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全科医生对患者近期因耐多药感染住院和隔离的感受进行评估。

Evaluation in general practice of the patient's feelings about a recent hospitalization and isolation for a multidrug-resistant infection.

机构信息

Service de Maladies Infectieuses, Hôpital Raymond Poincaré, Garches, France.

Service de Maladies Infectieuses, Hôpital Raymond Poincaré, Garches, France.

出版信息

Am J Infect Control. 2019 Sep;47(9):1077-1082. doi: 10.1016/j.ajic.2019.03.018. Epub 2019 Apr 30.

Abstract

BACKGROUND

Isolation precautions used against multidrug-resistant (MDR) organisms are responsible for many emotional side effects. We evaluated patient's feeling after a hospitalization for an MDR infection.

METHODS

We conducted a qualitative study that included 11 interviews from August 2017 to June 2018. We used phenomenology and verbatim transcription analysis was performed using NVivo software. Patients reported mainly negative feelings. Among them, 4 main themes were expressed: a desire to "be free from carriage," self-questioning regarding its nosocomial origin, the reduction of the therapeutic arsenal, and the expression of many fears especially relapse.

RESULTS

For most of the participants (n = 6/11), the type of bacteria that colonized their digestive tract was precisely known including the MDR characteristics of the infection. Participants were convinced that the infection was strongly linked to the hospital and considered it as nosocomial that led to anxiety, especially regarding the origin of the infection and the absence of formal source of infection.

CONCLUSIONS

MDR infections are negatively impacting patient's lived experience even after hospital discharge, partly owing to prior implementation of isolation precautions. We need to improve communication between specialists and general practitioners to reassure the patient and his surroundings regarding the anxiety resulting from such hospitalization.

摘要

背景

针对多重耐药(MDR)生物体使用的隔离预防措施会导致许多情绪副作用。我们评估了患者在因 MDR 感染住院后的感受。

方法

我们进行了一项定性研究,包括 2017 年 8 月至 2018 年 6 月的 11 次访谈。我们使用了现象学,并使用 NVivo 软件对逐字转录分析进行了分析。患者主要报告了负面情绪。其中,表达了 4 个主要主题:摆脱携带状态的愿望、对其医院获得性起源的自我质疑、治疗武器库的减少,以及对复发等许多恐惧的表达。

结果

对于大多数参与者(n=11 中的 6 人),其消化道定植的细菌类型包括感染的 MDR 特征都得到了明确的了解。参与者确信感染与医院有很强的联系,并认为这是医院获得性感染,导致了焦虑,特别是对感染的起源和感染源不存在的问题感到焦虑。

结论

即使在出院后,MDR 感染仍对患者的生活体验产生负面影响,部分原因是先前实施了隔离预防措施。我们需要改善专家和全科医生之间的沟通,以减轻患者及其周围环境因住院而产生的焦虑。

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