Tarzi S, Kennedy P, Stone S, Evans M
Shrodells Psychiatric Unit, Watford General Hospital, London, UK.
J Hosp Infect. 2001 Dec;49(4):250-4. doi: 10.1053/jhin.2001.1098.
A cross-sectional matched control study was designed to investigate the impact of hospitalization and MRSA isolation on the psychological functioning of older adults undergoing rehabilitation.Twenty-two MRSA-positive and 20 MRSA-negative older adults completed standardized measures relating to depression, anxiety and anger. Both groups of participants had higher scores for anger than those estimated for community-based older adults. The level of depressive and anxious symptoms amongst the isolated group was significantly higher than that found for the MRSA-negative group or estimates for community-based older adults. There was no correlation between length of hospitalization or isolation and the outcome measures. The results suggest that, amongst older adult inpatients, isolation has a negative impact on mood in addition to that resulting from hospitalization. Those involved in caring for hospitalized older adults should be made aware of the potential psychological distress of isolation, and alternative approaches to isolation (such as hand hygiene, antibiotic restriction, surveillance) should be used in the management of MRSA whenever possible. Future studies should examine the best ways of managing the detrimental effects of isolation.
一项横断面匹配对照研究旨在调查住院治疗和耐甲氧西林金黄色葡萄球菌（MRSA）隔离对接受康复治疗的老年人心理功能的影响。22名MRSA阳性和20名MRSA阴性老年人完成了与抑郁、焦虑和愤怒相关的标准化测量。两组参与者的愤怒得分均高于基于社区的老年人的估计得分。隔离组的抑郁和焦虑症状水平显著高于MRSA阴性组或基于社区的老年人的估计水平。住院时间或隔离时间与结果测量之间没有相关性。结果表明，在老年住院患者中，隔离除了会导致与住院相关的情绪问题外，还会对情绪产生负面影响。参与照顾住院老年人的人员应意识到隔离可能带来的心理困扰，并且在MRSA管理中应尽可能采用替代隔离的方法（如手部卫生、抗生素限制、监测）。未来的研究应探讨管理隔离有害影响的最佳方法。
