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The Effects of Source Isolation on Psychological Well-being in Hospitalized Patients

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Ashanti Starr Johnson, BSN, RN University of Central Florida In hospitalized patients, does source isolation negatively affect psychological well-being? – PowerPoint PPT presentation

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Title: The Effects of Source Isolation on Psychological Well-being in Hospitalized Patients


1
The Effects of Source Isolation on Psychological
Well-being in Hospitalized Patients
  • Ashanti Starr Johnson, BSN, RN
  • University of Central Florida

2
Research Question
  • In hospitalized patients, does source isolation
    negatively affect psychological well-being?

3
(No Transcript)
4
Background Significance
  • The of source isolated patients for MDRO is
    steadily increasing
  • Isolating patients may negatively affect
    psychological well-being such as depression,
    anxiety, etc.
  • Risk factors for suicide include depression,
    isolation and physical illness.
  • Anxiety and depression can be found in adults and
    children

5
Background Significance
  • Approximately 1/10 adult Americans suffer from
    depression
  • The national suicide rate increased from 13 to 15
    people per 100,000 people, from the year
    2000-2006
  • Possible correlation between negative
    psychological effects and source isolation be
    identified and researched thoroughly
  • Interdisciplinary interest/importance

6
Relevance
  • Isolation poses potential psychological harm to
    patients.
  • Affects Coping
  • Leads to depression, anxiety, etc.
  • Counter productive
  • Contrary to goal of holistic nursing of patient
    to wellness state.
  • Interdisciplinary interest
  • Public interest

7
Methods
  • Search Terms
  • Databases CINAHL Plus with Full text, Cochran
    Systematic Review, PsycARTICLES, Google Scholar
    and MEDLINE
  • Terms hospital, hospitalized, isolate,
    isolation, psychological, well-being and well
    being

8
Methods
Inclusion Criteria Exclusion Criteria
Articles published between 2005 and 2011 All ages English literature Human Source isolation Both genders. Social or protective isolation b) Non-peer reviewed journals
9
Methods
  • Validity of Findings
  • Two articles were systematic reviews of cohort
    studies (level 1)
  • Five articles were individual cohort studies
    (level 2)
  • Four studies were qualitative (level 4)
  • Study Characteristics
  • 475 from CINAHL 10 from MEDLINE 6 from
    PsycARTICLES 1 from Google Scholar
  • 11met criteria 8 from CINAHL, 2 from MEDLINE, 1
    from Google Scholar

10
Methods
  • Coding
  • Negative psychological effects of source
    isolation (including decreased coping)
  • Lack of education on isolation and treatments
  • Decrease in healthcare worker contact
  • Association between decreased contact and
    increase in adverse events and delayed care.

11
Findings Negative psychological effects of
source isolation
  • Anxiety Depression
  • Abad, et al. 2010 (N1288) Depression Plt.01
    Anxiety Plt.02
  • Catalano, et al. 2003 (N51) Depression Plt0.001
    Anxiety Plt0.001
  • Day, 2011, (N102) P.47- OR1.81(0.61-5.67)-hig
    her scores but not significant (HADS)
  • Tarzi, et al. 2001 (N44) Depression Anxiety
    Plt0.01
  • Morgan, 2009 (15 studies)-P.06
  • Wassenberg, 2010 (N126) P.480 findings not
    significant.

12
Findings Negative psychological effects of
source isolation
  • Fear, anger, frustration, concern for others
    guilt
  • Barratt, et al. 2011(N10)
  • Guilt, shame, confined, alienated unwelcome
  • Skyman 2010 (N6)
  • Sadness, loneliness distress
  • Koller, et al. 2006 (N23)
  • Pacheco Spyropoulos, 2010 (n10)

13
Findings Lack of education on isolation and
treatments
  • Inconsistency of education given
  • Barratt et al. 2011(N10)
  • Pacheco Spyropoulos, 2010 (N10)
  • Decreased Education
  • Gasink, 2008 (N86) P.007
  • Barratt et al. 2011(N10)
  • Pacheco Spyropoulos 2010 (N10)
  • Skyman et al., 2010 (N6)

14
Findings Decreased Quality of Care
  • Decreased contact with Healthcare worker (HCW)
  • Abad, et al. 2010 Plt.05
  • Barratt, et al, 2011 (N10)
  • Morgan et al. 2009 plt.001
  • Skyman 2010 (N6)
  • Decrease in patient satisfaction
  • Abad et al. 2010 Plt.008
  • Morgan 2009 (15 studies) Plt.001
  • Pacheco Spyropoulos, 2010 (n10)
  • Gasink 2008 (N86) P.02 (not significant)
  • Increased adverse events
  • Abad, et al. 2010 Plt.001
  • Morgan et al. 2009 Plt.001

15
Limitations
  • Small sample sizes
  • Qualitative studies
  • Inability to conduct blind studies due to nature
    of topic
  • Sample sizes not always included for one SLR
  • Non-validated survey tool
  • Short study duration
  • Recall bias
  • No adjustment for mental health history/illness

16
Recommendations
  • Educating Healthcare Providers and Nurses
  • Educating patients, families and community
  • Implementing preventative measures
  • Conducting further research

17
Recommendations for Future Research
  • Development of a well-validated standardized
    tools
  • Research for identification of nursing
    interventions to ameliorate the negative effects
  • Research to find definitive link between
    isolation, decreased healthcare worker contact
    and adverse events.
  • Reconsideration of isolation precautions as
    preventative measure

18
Conclusion
  • Current evidence does suggest that source
    isolation has negative effects on psychological
    well-being, decreased patient satisfaction,
    decreased patient education, decreased healthcare
    worker contact and an increase in adverse events.

19
  • Questions??
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