Isolation

The recognition of the medical benefits of isolating patients to prevent the spread of infection has led to the development of specific guidelines aiming to clarify principles of isolation (Gould and Chamberlaine 1995). Source isolation is the main guiding principle whereby the patient, as the source of infection, is nursed in isolation from other patients. Until recently, the emphasis on prevention of hospital epidemics has overshadowed consideration of the consequences for the isolated patient. In particular, interest in the psychological consequences is relatively new. Lesko et al (1984) and Collins et al (1989) conducted research on the experiences of patients in protective isolation – those who are in isolation because they are at high risk of cross-infection from other patients. Lesko et al (1984) found in particular, that only eight hours of isolation in a cubicle resulted in higher generalized stress levels. Knowles (1993) highlights, however, that despite the similarities between protective isolation and source isolation, there are important differences.
Protective isolation involves awareness of benefits to oneself, choice, and a period of preparation by the patient for the experience. Source isolation confers no benefit to the patient, deprives him or her of choice, and often leaves no time to prepare.
There is currently an increasing prevalence of infection with antibiotic-resistant bacteria in hospitals in the developed world, the most frequently identified bacterium being methicillin-resistant
Staphylococcus aureus (MRSA) (Gould and Chamberlaine1995).
Research has identified many variables that can positively influence mood. For example, Kennedy and Hamilton (1997) highlighted factors which might have mitigated mood disturbance in their population of isolated spinal cord injury patients, such as younger age, and the high levels of concurrent supportive interventions available in that rehabilitation setting. Patients also commented that additional...