Measuring Salivary Cortisol to Assess the Effect of Natural Environments on Stress Level in Acute Patients With Severe Brain Injuries: An Exploratory Study.
acute phase
brain injury
nature
neurorehabilitation
salivary cortisol
stress
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
accepted:
07
09
2023
medline:
10
10
2023
pubmed:
10
10
2023
entrez:
10
10
2023
Statut:
epublish
Résumé
Salivary cortisol is a safe and non-invasive measure of hypothalamic-pituitary-adrenal axis function and is used as a biomarker of the human stress response. Natural environments are recognized to contribute to help reduce the effect of stress. To determine the feasibility of a salivary cortisol collection protocol for acute severely brain-injured patients, and to explore the influence of exposure to natural settings on salivary cortisol concentration as an index of stress level. An exploratory study on 17 acute patients with severe brain injury was performed. We collected salivary samples in a closed hospital ward and a therapeutic garden at the start of the session and after 30 minutes of rest time. Physiological parameters, level of communication, and subjective well-being were also assessed. The primary objectives regarding the feasibility of the protocol were met overall. We found no significant differences in cortisol values when including the whole population. However, cortisol values were significantly higher in the indoor environment in patients with communication attempts. A salivary collection protocol with brain-injured patients in the acute phase is feasible and safe, and this type of measurement could pave the way for future research supporting the benefits of nature as an additional resource in their neurorehabilitation.
Sections du résumé
BACKGROUND
BACKGROUND
Salivary cortisol is a safe and non-invasive measure of hypothalamic-pituitary-adrenal axis function and is used as a biomarker of the human stress response. Natural environments are recognized to contribute to help reduce the effect of stress.
OBJECTIVE
OBJECTIVE
To determine the feasibility of a salivary cortisol collection protocol for acute severely brain-injured patients, and to explore the influence of exposure to natural settings on salivary cortisol concentration as an index of stress level.
METHODS
METHODS
An exploratory study on 17 acute patients with severe brain injury was performed. We collected salivary samples in a closed hospital ward and a therapeutic garden at the start of the session and after 30 minutes of rest time. Physiological parameters, level of communication, and subjective well-being were also assessed.
RESULTS
RESULTS
The primary objectives regarding the feasibility of the protocol were met overall. We found no significant differences in cortisol values when including the whole population. However, cortisol values were significantly higher in the indoor environment in patients with communication attempts.
CONCLUSIONS
CONCLUSIONS
A salivary collection protocol with brain-injured patients in the acute phase is feasible and safe, and this type of measurement could pave the way for future research supporting the benefits of nature as an additional resource in their neurorehabilitation.
Identifiants
pubmed: 37814730
doi: 10.7759/cureus.44878
pmc: PMC10560321
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e44878Informations de copyright
Copyright © 2023, Jöhr et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Clin Chem Lab Med. 2017 May 1;55(6):826-835
pubmed: 27898397
Int J Biometeorol. 2019 Aug;63(8):1117-1134
pubmed: 31001682
Int J Environ Health Res. 2022 Aug;32(8):1842-1867
pubmed: 33910423
Gerodontology. 1997 Jul;14(1):33-47
pubmed: 9610301
Neurocrit Care. 2021 Oct;35(2):559-572
pubmed: 33403583
Eur J Intern Med. 2019 Oct;68:66-70
pubmed: 31399330
Science. 1984 Apr 27;224(4647):420-1
pubmed: 6143402
NeuroRehabilitation. 2019;44(4):545-554
pubmed: 31282434
Psychoneuroendocrinology. 2009 Nov;34(10):1437-48
pubmed: 19632788
J Clin Neurosci. 2014 Dec;21(12):2150-4
pubmed: 25065844
Scand J Trauma Resusc Emerg Med. 2013 Apr 20;21:33
pubmed: 23601250
J Speech Lang Hear Res. 2019 May 21;62(5):1416-1426
pubmed: 31021679
J Neurol. 2014 Mar;261(3):533-45
pubmed: 24477489
J Stroke Cerebrovasc Dis. 2013 Oct;22(7):e124-35
pubmed: 23149149
Environ Res. 2018 Oct;166:628-637
pubmed: 29982151
Commun Mater. 2021;2(1):10
pubmed: 33506228
Eur Neuropsychopharmacol. 2011 Oct;21(10):718-79
pubmed: 21924589
Psychoneuroendocrinology. 2009 Feb;34(2):163-171
pubmed: 19095358
Int J Neurosci. 2017 Mar;127(3):199-203
pubmed: 27033879
J Clin Exp Neuropsychol. 2012;34(5):489-96
pubmed: 22352852