Salivary cortisol, subjective stress and quality of sleep among female healthcare professionals

Wegdan Bani-Issa, Hadia Radwan, Farah Al Marzooq, Shamsa Al Awar, Arwa M. Al-Shujairi, Ab Rani Samsudin, Wafa Khasawneh, Najla Albluwi

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


Background: Stress is globally recognised as a risk factor impacting workers’ health and workplace safety. Women healthcare professionals are at risk for considerable stress given the demanding nature of their jobs and current working conditions. This study assessed levels of stress among women healthcare professionals using measures of their cortisol levels, subjective stress and quality of sleep. Participants and Methods: This study used a cross-sectional design. Data were collected from 335 apparently healthy adult women healthcare professionals working in the United Arab Emirates. Participants provided morning and bedtime saliva samples for analysis of their cortisol levels. The Perceived Stress Scale, Stress Symptoms Scale, Brief Coping Scale and Pittsburgh Sleep Quality Index were used to assess perceived stress level, symptoms of stress, stress-coping strategies and sleep quality, respectively. Results: In total, 121 (36.15%) women had impaired morning cortisol levels (below the normal range of 0.094–1.551 µg/dL) and 48 (14.3%) had impaired bedtime cortisol levels (above 0.359 µg/dL). Around 57% of women reported moderate levels of perceived stress, with the most frequently reported stress symptoms being heart rate and back/neck pain. Poor sleep quality was reported by around 60% of participating women. No significant association was found between cortisol and psychosocial measurements of stress or sleep quality. However, night shift and longer shift duration (more than 8 hrs) were significantly associated with impaired morning and bedtime cortisol levels (P ≥ 0.05). Impaired cortisol levels were strongly dependent on using adaptive coping strategies such as active coping, acceptance and seeking emotional support (P ≥ 0.05). Conclusion: Evaluating cortisol levels and subjective stress could help to identify groups with impaired response to stress and elevated cortisol levels. Our findings support the need to examine shift work patterns and stress coping strategies in women healthcare professionals to promote their health and productivity and maintain workplace safety.

Original languageEnglish
Pages (from-to)125-140
Number of pages16
JournalJournal of Multidisciplinary Healthcare
Publication statusPublished - 2020


  • Coping strategies
  • Cortisol
  • Female healthcare professionals
  • Nurses
  • Sleep quality
  • Subjective stress

ASJC Scopus subject areas

  • General Nursing


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