Acute stress in residents during emergency care: a study of personal and situational factors

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art_DIAS_Acute_stress_in_residents_during_emergency_care_a_2017.PDF (1.26 MB)
Citações na Scopus
23
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article
Data de publicação
2017
Editora
TAYLOR & FRANCIS LTD
DOI
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Scopus
Web of Science
PubMed
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Citação
STRESS-THE INTERNATIONAL JOURNAL ON THE BIOLOGY OF STRESS, v.20, n.3, p.241-248, 2017
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Providing care for simulated emergency patients may induce considerable acute stress in physicians. However, the acute stress provoked in a real-life emergency room (ER) is not well known. Our aim was to assess acute stress responses in residents during real emergency care and investigate the related personal and situational factors. A cross-sectional observational study was carried out at an emergency department of a tertiary teaching hospital. All second-year internal medicine residents were invited to voluntarily participate in this study. Acute stress markers were assessed at baseline (T1), before residents started their ER shift, and immediately after an emergency situation (T2), using heart rate, systolic, and diastolic blood pressure, salivary -amylase activity, salivary interleukin-1 , and the State-Trait Anxiety Inventory (STAI-s and STAI-t). Twenty-four residents were assessed during 40 emergency situations. All stress markers presented a statistically significant increase between T1 and T2. IL-1 presented the highest percent increase (141.0%, p<.001), followed by AA (99.0%, p=.002), HR (81.0%, p<.001), DBP (8.0%, p<.001), and SBP (3.0%, p<.001). In the multivariable analysis, time of residency had a negative correlation with HR during the emergency (adjusted R-square=.168; F=8.69; p=.006), SBP response (adjusted R-square=.210; F=6.19; p=.005) and DBP response (adjusted R-square=.293; F=9.09; p=.001). Trait anxiety (STAI-t) was positively correlated with STAI-s (adjusted R-square=.326; F=19.9; p<.001), and number of procedures performed during emergency care had a positive association with HR response (adjusted R-square=.241; F=5.02; p=.005). In the present study, emergency care provoked substantial acute stress in residents. Resident experience, trait anxiety, and number of emergency procedures were independently associated with acute stress response.
Palavras-chave
Acute stress, emergency medicine, physician well-being, stress biomarkers, emergency procedures, emergency room
URI
https://observatorio.fm.usp.br/handle/OPI/21243
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/51