Relationship between psychosocial stress dimensions and salivary cortisol in military police officers

Original Article Rev. Latino-Am. Enfermagem 2017;25:e2873 DOI: 10.1590/1518-8345.1199.2873 www.eerp.usp.br/rlae Relationship between psychosocial stress dimensions and salivary cortisol in military police officers1 Juliana Petri Tavares2 Liana Lautert3 Tânia Solange Bosi de Souza Magnago4 Angélica Rosat Consiglio5 Daiane Dal Pai2 Objective: to analyze the relationship between psychosocial stress dimensions and salivary cortisol in military police officers. Method: cross-sectional and analytical study with 134 military police officers. The Effort-Reward Imbalance (ERI) Model scale has been used to assess psychosocial stress. Salivary cortisol was collected in three samples. The following tests were used: Student’s t-test, Mann-Whitney, ANOVA, Bonferroni, Kruskal-Wallis and Dunn. Pearson and Spearman correlation methods were used, as well as multiple linear regression. Cortisol at night showed an ascending statistical association with the psychosocial reward (p=0.004) and a descending association with the effort-impairment scores (p=0.017). Being part of the Special Tactical Operations Group (GATE) and the diastolic blood pressure explained 13.5% of the variation in cortisol levels on waking up. The sectors GATE, Special Patrol of the Elite Squad of the Military Police and Motorcyclists explained 21.9% of the variation in cortisol levels 30-minute after awakening. The variables GATE sector and Effort Dimension explained 27.7% of the variation in cortisol levels at night. Conclusion: it was evidenced that salivary cortisol variation was influenced by individual, labor and psychosocial variables. Descriptors: Worker`s Health; Psychologic Stress; Police; Physiologic Stress. 1 Paper extracted from Doctoral Dissertation “Relationship among dimensions of the effort-reward imbalance model, resilience, and salivary cortisol levels in police officers”, presented to Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, process #480934/2010-0. 2 PhD, Adjunct Professor, Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. 3 PhD, Full Professor, Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. 4 PhD, Associate Professor, Departamento de Enfermagem, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil. 5 PhD, Associate Professor, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. How to cite this article Tavares JP, Lautert L, Magnago TSBS, Consiglo AR, Dal Pai D. Relationship between psychosocial stress dimensions and salivary cortisol in military police officers. Rev. Latino-Am. Enfermagem. 2017;25:e2873. [Access ___ __ ____]; Available in: ____________________. DOI: http://dx.doi.org/10.1590/1518-8345.1199.2873. URL month day year 2 Rev. Latino-Am. Enfermagem 2017;25:e2873. Introduction loading condition(10). The dosage of free salivary cortisol for the diagnosis of stress has become routine, due to Police officers, all over the world, are one of the categories of workers at greatest risk of death and the easy of collection and the low cost, when compared to other methods(7). exposure to stress(1-3). The exposure and level of stress Regarding stress, some studies that have assessed of the police officers have been pointed out as higher stress in the Brazilian(11) and Swiss military police than those of other professionals due to the nature of officers(12) and in the elite squad of the Italian military the activities performed, the low remuneration and the police(2) are highlighted. As for salivary cortisol levels, work overload resulting from internal relations in the these were investigated in German(3), American(13) corporation . Therefore, work can be a source of stress and Dutch(14-16) police officers. However, these studies when the worker realizes the imbalance between the assessed separately the self-perception of stress or the high effort made at work and the low reward(4). salivary cortisol curve, which allow identifying a gap in (1) Being repeatedly subjected to work stress can the knowledge about the health of the police officers. cause damage to physical and/or mental health when In this context, it was established as study problem: there is an organic vulnerability and an inappropriated Is there a relationship between self-perception of form of evaluation and coping with the stressful event. psychosocial stress and salivary cortisol in military Health problems begin in a discreet and silent manner, police officers? and are usually diagnosed late, through physical and mental symptoms. Interest in this issue is based on the vulnerability of the Brazilian police officers due to the high daily One of the theoretical models that assesses demands in the fight against urban violence, among psychosocial work stress is the Effort-Reward Imbalance other sources of stress experienced by these workers (ERI), which is based on the reciprocity between these two constructs in professional life(4-6). Therefore, a person with a greater need for control responds differently to work situations that require a lot of effort and low reward, which causes stress and activates several physiological axes of response to stress in the body(4,6). The modulation of physiological responses to stress is performed, in addition to the Autonomic Nervous System, by the Hypothalamic-Pituitary-Adrenal axis, which plays a fundamental role in the response to the external and internal stimuli of the stress agents, by regulating the circulating level of glucocorticoids(7). Cortisol is one of these glucocorticoids secreted in response to stress and found in body fluids. It follows a circadian rhythm both in plasma and urine and saliva: its maximum level occurs in the morning, declines throughout the day, is in low concentration near midnight and increases in the first hours after sleeping(7). The cortisol peak on waking up represents a 5075% increase of its levels within 30 minutes after awakening and has been referred to as a response to cortisol on waking up(8). After decreasing throughout the seeking to promote the safety of the population. Therefore, this study is justified by the social implications of the collective under study - the military police officers – on the public safety and well-being, as well as on their high risk of illness, which requires attention from health professionals, especially from nursing professionals since they play a key role in health education and promotion practices. In view of the above, the objective of this study was to analyze the relationship between psychosocial stress dimensions and salivary cortisol levels in military police officers. The military police is a permanent and regular part of the public security system of the State of Rio Grande do Sul and responsible for ostensiv (...truncated)