Anxiety, anger, salivary cortisol and cardiac autonomic activity in palliative care professionals with and without mind–body training experience: results from a pilot study

Abstract

Introduction: Palliative care practitioners suffer a considerable burden of stress. Although it is not possible to eliminate stress entirely, people can learn to manage it. Mind/body intervention helps individuals turn maladaptive responses to stress into more adaptive ones. The aim of the study was to assess the impact of mind–body techniques in a group of palliative care professionals. Methods: We investigated anxiety, anger, baseline salivary cortisol levels immediately after awakening and autonomic nervous system activity in a group of health care professionals from a Palliative Care Unit (n = 22). In addition, we assessed the autonomic response to relaxation instructions. The participants were divided into two groups according to their regular practice of mind–body techniques. Results: No significant differences between groups were found for anxiety and anger. Baseline salivary cortisol levels were significantly greater in the untrained group (5.23 ± 5.16 μg/dl) when compared with the trained one (0.57 ± 0.19 μg/dl) (Mann–Whitney U test = 0; p < 0.001). When comparing heart rate variability (HRV) values during relaxation with HRV values at rest within each group, trained subjects showed a significant increase in LF% (z = −2.073, p = 0.038), while untrained subjects showed a significant increase in HF% (z = −2.100, p = 0.036). Conclusions: Subjects who regularly practice mind–body techniques evidenced lower baseline morning cortisol levels and achieved a differential autonomic response to relaxation instructions.