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

Purssell, E. ORCID: 0000-0003-3748-0864, Gould, D. J. & Chudleigh, J. H. ORCID: 0000-0002-7334-8708 (2020). Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis. BMJ Open, 10(2), article number e030371. doi: 10.1136/bmjopen-2019-030371

Abstract

Objective
To systematically review the literature exploring 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 Psychinfo were searched from inception until December 2018. Reference lists and Google Scholar were also handsearched.

Results
Twenty six papers published from database inception until 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 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.

Strengths and limitations of this study
• This review covers a wide variety of literature from a range of different clinical areas.
• Data collected and the methods of collecting data on the impact of isolation is varied across studies.
• These data do not show if these effects are temporary, or in most cases if they are clinically significant.

Funding statement
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors

Competing interests statement
No authors have any competing interests to declare

Publication Type: Article
Additional Information: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences > Nursing
SWORD Depositor:
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