Psychological impact of the management of methicillin-resistant staphylococcus aureus (MRSA) in patients with spinal cord injury
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 affective states of anger, vigour, fatigue and confusion. Findings: The MRSA positive spinal cord injured patients were only significantly more angry than the control group, although these isolated patients scored higher in all measures. Interpretations: In this spinal cord injured group the difference between the psychological well-being 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 affected, but the situation may be improved by providing more space and a better view onto the ward.