University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Infect Control Hosp Epidemiol. 2013 Mar;34(3):251-8. doi: 10.1086/669526. Epub 2013 Jan 23.
To determine the association between contact precautions and depression or anxiety as well as feelings of anger, sadness, worry, happiness, or confusion.
Prospective frequency-matched cohort study.
The University of Maryland Medical Center, a 662-bed tertiary care hospital in Baltimore, Maryland.
A total of 1,876 medical and surgical patients over the age of 18 years were approached; 528 patients were enrolled from January through November 2010, and 296 patients, frequency matched by hospital unit, completed follow-up on hospital day 3.
The primary outcome was Hospital Anxiety and Depression Scale (HADS) scores on hospital day 3, controlling for baseline HADS scores. Secondary moods were measured with visual analog mood scale diaries. Patients under contact precautions had baseline symptoms of depression 1.3 points higher (P<.01) and anxiety 0.8 points higher (P=.08) at hospital admission using HADS. Exposure to contact precautions was not associated with increased depression (P=.42) or anxiety (P=.25) on hospital day 3. On hospital day 3, patients under contact precautions were no more likely than unexposed patients to be angry (20% vs 20%; P=.99), sad (33% vs 38%; P=.45), worried (51% vs 46%; P=.41), happy (58% vs 67%; P=.14), or confused (23% vs 24%; P=.95).
Patients under contact precautions have more symptoms of depression and anxiety at hospital admission but do not appear to be more likely to develop depression, anxiety, or negative moods while under contact precautions. The use of contact precautions should not be restricted by the belief that contact precautions will produce more depression or anxiety.
确定接触预防措施与抑郁或焦虑以及愤怒、悲伤、担忧、快乐或困惑等情绪之间的关联。
前瞻性频率匹配队列研究。
马里兰州巴尔的摩市的马里兰大学医学中心,这是一家拥有 662 张床位的三级保健医院。
共对 1876 名 18 岁以上的内科和外科患者进行了调查;2010 年 1 月至 11 月期间,共有 528 名患者入选,按医院科室进行频率匹配,其中 296 名患者在住院第 3 天完成了随访。
主要结果是在控制基线 HADS 评分的情况下,住院第 3 天的医院焦虑和抑郁量表(HADS)评分。次要情绪通过视觉模拟情绪量表日记进行测量。与未接触接触预防措施的患者相比,接触接触预防措施的患者在入院时 HADS 显示出更高的抑郁症状(1.3 分,P<.01)和焦虑症状(0.8 分,P=.08)。在住院第 3 天,接触预防措施暴露与抑郁(P=.42)或焦虑(P=.25)的增加无关。在住院第 3 天,接触接触预防措施的患者与未接触接触预防措施的患者相比,愤怒(20%比 20%;P=.99)、悲伤(33%比 38%;P=.45)、担忧(51%比 46%;P=.41)、快乐(58%比 67%;P=.14)或困惑(23%比 24%;P=.95)的可能性均无差异。
接触预防措施的患者在入院时表现出更多的抑郁和焦虑症状,但在接触预防措施期间似乎不太可能出现抑郁、焦虑或负面情绪。不应因接触预防措施会产生更多的抑郁或焦虑而限制接触预防措施的使用。