Psychological aspects of patients in germ-free isolation: A review of child, adult, and patient management literature

Abstract

Life-threatening medical conditions such as severe combined immunodeficiency disease, leukemia, severe aplastic anemia, radiation injury, burns, organ transplantation, and aggressive administration of chemotherapy often necessitate the isolation of the patient in a protected germ-free environment for weeks or months. This treatment milieu has the effect of extensive psychological and physical isolation from family and staff. A review of the literature was undertaken to investigate the psychological implications of such treatment and to question the possibility that this isolation therapy might produce a unique type of psychological stress. Most authors agree that patients are able to withstand the emotional stress of germ-free isolation and that behavioral changes relate more to the severity of the illness rather than to the isolation. However, there may be inherent stresses related to isolator therapy that can be alleviated by environmental manipulation. Case vignettes are included and patient management in such an environment is outlined.

The psychological consequences of source isolation: a review of the literature

“…(1994 ) support many of the previous research findings and also argue that patients in protective isolation develop symptoms of anxiety, depression, and cognitive disorders. Severe psychological reactions to protective isolation have also been reported by Lesko et al . (1984 ) and Kellerman et al .…”

Measurement of Behavioral, Affective, and Somatic Responses to Pediatric Bone Marrow Transplantation: Development of the BASES Scale

“…[3][4][5][6][7][8][9] To date, the responses of children to this stressful BMT environment have been described narratively and anecdotally, but there has been surprisingly little empiric data presented depicting patient response in pediatric BMT settings. A significant obstacle to the study of the acute psychosociaVsomatic effects of transplant has been a lack of appropriate measurement instruments.…”

Risk Perception and Compliance With Quarantine During the SARS Outbreak

“…Recent studies have indicated that quarantine during the SARS outbreak was an emotional and, for some, a financial hardship (Blendon, Benson, DesRoches, Raleigh, & Taylor‐Clark, 2004; Hawryluck et al, 2004). Although some researchers have investigated the psychological consequences of hospital isolation practices (Gammon, 1999; Lesko, Kern, & Hawkins, 1984), little is known about the subjective experience of quarantine, for example, how people manage protocols and the supports or barriers to compliance. We therefore undertook a descriptive, qualitative study to explore the experience of being quarantined, specifically the relationship between perceived risk of contracting SARS and reported compliance with the quarantine order and protocols.…”