Salivary Biomarker Profiles and Chronic Fatigue among Nurses Working Rotation Shifts: An Exploratory Pilot Study, 2022, Yamaguchi et al

Abstract

Although nurses’ fatigue affects their well-being and patient safety, no effective objective measurements exist. We explored the profiles of salivary biomarkers associated with nurses’ chronic fatigue across several shifts. This longitudinal study involved 45 shiftwork nurses and collected their saliva samples before two night and two day shifts for a month.

Chronic fatigue was measured using the Cumulative Fatigue Symptom Index before the first night shift. Biomarker profiles were analyzed using hierarchical cluster analysis, and chronic fatigue levels were compared between the profiles. Cortisol profiles were classified into high- and low-level groups across two day shifts; the low-level group presented significantly higher irritability and unwillingness to work. Secretory immunoglobulin A (s-IgA) profiles across the four shifts were classified into high- and low-level groups; the high-level group had significantly higher depressive feelings, decreased vitality, irritability, and unwillingness to work.

Cortisol (two day shifts) and s-IgA (four shifts) profiles were combined, and (i) cortisol low-level and s-IgA high-level and (ii) cortisol high-level and s-IgA low-level groups were identified. The former group had significantly higher chronic fatigue sign and irritability than the latter group. The profiles of salivary cortisol and s-IgA across several shifts were associated with nurses’ chronic fatigue.

Open access, https://www.mdpi.com/2227-9032/10/8/1416/htm

 

Cumulative Fatigue Symptom Index = Kosugo, R.; Fujii, H. An index for rating Cumulative Fatigue Symptoms (CFSI) in different occupations. J. Sci. Labour 1987, 63, 229–246. (In Japanese) [Google Scholar]

The Google Scholar link is to a citation only, and the article doesn't appear be available online anywhere, at least not through a search in English. Given the 1987 date I wonder whether it was part of the response to"burn out" anxiety that affected so much of Japanese public life in the late 80s and 1990s https://en.wikipedia.org/wiki/Karoshi

 

Somewhat interesting, but this isn't about chronic fatigue. Of course lots of physicians think that chronic fatigue is basically burnout, but in the end this confusion is more harmful than helpful. The inability to get basic concepts right is one of the biggest blockers in healthcare, it just cancels out almost all efforts.