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隔离应对方案对多重耐药菌定植或感染患者的影响:一项准实验研究。

Effect of an isolation-coping programme on patients isolated for colonization or infection with multi-drug-resistant organisms: a quasi-experimental study.

机构信息

Gachon University Gil Hospital, Incheon, South Korea.

Gachon University College of Nursing, Incheon, South Korea.

出版信息

J Hosp Infect. 2022 Nov;129:31-37. doi: 10.1016/j.jhin.2022.08.002. Epub 2022 Aug 17.

Abstract

BACKGROUND

The global increase in the prevalence of vancomycin-resistant enterococci (VRE) and carbapenem-resistant Enterobacterales (CRE) among multi-drug-resistant organisms (MDROs) has necessitated contact precaution and isolation in medical institutions. Contact isolation has a negative effect on the mental health of patients, but few interventions have addressed this issue.

AIM

To evaluate an isolation-coping programme delivered by an infection control nurse for patients colonized or infected with VRE or CRE.

METHODS

An isolation-coping programme was developed to mitigate the negative effects of isolation due to MDROs, and the effects of the programme on uncertainty, anxiety, depression and knowledge of patients isolated because of MDROs (VRE or CRE) were validated using a pre-post quasi-experimental design.

FINDINGS

The experimental group (N=56) received education and emotional support via the isolation-coping programme, and the control group (M=55) received verbal isolation guidelines alone from the medical institution. Compared with the control group, the experimental group showed a reduction in uncertainty (t=-8.925), anxiety (Z=-6.131) and depression (Z=-5.379), and better knowledge (Z=-8.372) (P<0.001 for all).

CONCLUSION

This novel isolation-coping programme delivered by an infection control nurse was found to be an effective intervention to improve uncertainty, anxiety, depression and knowledge in patients isolated with VRE or CRE.

摘要

背景

耐万古霉素肠球菌(VRE)和耐碳青霉烯肠杆菌科(CRE)在多重耐药菌(MDROs)中的全球流行率增加,使得医疗机构必须采取接触预防和隔离措施。接触隔离对患者的心理健康有负面影响,但很少有干预措施解决这个问题。

目的

评估感染控制护士为 VRE 或 CRE 定植或感染患者实施的隔离应对方案。

方法

制定了一种隔离应对方案,以减轻由于 MDRO 导致的隔离的负面影响,并使用预-后准实验设计验证了该方案对 MDRO 隔离患者(VRE 或 CRE)的不确定性、焦虑、抑郁和知识的影响。

发现

实验组(N=56)接受了隔离应对方案的教育和情感支持,对照组(M=55)仅从医疗机构接受了口头隔离指南。与对照组相比,实验组的不确定性(t=-8.925)、焦虑(Z=-6.131)和抑郁(Z=-5.379)均有所降低,知识水平更好(Z=-8.372)(均 P<0.001)。

结论

由感染控制护士实施的这种新型隔离应对方案被发现是一种有效的干预措施,可改善 VRE 或 CRE 隔离患者的不确定性、焦虑、抑郁和知识水平。

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