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Oplevelseaf isolation under indlæggelse: Et kvalitativt studie
Nordic Council of Ministers, Nordic School of Public Health NHV.
2014 (Danish)Independent thesis Advanced level (degree of Master (Two Years))Student thesisAlternative title
Experience of source isolation during hospitalization : A qualitative study (English)
Abstract [da]

Formål: Formålet med dette studie var at undersøge faktorer der kan have betydning for hvordan patienten magter at være isoleret under indlæggelse på hospital. Der søges afdækning af om der er baggrundsvariabler som køn, alder og tidligere erfaringer, som har betydning og hvilke konsekvenser det medfører. Formålet var endvidere på baggrund af en risikoanalyse af den enkelte patientat fokusere på at tilrettelægge organiseringen af pleje og behandling.

Metode: Studiet er et kvalitativstudie, hvor det empiriske materiale blev indsamlet ved fempatientinterviews. Som analysemetode blev anvendt indholdsanalyse. Den konceptuelle ramme omfatter antibiotikaresistens i et folkesundhedsperspektiv, en beskrivelse af rammerne for infektionsforebyggelse i Danmark samt en teoretisk ramme af hvad det indebærer for patienter at være smittet med en multiresistent bakterie og oplevelse af at være isoleret.

Resultater: Studiet viser, at lukket dør, mangel på kontakt og stimuli resulterer i følelsen af kedsomhed, monotoni og angst. Studiet viser endvidere at baggrundsvariabler synes at have betydning for hvordan isolationen opleves. Kvinder udviser større bekymringer omkring smitteforholdsregler, og er mere observante på personalets adfærd end mænd. Kvinder bekymrer sig mere om risikoen for smitteoverførsel til besøgende og familie. Kvinder er mere emotionelle under indlæggelsen og under isolationen. Mænd affinder sig udadtil med situationen og har ikke samme spekulationer omkring smitteforholdsregler. Mænd har en mere rationel tilgang, og der er en tendens til at mænd bedre magter at være isoleret på enestue. Yngre patienterser ud til at magte isolationen bedre og anser enestue som en fordel. De ældre bliver mere triste og føler sig ensomme. Erindringer fra tidligere indlæggelser kan lejres som negative oplevelser, og influere på nuværende indlæggelse. Forat patienterne kunne magte situationen, udviklede de selv strategier til egen hjælp og befandt sig således i en balance mellem stress og mestring.

Konklusion: For at kunne forebygge de negative oplevelser det har for patienter som er isoleret, uden at kompromittere smitteforebyggelsen, vil et skærpet fokus på hele organiseringen, undervisning af personale, tilrettelæggelsen af isolationen med fokus på sengestuefaciliteter, tid til kontakt og grundig information være nødvendig. Her udover kan individuelle foranstaltninger på baggrund af en risikoanalyse overvejes.

Abstract [en]

Aim: This study explored and describedthe factors that may influence how patients react to source isolation from others during hospitalization. The study also sought to determine how background variables such as gender, age, and previous hospitalization affect source isolation. Based on individuals’ risk assessment, this study also focusedon how hospitalsplan and the organization of care and treatment.

Method: This qualitative study used content analysisto reviewd ata collected from interviews with five patients. The conceptual framework describes antibiotic resistance and infection control from a public health perspective and exploredits prevention in Denmark. Thetheoretical framework describe show patients experiencean infection acquired by exposure to drug-resistant bacteria, as well assubsequent source isolation.

Results: Thelimited space of an isolation room, including closed doors, lack of contact with people, and few sensory stimuli, resulted in patient boredom, monotony,and anxiety. Moreover, the data showed that background variables affected how patients experience source isolation. Compared with men, women showed greater concern about precautions against infection and greater awareness of staff behavior. Women also worried more about the risk of transmitting bacteria/disease to visitors and familymembers, and display more emotion during isolation. In contrast, men outwardly resigned themselves to the situation and didnot speculate about infection precautions. Men had more rational approach, and tended to cope better when isolated in a single room. Younger patients seemed to have a better coping strategy during isolation, and considered a single room an advantage compared to the ward. Elderly patients felt sad and lonely during source isolation. In addition, previous negative experiences from earlier hospitalization seemedto influence current isolation. Patients developed their own strategies for coping with source isolation and found themselves balanced between being stressed and coping.

Conclusion: Hospitals need more alternatives (e.g., better training and improved treatment culture) to prevent negative psychological affects due to isolation without compromising infection prevention. Hospitals should update their personnel at all organizational levels, and focus on room facilities in the ward, contact time,and improved information and communication. Riskassessment should be individualizedfor each patient.

Place, publisher, year, edition, pages
2014. , 38 p.
Series
Master of Public Health, MPH, ISSN 1104-5701 ; MPH 2014:33
Keyword [en]
Antibiotic resistance, isolated patients, gender, age, coping strategy
Keyword [da]
antibiotikaresistens, isolationspatienter, køn, alder, mestringsstrategi
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3632OAI: oai:DiVA.org:norden-3632DiVA: diva2:783498
Presentation
2014-11-12, Nordic School of Public Health NHV, Göteborg, Sweden, 14:13 (Danish)
Supervisors
Note

ISBN 978-91-86739-98-0

Available from: 2015-01-26 Created: 2015-01-26 Last updated: 2015-01-26Bibliographically approved

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