Research Article: Stress, self-esteem and well-being among female health professionals: A randomized clinical trial on the impact of a self-care intervention mediated by the senses

Date Published: February 27, 2017

Publisher: Public Library of Science

Author(s): Eliseth Ribeiro Leão, Daniela Reis Dal Fabbro, Rebeca Barqueiro de Oliveira, Ingrid Ribeiro dos Santos, Elivane da Silva Victor, Rita Lacerda Aquarone, Cristiane Benvenuto Andrade, Vivian Finotti Ribeiro, Roselaine Coelho de Oliveira, Rosa Friedlander, Daniela Santos Ferreira, Alanna M. Chamberlain.


Stress levels are evident among health professionals. However, there are few studies on sensory-based self-care aimed at stress management, self-esteem and subjective well-being in this group of professionals.

To assess the impact of a self-care intervention mediated by the senses on the stress levels, self-esteem and well-being of health professionals in a hospital environment.

A total of 93 health professionals participated in an unblinded clinical trial, randomized into four groups: 1) control (no intervention); 2) Monosensory—daily body moisturizing (DBM) with odorless cream; 3) Bisensory—DBM with scented cream; 4) Multisensory—DBM with scented cream associated with audiovisual material. Participants answered specific questionnaires to assess stress, self-esteem and well-being and cortisol samples were collected at baseline, 15 and 30 days following intervention, and at the 30-day follow-up.

Self-care was characterized as neglected, with most participants reporting inadequate hours of sleep (74%), irregular physical activity (68%), and inadequate nutrition (45%). Compared to the other groups, the Bisensory group had lower stress on all three assessments (p = 0.017; 0.012; 0.036), a life satisfaction 8% higher at follow-up than at baseline (95% CI: 2% to 15%, p = 0.016), a 10% increase in positive affect (95% CI: 2% to 19%, p = 0.011) and a 12% reduction in negative affect (95% CI: 3% to 21% less, p = 0.014) after 30 days. The Multisensory group showed improvement in self-esteem (p = 0.012) and reduced cortisol (p = 0.036) after 30 days of intervention. The control group showed no changes in the variables studied, except for cortisol: an increase at the 15-day evaluation (denoting higher risk for stress, p = 0.009) and a reduction at follow-up (p = 0.028), which was nevertheless within normal levels. NCT02406755

Partial Text

The stress of health professionals has been the subject of scientific research due to its costs and deleterious effects on individuals and organizations. For over two decades, national and international studies have shown the potential negative effects of occupational stress on the health and well-being of health professionals, particularly in terms of low satisfaction [1], physical and psychological complaints [2] and absenteeism [3–4]. Women are particularly prone to problems related to occupational stress [5].

The protocol for this trial and supporting CONSORT checklist are available as supporting information; see S1 and S2 Texts.

In order to assess the impact of a self-care intervention mediated by the senses on the stress, self-esteem and well-being of health professionals working in a hospital environment, we needed to identify the basic self-care profile among the participants tested. The first thing that caught our attention was the fact that self-care was overlooked by many participants, with basic human needs not being fully met by a significant number of participants. Maslow’s hierarchy of basic human needs [26] indicates that physiological, safety, love and/or social, esteem and self-realization needs, when not met, can generate dissatisfaction and preclude meeting human needs for growth, self-realization and self-development.

In this study, we observed that the self-care method (mediated by touch, smell, sight and hearing) does not reduce stress. However, it improved participants’ self-esteem. This finding indicates that self-esteem and stress are not always related; opposing what has been suggested by several studies. Self-care intervention mediated by touch and smell can help in fighting the stress in health professionals and thus should be further explored as a strategy to ameliorate the stress that these professionals usually carry in their professional lives.