Impact of IV-line Insertion on Salivary Cortisol Levels as a Stress Biomarker in Children

Idyatul Hasanah; Nursalam Nursalam; Zikrul Haikal; Alin Marhamah Azizah; Tita Rohita

doi:10.3889/oamjms.2023.10268

Authors

Idyatul Hasanah Department of Nursing, Faculty of Nursing, Airlangga University, Surabaya, Indonesia; Department of Nursing, Faculty of Health Science, Universitas Nahdlatul Wathan, Mataram, Indonesia https://orcid.org/0000-0002-5720-9230
Nursalam Nursalam Department of Nursing, Faculty of Nursing, Airlangga University, Surabaya, Indonesia
Zikrul Haikal Department of Surgery, Faculty of Medicine, Universitas Mataram, Mataram, Indonesia
Alin Marhamah Azizah Department of Nursing, Moewardi General Hospital, Surakarta, Central Java, Indonesia
Tita Rohita Department of Nursing, Faculty of Nursing, Airlangga University, Surabaya, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2023.10268

Keywords:

IV-line insertion, Salivary cortisol, stress, Biomarkers, Leukemia

Abstract

BACKGROUND: Children with leukemia will be treated for a quite long period of time that they will be subjected to multiple invasive procedures, one of which is IV-line insertion. This procedure can cause stress, which increases cortisol levels in the body.

AIM: This study aimed to investigate how IV-line insertion affected cortisol levels as a stress biomarker in children.

METHODS: This is a single-group pre-test and post-test design pre-experimental study. The study enrolled 30 children undergoing IV line insertion, aged from 6 to 18 years, who had not been eating or drinking for 30 min before the saliva sampling was scheduled to get IV-line insertion. The ELISA test was used to measure the salivary cortisol. If the difference in the cortisol levels is > 0.05 ng/ml, it is clinically significant. Furthermore, the Wilcoxon test was used to analyze the data. Cortisol changes were considered statistically significant if the p-value was <0.05.

RESULTS: The cortisol levels were 3.43 (0.19–16.67) ng/ml and 4.14 (0.19–16.67) ng/ml before and after IV-Line insertion, respectively. The difference in the median was 0.71 ng/ml. The > 0.05 ng/ml difference indicates that IV-line insertion affects cortisol elevation. The Wilcoxon test showed a value of p = 0.34 (p > 0.05) indicating that IV-line insertion had no statistically significant effect on cortisol.

CONCLUSION: Although an IV-line insertion does not have a statistically significant effect on cortisol, it clinically influences the increase of cortisol in children with leukemia.

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