Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.
Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.
J Hosp Infect. 2020 Sep;106(1):126-133. doi: 10.1016/j.jhin.2020.06.034. Epub 2020 Jul 3.
Isolation precautions are applied to control the risk of transmission of multi-drug resistant organisms (MDROs). These precautions have been associated with adverse effects, such as anxiety and depression. This study aimed to quantify stigma among MDRO carriers and its association with perceived mental health and experienced quality of care.
A quantitative questionnaire study was performed in MDRO carriers exposed to ≥3 days of isolation precautions during hospitalization. Items derived from the Consumer Quality Index questionnaire (CQI) were used to assess perception of care. Stigma scores were calculated using the recently modified Berger Stigma Scale for meticillin-resistant Staphylococcus aureus (MRSA). Mental health was measured with the RAND Mental Health Inventory. The Spearman rank correlation test was used to assess the association between stigma score and RAND mental health score.
Of the 41 included carriers, 31 (75.6%) completed both questionnaires. The experienced quality of care was 'good' according to CQI score. Twenty-four percent reported not to have received proper explanation about MDRO carriership from healthcare workers (HCWs). MDRO-associated stigma was reported in 1/31 (3.2%). Poor mental health was self-reported in 3/31 (9.7%). There was no correlation between stigma score and RAND mental health score (Spearman correlation coefficient: 0.347).
In this study, MDRO carriers exposed to ≥3 days of isolation precautions did not report stigma. This contrasts with a recent study that investigated MRSA-associated stigma and may be explained by contact plus airborne isolation protocols in MRSA compared with contact isolation alone in most other MDROs. Also, the psychological impact may be of a different magnitude due to as yet unknown reasons.
隔离预防措施用于控制多重耐药菌（MDRO）传播的风险。这些预防措施与焦虑和抑郁等不良影响有关。本研究旨在量化 MDRO 携带者的污名，并研究其与感知的心理健康和所经历的护理质量之间的关联。
对住院期间暴露于隔离预防措施≥3 天的 MDRO 携带者进行了一项定量问卷调查研究。使用源自消费者质量指数问卷（CQI）的项目评估护理感知。使用最近修改的耐甲氧西林金黄色葡萄球菌（MRSA） Berger 污名量表计算污名评分。使用 RAND 心理健康量表测量心理健康。使用 Spearman 秩相关检验评估污名评分与 RAND 心理健康评分之间的相关性。
在 41 名纳入的携带者中，有 31 名（75.6%）完成了两份问卷。根据 CQI 评分，所经历的护理质量为“良好”。24%的人报告说没有从医护人员那里得到关于 MDRO 携带的适当解释。31 名携带者中有 1 名（3.2%）报告存在与 MDRO 相关的污名。31 名携带者中有 3 名（9.7%）自我报告心理健康状况不佳。污名评分与 RAND 心理健康评分之间无相关性（Spearman 相关系数：0.347）。
在这项研究中，暴露于≥3 天隔离预防措施的 MDRO 携带者没有报告污名。这与最近一项研究中调查的 MRSA 相关污名形成对比，这可能是由于 MRSA 中接触加空气传播隔离方案与大多数其他 MDRO 中仅接触隔离有关。此外，由于未知原因，心理影响的程度可能不同。
