://doi.org/10.1111/medu.14068 DOI: https://doi.org/10.1111/medu.14068
  45. Torres Lagunas, M. A., Vega Moralres, E. G., Vinalay Carrillo, G., & Rodriguez Alonzo, E. (2015). Validacion psicometrica de escala PSS-14, AFA-R, HDRS, CES-D, EV en puerperas mexicas con y sin preeclamsia. Elsevier, 12(3), 122–133. http://www.scielo.org.mx/pdf/eu/v12n3/1665-7063-eu-12-03-00122.pdf DOI: https://doi.org/10.1016/j.reu.2015.08.001
  46. Urwyler, S. A., Schuetz, P., Sailer, C., & Christ-Crain, M. (2015). Copeptin as a stress marker prior and after a written examination--the CoEXAM study. Stress, 18(1), 134–137. https://dx.doi.org/10.3109/10253890.2014.993966 DOI: https://doi.org/10.3109/10253890.2014.993966
  47. West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: contributors, consequences and solutions. Journal of Internal Medicine, 283(6), 516–529. https://doi.org/10.1111/joim.12752 DOI: https://doi.org/10.1111/joim.12752
  48. Wu, H., Zhou, K., Xu, P., Xue, J., Xu, X., & Liu, L. (2018). Associations of perceived stress with the present and subsequent cortisol levels in fingernails among medical students: A prospective pilot study. Psychology Research and Behavior Management, 11, 439–445. https://doi.org/10.2147/PRBM.S181541 DOI: https://doi.org/10.2147/PRBM.S181541
  49. Zepeda, P. y Quintana, M. (2021). Disincronía circadiana y su efecto sobre parámetros de síndrome metabólico en trabajadores : revisión integradora de la literatura Circadian dyssynchrony and its effect on metabolic syndrome parameters in workers : Revista Electrónica Trimestral de Enfermería, 62, 592–602. DOI: https://doi.org/10.6018/eglobal.426881
  50. Zhang, J. Y., Shu, T., Xiang, M., & Feng, Z. C. (2021). Learning Burnout: Evaluating the Role of Social Support in Medical Students. Frontiers in Psychology, 12(February), 1–7. https://doi.org/10.3389/fpsyg.2021.625506 DOI: https://doi.org/10.3389/fpsyg.2021.625506
  51. Zimmaro, L. A., Salmon, P., Naidu, H., Rowe, J., Phillips, K., Rebholz, W. N., Giese-Davis, J., Cash, E., Dreeben, S. J., Bayley-Veloso, R., Jablonski, M. E., Hicks, A., Siwik, C., & Sephton, S. E. (2016). Association of Dispositional Mindfulness with Stress, Cortisol, and Well-Being Among University Undergraduate Students. Mindfulness, 7(4), 874–885. https://doi.org/10.1007/s12671-016-0526-8 DOI: https://doi.org/10.1007/s12671-016-0526-8

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