Background: Management of MRSA infection includes immediate isolation of the patient. Long periods of isolation are considered to be psychologically detrimental, though little information is available about the impact of isolation as an infection control procedure. The purpose of this study is to examine the psychological well-being of spinal cord injured patients who are isolated as a result of being MRSA positive. Methods: A cross-sectional matched-control study of MRSA positive patients with MRSA negative patients was carried out at the National Spinal Injuries Centre, Stoke Mandeville Hospital, Bucks, England. Sixteen MRSA positive patients, aged 18 to 65, and their matched controls completed a series of questionnaires to measure aspects of psychological impact. The measures used were functional independence, depression, anxiety, and the a ective states of anger, vigour, fatigue and confusion. Findings: The MRSA positive spinal cord injured patients were only signi®cantly more angry than the control group, although these isolated patients scored higher in all measures. Interpretations: In this spinal cord injured group the di erence between the psychological wellbeing of isolated MRSA positive patients and non-isolated MRSA negative patients is not as great as might have been expected. Patients feel that rehabilitation is a ected, but the situation may be improved by providing more space and a better view onto the ward.

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Most research into psychological aspects of spinal cord injury (SCI) has focused on adult onset. This is a retrospective study of self-perceptions following a childhood onset of SCI. Self-esteem, depression and self-perception were examined in 86 people who had a traumatic SCI before the age of 16. Depression was measured using the Beck Depression Inventory, and self-esteem using the Culture-Free Self-Esteem Inventory Self-perception was measured using a scale developed for this study, consisting of 20 adjectives, with participants themselves on dimensions of`As I am',`As I would be without the injury', and`as I would be ideally'. The participants' self perceptions of the injured self and the uninjured self were found to be signi®cantly dierent on only nine of the 20 adjectives. Low self-perception was found to be associated with low self-esteem and high depression levels, but independent of age at injury, level of injury and gender. The change noted by the participants between how they see themselves now and how they would have been without the injury is not as great as might have been expected.

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