[Occupational stress among care workers: evaluation by a novel physiological method].

Objectives　In this report, I studied the occupational stress response in care workers using a novel physiological method. Specifically, I evaluated the individual level of stress response in these care workers and further examined the relationship between the stress responses and various types of jobs.Methods　This study included 35 care workers working at different geriatric health facilities. During working hours, the stress response levels of these care workers were evaluated based on the changes in their sympathetic functions as measured by frequency analysis of an electrocardiogram and recorded using Holter electrocardiography. Additionally, workers were asked to maintain a diary to record the types of work they performed throughout the day. Based on the collected data, I examined the stress response values and determined their associations with different types of work. Levels of salivary chromogranin A (CgA) protein were also measured in the participating care workers.Results　The maximum job stress index (i.e., the strongest job-related stress response exhibited during the day) and CgA concentrations were significantly higher in the shift-change group than the regular-shift group (maximum job stress index: 26.2±12.0 vs. 16.1±6.5, CgA protein: 10.8±14.6 vs. 2.3±1.2 pmol/mg; P<0.05 for both measurements). For the day-shift group, the job stress index (i.e., stress response while performing a job) and job stress peak value (i.e., peak value of stress response while performing a job) were significantly higher for the worker groups performing inter-professional tasks (148.9±27.0, 29.8±9.1, respectively) and oral care (82.4±16.7, 15.4±8.7, respectively) than the groups involved in other jobs. The job stress peak value was also significantly high (20.5±9.6) for the bathing care worker group. For the night-shift worker groups, the job stress index and job stress peak value were significantly higher for oral care and clothing care groups than the groups performing other jobs (oral care: 100.1±23.1, 17.6±8.6; clothing care: 102.8±22.8, 19.8±11.7). Interestingly, for the sheet-changing group, the job stress index and job stress peak value were significantly higher for the night-shift group than the day-shift group (night: 120.6±23.3, 25.7±10.9; day: 65.0±10.6, 16.4±10.9).Conclusions　In this study, I present a novel method for analyzing the occupational stress responses in care workers; this method employs frequency analysis of an electrocardiogram and measurement of the salivary concentration of CgA protein. Further, the stress response in these workers appeared to be enhanced by changing their shift schedules. In conclusion, inter-professional tasks, oral care, and tasks requiring the caregivers to touch patients were found to be stressful jobs. Interestingly, the stress response among sheet-changing workers seemed to differ between night and day shifts.