The lived experience of haemodialysis patients managed with transmission-based precautions for MDRO colonisation: A qualitative study.

Autor: Gray NA; Department of Nephrology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; Sunshine Coast Health Institute, Birtinya, Queensland, Australia. Electronic address: Nicholas.Gray@health.qld.gov.au., Toy L; University of the Sunshine Coast, Sippy Downs, Queensland, Australia., Dalla-Bona K; Department of Nephrology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia., Broom J; Infectious Diseases Research Network, Sunshine Coast University Hospital, Birtinya, Queensland, Australia; The University of Queensland, Herston, Queensland, Australia. Electronic address: https://twitter.com/jenniferkbroom., Gray M; University of Southern Queensland, Ipswich, Queensland, Australia.
Jazyk: angličtina
Zdroj: Infection, disease & health [Infect Dis Health] 2022 Nov; Vol. 27 (4), pp. 211-218. Date of Electronic Publication: 2022 Jun 08.
DOI: 10.1016/j.idh.2022.05.003
Abstrakt: Background: Patients undergoing haemodialysis colonised with multi-drug resistant organisms (MDROs) are commonly managed with transmission-based precautions (TBP) to prevent nosocomial transmission. TBP have been linked to mixed effects on patient psychological well-being and clinical care. This study was designed to report the lived experience of dialysis patients managed with TBP.
Methods: A qualitative study of 15 patients undergoing haemodialysis managed with TBP was performed. Participants took part in individual semi-structured interviews. Data was analysed utilising an interpretive phenomenological approach.
Results: Four themes were identified. 1. Communication of what MDRO screening meant, the results, and implications of MDRO positivity was perceived by many patients as insufficient and inconsistent. 2. Experiences of care in isolation were described, with both positive (privacy) and negative (reduced interaction) experiences identified. 3. Psychosocial and emotional responses including concern about health implications and stigma were reported, but also screening was described by some as increasing their perception of being cared for by health care workers, as they felt all health risks were being managed. 4. Confusion around perceived inconsistencies of management, particularly across different environments (eg hospital vs home) and staff.
Conclusion: TBP have complex positive and negative impacts on patients which should be considered when developing MDRO management policy and communication around such policy. Strategies to improve communication, patient and staff education, and remove (or explain) perceived inconsistencies of practice may reduce the negative consequences of TBP leading to improved delivery of quality, person-centred care.
(Copyright © 2022 Australasian College for Infection Prevention and Control. All rights reserved.)
Databáze: MEDLINE
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