School of Health Sciences, City, University of London, London, UK
School of Health Sciences, City, University of London, London, UK.
BMJ Open. 2020 Feb 18;10(2):e030371. doi: 10.1136/bmjopen-2019-030371.
To systematically review the literature exploring the impact of isolation on hospitalised patients who are infectious: psychological and non-psychological outcomes.
Systematic review with meta-analysis.
Embase, Medline and PsycINFO were searched from inception until December 2018. Reference lists and Google Scholar were also handsearched.
Twenty-six papers published from database inception to December 2018 were reviewed. A wide range of psychological and non-psychological outcomes were reported. There was a marked trend for isolated patients to exhibit higher levels of depression, the pooled standardised mean difference being 1.28 (95% CI 0.47 to 2.09) and anxiety 1.45 (95% CI 0.56 to 2.34), although both had high levels of heterogeneity, and worse outcomes for a range of care-related factors but with significant variation.
The review indicates that isolation to contain the risk of infection has negative consequences for segregated patients. Although strength of the evidence is weak, comprising primarily single-centre convenience samples, consistency of the effects may strengthen this conclusion. More research needs to be undertaken to examine this relationship and develop and test interventions to reduce the negative effects of isolation.
系统回顾探讨隔离对感染住院患者的心理和非心理影响的文献。
系统评价与荟萃分析。
从建库开始至 2018 年 12 月,检索了 Embase、Medline 和 PsycINFO 数据库。还手工检索了参考文献列表和 Google Scholar。
共评价了 26 篇从数据库建立到 2018 年 12 月发表的论文。报告了广泛的心理和非心理结果。与未被隔离的患者相比,被隔离的患者表现出更高水平的抑郁, pooled 标准化均数差为 1.28(95%CI 0.47 至 2.09)和焦虑 1.45(95%CI 0.56 至 2.34),尽管两者的异质性都很高,而且在一系列与护理相关的因素上也有较差的结果,但存在显著差异。
本综述表明,为了控制感染风险而对患者进行隔离会对被隔离的患者产生负面影响。尽管证据强度较弱,主要是来自单一中心的便利样本,但效应的一致性可能会加强这一结论。需要进一步研究以检验这种关系,并开发和测试干预措施,以减少隔离的负面影响。