Measuring perception of mental well-being in patients under isolation precautions: a prospective comparative study

Abstract

ObjectivesIsolation precautions (IP) are applied to prevent transmission of pathogens in healthcare settings. Potential negative health outcomes experienced by patients have been previously described but results remain conflicting. We aimed at evaluating the psychological impact of IP in adult patients in isolation using a novel psychological assessment tool.Study designProspective matched cohort study.SettingTertiary care centre in Switzerland.ParticipantsHospitalised patients under IP and non-isolated patients were matched by ward, age and illness severity.Outcome measuresWe measured surrogates of mental and social well-being by using the Pictorial Representation of Illness and Self Measure (PRISM) instrument once during hospitalisation. PRISM is a visual psychometric instrument that has been validated as a quantitative measure of suffering. Smaller distance in self-to-illness separation (SIS) signifies higher importance for a patient.Results156 patients agreed to participate of which 63 were under IP and 93 were matched controls. Median (IQR) duration of isolation was 5 days (2–10). The median SIS (IQR) for perceived inferior nurses’ care was 22.8 (18.5–24.3) and 23.8 (23.3–25.5) for isolated and non-isolated patients, respectively (p<0.001). Similarly, median SIS (IQR) was significantly smaller in isolated than non-isolated patients for avoidance by visitors with 17.5 (7.7–22.0) and 22.2 (21.8–22.6), for loneliness with 7.5 (3.6–16.0) and 18 (10.2–21.6) and for feeling impure with 19 (17.0–21.5) and 21.5 (18.9–22.1), respectively (all p values<0.05).ConclusionsIP to prevent transmission of pathogens may negatively impact mental and social well-being. Measures to alleviate adverse effects of IP should be taken routinely.

To Assess the Effect of Hospitalization on Adult Patients’ Mental Health

“…Hospitalization may sternly disrupt sleep, which can worsen pain, mental status, and the psychiatric health of ill patients [11]. Inadequate sleep may lead to both psychological and physiological consequences on adult patients thus instigating anxiety, anger and stress among hospitalized patients [12,13].Like vital signs, the patient sleep quality reveals much about patients' overall well-being, and should be a routine part of medical evaluation [14].Subsequently, occurrence of psychophysiological capability should be examined in adult patients during their medical stay alongside adequacy of assessment outside the medical setting when they are discharged in order to decide if there are patients for whom hospitalization isn't the only optimal treatment required but other medical interventions are needed to ensure wellbeing of their mental health [15,16] . Thus, the aim of this research is to evaluate the effect of hospitalization on adults' patients' mental health and also to identify the contributing factors that effects their behaviour and functionality.…”