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Meta-Analysis
. 2020 Feb 18;10(2):e030371.
doi: 10.1136/bmjopen-2019-030371.

Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis

Edward Purssell  1 , Dinah Gould  2 , Jane Chudleigh  2
Affiliations
Meta-Analysis

Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis

Edward Purssell et al. BMJ Open. .

Abstract

Objective: To systematically review the literature exploring the impact of isolation on hospitalised patients who are infectious: psychological and non-psychological outcomes.

Design: Systematic review with meta-analysis.

Data sources: Embase, Medline and PsycINFO were searched from inception until December 2018. Reference lists and Google Scholar were also handsearched.

Results: Twenty-six papers published from database inception to December 2018 were reviewed. A wide range of psychological and non-psychological outcomes were reported. There was a marked trend for isolated patients to exhibit higher levels of depression, the pooled standardised mean difference being 1.28 (95% CI 0.47 to 2.09) and anxiety 1.45 (95% CI 0.56 to 2.34), although both had high levels of heterogeneity, and worse outcomes for a range of care-related factors but with significant variation.

Conclusion: The review indicates that isolation to contain the risk of infection has negative consequences for segregated patients. Although strength of the evidence is weak, comprising primarily single-centre convenience samples, consistency of the effects may strengthen this conclusion. More research needs to be undertaken to examine this relationship and develop and test interventions to reduce the negative effects of isolation.

Keywords: anxiety disorders; infection control; quality in health care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Risk ratio (RR) of psychological events in those isolated versus not isolated.
Figure 2
Figure 2
Standardised mean difference of psychological scores in those isolated versus those not isolated.
Figure 3
Figure 3
Meta-analysis of the standardised mean difference of anxiety in those isolated versus those not isolated.
Figure 4
Figure 4
Meta-analysis of the standardised mean difference of depression in those isolated versus those not isolated.
Figure 5
Figure 5
Risk ratio (RR) of non-psychological events in those isolated versus not isolated with an RR of ≤0.8 or ≥1.2. *Outcome was measured in rate per 100 admissions.
Figure 6
Figure 6
Standardised mean difference of non-psychological scores in those isolated versus those not isolated FIM. FIM, functional independence measure.
See this image and copyright information in PMC

References

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