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Association between burnout and cortisol secretion, perceived stress, and psychopathology in palliative care unit health professionals

Published online by Cambridge University Press:  24 April 2017

José Carlos Fernández-Sánchez
Programa de Doctorado en Medicina Clínica y Salud Pública, University of Granada, and San Rafael University Hospital, Granada, Spain
José Manuel Pérez-Mármol*
Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
Antonia Blásquez
Area de Bioquimica Clinica, Hospital Alejandro Otero, Granada, Spain
Ana María Santos-Ruiz
Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Alicante, Spain
María Isabel Peralta-Ramírez
Department of Clinical Psychology, University of Granada, Granada, Spain Mind, Brain and Behavior Research Center, Granada, Spain
Address correspondence and reprint requests to: José Manuel Pérez Mármol, Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016 Granada, Spain. E-mail:



A high incidence of burnout has been reported in health professionals working in palliative care units. Our present study aims to determine whether there are differences in the secretion of salivary cortisol between palliative care unit health professionals with and without burnout, and to elucidate whether there is a relationship between burnout syndrome and perceived stress and psychopathological status in this population.


A total of 69 health professionals who met the inclusion criteria participated in our study, including physicians, nurses, and nursing assistants. Some 58 were women (M = 29.65 years, SD = 8.64) and 11 men (M = 35.67 years, SD = 11.90). The level of daily cortisol was registered in six measurements taken over the course of a workday. Burnout syndrome was evaluated with the Maslach Burnout Inventory–Human Services Survey (MBI–HSS), the level of perceived stress was measured using the Perceived Stress Scale, and psychopathological status was gauged using the SCL–90–R Symptoms Inventory.


There were statistically significant differences in secretion of cortisol in professionals with high scores on a single subscale of the MBI–HSS [F(3.5) = 2.48, p < 0.03]. This effect was observed 15–30 minutes after waking up (p < 0.01) and at bedtime (p < 0.06). Moreover, the professionals with burnout showed higher scores on the psychopathology and stress subscales than professionals without it.

Significance of results:

A higher score in any dimension of the burnout syndrome in palliative care unit health professionals seems to be related to several physiological and psychological parameters. These findings may be relevant for further development of our understanding of the relationship between levels of burnout and cortisol secretion in the health workers in these units.

Original Article
Copyright © Cambridge University Press 2017 

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