Made available in DSpace on 2012-05-07T14:48:02Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 000008.pdf: 703280 bytes, checksum: 1d25f150117d1a0567821a31251d5dce (MD5) Previous issue date: 2005 / Analisa as políticas estatais de combate à lepra (hanseníase) no período 1920-1941, tendo como foco principal o debate e as ações em torno do isolamento compulsório dos doentes. No primeiro período de análise (1920-1930), a prática isolacionista foi definida pelo regulamento sanitário de 1920 como uma política compulsória a ser adotada contra a doença. Entretanto, a escassez de verbas, incertezas biomédicas e as características políticas do período puseram obstáculos à atuação da inspetoria de profilaxia da lepra e das doenças venéreas. Foi somente no segundo período (1930-1941) que o isolamento compulsório tomou vigor. A partir de 1935, com a elaboração de um plano de construção de leprosários, promovido pelo governo federal, foi possível pôr em prática a política de isolamento. A criação do Serviço Nacional de Lepra, em 1941, não substituiu o plano elaborado em 1935, e ainda acrescentou as definições de competências dos poderes federais, estaduais e municipais, como também das associações particulares na profilaxia da doença. Durante todo o processo de construção institucional da saúde pública brasileira, no período 1920-1941, o isolamento compulsório dos doentes foi a principal política adotada pelo poder público contra a lepra e esteve associada ao processo de consolidação da capacidade do Estado brasileiro agir sobre territórios e populações.

According to recommendations from the Facility Guidelines Institute (FGI) of the American Institute of Architects (AIA), World Health Organization (WHO) and Center for Disease Control and Prevention (CDC), a common engineering approach to isolation room design is to maintain the air ventilation rate at a minimum of 12 air changes per hour (ACH) for mixing and dilution, and a negative pressure in the room to direct airflow inwards, instead of leaking outwards. / In collaborations with physicians in the Respiratory Division and the Intensive Care Unit (ICU) at the Chinese University of Hong Kong (CUHK), a series of experiments were carried out to verify the ventilation performance of an All room at the Princess Margaret Hospital (PMH). Experiments investigated the effects of ACH, the control of airflow direction, the air tightness of the automatic swing door and the application of positive pressure ventilation procedures, such as high flow rate oxygen masks, jet nebulizers and NPPV. These were extensively tested in two different isolation rooms of the Prince of Wales Hospital (PWH) and PMH, under common clinical circumstances and environmental conditions. / Many patients with severe respiratory infection require supportive therapy for respiratory failure. Common interventions involve supplemental oxygen to improve tissue oxygenation. In the worst scenario, mechanical ventilation via non-invasive positive pressure ventilation (NPPV) may be required. Since a large amount of aerosols is generated during these interventions, there is a great risk of spreading infectious aerosols from the respiratory tract of the patient to the surrounding environment. / The aerodynamic data in this thesis infonns architects and engineers on how to improve the hospital ward ventilation design so as to avoid aerosol and ventilation leakage. Ultimately, it is hoped that this work may play a role in preventing devastating nosocomial outbreaks in the future. / The design of airborne infection isolation (AII) room has become one of the major research domains following the emergence of the global concern of acute respiratory diseases in this century. These include severe acute respiratory syndrome (SARS) in 2003, H5N1 avian influenza, and pandemic influenza H1N1 in 2009. All of which have claimed thousands of lives. Even with the current stringent design and practice guidelines, nosocomial infection of healthcare workers (HCWs) and inpatients continues to occur. This implies that there might be limitations in current isolation ward designs. / The experiments implemented a high-fidelity human patient simulator (HPS) which could be programmed with different lung breathing conditions and oxygen flow rate settings. The patient exhaled air dispersion distances and airflow patterns were captured in detail with a non-intrusive, laser light sheet, smoke particle scattering technique, designed for this thesis. Thin laser light sheets were generated by a high energy YAG laser with custom cylindrical optics. Smoke concentration in the patient exhaled air and leakage jets was estimated from the intensity of light scattered, which was then expressed as nonnalized particle concentration contours using computer programs developed for this study. / The study quantitatively revealed the distinctive patient exhaled airflow patterns and the extent of bioaerosol, generated directly from the patient source with the application of different oxygen delivery interventions for different patient lung conditions and oxygen flow rates. It was found that contamination was more critical during the administration of oxygen therapies, which is common in clinical circumstances. Source control is therefore the most efficient and effective approach to the reduction and even elimination of patient exhaled bioaerosol contaminants. Thus, when working in an isolation room environment, full preventive measure should be taken and it is essential to consider the location of mechanical vents and the patient exhaled airflow patterns. It has also been shown in experiment that applications of bacterial viral filter could be a solution to the problem. / Chow, Ka Ming. / Advisers: Puay Peng Ho; Jin Yeu Tsou. / Source: Dissertation Abstracts International, Volume: 73-09(E), Section: A. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 115-147). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Introdução: o aumento gradativo da resistência dos microrganismos aos antimicrobianos usados na prática clínica tem contribuído efetivamente para que as infecções hospitalares sejam consideradas um problema de saúde pública. Assim, diminuir a disseminação destes microrganismos no ambiente hospitalar tem se tornado um desafio aos profissionais que atuam nos serviços de controle de infecção hospitalar. Objetivo: identificar a sensibilidade e especificidade dos critérios para isolamento de pacientes admitidos num hospital especializado em oncologia. Material e Método: trata-se de um estudo de corte transversal de caráter prospectivo, aprovado pelo Comitê de Ética em Pesquisa de um hospital especializado em oncologia. A população do estudo foi composta por 61 pacientes admitidos no hospital, no período de 01 março a 31 de agosto de 2009, segundo o protocolo para isolamento de pacientes procedentes de outros hospitais. Os dados foram obtidos por meio de entrevista individual e consulta aos resultados de cultura provenientes de swab nasal e anal, coletados pela equipe de enfermagem no momento da admissão no hospital e disponibilizados no laboratório de microbiologia. Resultado: dos 61 pacientes admitidos no hospital, 56 preencheram os critérios para que as precauções de contato fossem instituídas. Destaca-se que 30(49,2%) pacientes tiveram culturas positivas para microrganismos multirresistentes, sendo o Staphylococcus aureus resistente à oxacilina o microrganismo mais freqüentemente isolado no swab nasal e anal. A sensibilidade dos critérios para isolamento de pacientes admitidos no referido hospital e procedentes de outros hospitais foi de 90%. Conclusão: foram altamente sensíveis os critérios utilizados para o isolamento de pacientes provenientes de outros hospitais, portanto a maioria dos pacientes colonizados por microrganismos multirresistentes foi isolada no momento da admissão. / Introduction: the gradual increase of microorganisms\' resistance to antimicrobials used in clinical practice has effectively contributed to hospital-acquired infections be considered a public health problem. Hence, reducing the dissemination of these microorganisms in the hospital setting has become a challenge for professionals working in hospital-acquired infection control services. Objective: to identify the sensitivity and specificity of criteria for isolation of patients admitted to a cancer specialized hospital. Material and method: this prospective cross-sectional study was approved by the Research Ethics Committee of a cancer specialized hospital. The study\'s population was composed of 61 patients, who were admitted to the hospital between March 1 and August 31 2009 according to the protocol for isolation of patients from other hospitals. Data were collected through individual interview and consultation of the results from nasal and anal swabs culture collected by the nursing team at the moment patients were admitted to the hospital and available in the microbiology laboratory. Results: 56 out of the 61 patients met the criteria establishing contact precautions. It is worthy noting that 30(49,2%) patients presented positive cultures for multi-resistant microorganisms, while the Staphylococcus aureus resistant to oxacillin was the microorganism most frequently isolated in nasal and anal swabs. The sensitivity of the criteria for isolation of patients from other hospitals admitted in the studied hospital was of 90%. Conclusions: criteria used for isolation of patients from other hospitals were highly sensitive, thereby the majority of patients colonized by multi-resistant microorganisms were isolated at the moment of admission.

<p> </p><h2>Sammanfattning</h2><p> </p><p>Studien syftade till att belysa hur vuxna patienter som isolerats på en infektionsavdelning upplever sin vårdtid. Den ville även utröna om patienterna från sitt perspektiv kunde ge några förslag på hur vårdprocessen skulle kunna förbättras. Fem informanter valdes ut genom bekvämlighetsurval och intervjuades utifrån en strukturerad frågeguide innehållande både faktafrågor, åsiktsfrågor och känslolägesfrågor. Den insamlade informationen bearbetades genom innehållsanalys. Denna process ledde fram till sex kategorier av vikt. Av dessa handlade tre om patienternas känslor och uppleveler – vilka var instängdhet, långtråkighet och fördelar av att vara isolerad – och tre berörde områden som informanterna ansåg kunde förbättras – bättre miljö, hjälp med tidsfördriv samt förbättrad information. Informanterna upplevde överlag att sjukvården tog väl hand om deras somatiska behov emedan det psykosociala omhändertagandet hade något större behov av förbättring. Slutsatsen blev att isolering kan ge upphov till både positiva och negativa känslor och att patienter ofta kan uppleva fluktuationer mellan dessa. Studien visade att behovet av god information inte kan anses vara tillfredsställt. Vidare önskade informanterna bättre hjälp från vårdpersonalen att hantera den tristess som uppkom under tiden som isolerad. Tristessen ökades av en ostimulerande miljö. Kvaliteten på omvårdnaden av isolerade patienter kan därmed ökas genom att öka resurserna inom dessa områden.</p><p> </p> / <p> </p><h2>Abstract</h2><p> </p><p>The study aimed to enlighten how adult patients isolated in an infection ward experienced their stay. A further object was to explore if the patients from their point of view could suggest any improvements in the nursing process. Five informants were chosen by convenience sampling and were interviewed using a structured questioning guide containing questions about facts, opinions and emotions. The collected information was processed with content analysis. This process resulted in six categories of importance. Three of these were about the informant’s feelings and experiences – which were a feeling of being shut in, boredom and advantages of being isolated – and the other three concerned areas that the informants thought could be improved – better environment, help with recreation and improved information. The total experience of the informants was that the medical service handled their somatic needs well while improvements can be done considering the psychosocial care. The conclusion is that isolation care can bring both positive and negative feelings and that the patients often experience fluctuations between these. The study showed that the need of information is not satisfactory fulfilled. Furthermore the informants wished for better help from the hospital staff to counteract the boredom brought on by isolation. This boredom was increased by an uninspiring environment. The quality of care of isolated patients can be improved by increased resources in these areas.</p><p> </p>

Sammanfattning   Studien syftade till att belysa hur vuxna patienter som isolerats på en infektionsavdelning upplever sin vårdtid. Den ville även utröna om patienterna från sitt perspektiv kunde ge några förslag på hur vårdprocessen skulle kunna förbättras. Fem informanter valdes ut genom bekvämlighetsurval och intervjuades utifrån en strukturerad frågeguide innehållande både faktafrågor, åsiktsfrågor och känslolägesfrågor. Den insamlade informationen bearbetades genom innehållsanalys. Denna process ledde fram till sex kategorier av vikt. Av dessa handlade tre om patienternas känslor och uppleveler – vilka var instängdhet, långtråkighet och fördelar av att vara isolerad – och tre berörde områden som informanterna ansåg kunde förbättras – bättre miljö, hjälp med tidsfördriv samt förbättrad information. Informanterna upplevde överlag att sjukvården tog väl hand om deras somatiska behov emedan det psykosociala omhändertagandet hade något större behov av förbättring. Slutsatsen blev att isolering kan ge upphov till både positiva och negativa känslor och att patienter ofta kan uppleva fluktuationer mellan dessa. Studien visade att behovet av god information inte kan anses vara tillfredsställt. Vidare önskade informanterna bättre hjälp från vårdpersonalen att hantera den tristess som uppkom under tiden som isolerad. Tristessen ökades av en ostimulerande miljö. Kvaliteten på omvårdnaden av isolerade patienter kan därmed ökas genom att öka resurserna inom dessa områden. / Abstract   The study aimed to enlighten how adult patients isolated in an infection ward experienced their stay. A further object was to explore if the patients from their point of view could suggest any improvements in the nursing process. Five informants were chosen by convenience sampling and were interviewed using a structured questioning guide containing questions about facts, opinions and emotions. The collected information was processed with content analysis. This process resulted in six categories of importance. Three of these were about the informant’s feelings and experiences – which were a feeling of being shut in, boredom and advantages of being isolated – and the other three concerned areas that the informants thought could be improved – better environment, help with recreation and improved information. The total experience of the informants was that the medical service handled their somatic needs well while improvements can be done considering the psychosocial care. The conclusion is that isolation care can bring both positive and negative feelings and that the patients often experience fluctuations between these. The study showed that the need of information is not satisfactory fulfilled. Furthermore the informants wished for better help from the hospital staff to counteract the boredom brought on by isolation. This boredom was increased by an uninspiring environment. The quality of care of isolated patients can be improved by increased resources in these areas.

Background: The development of contemporary isolation measures has emerged through centuries from the time of ships under quarantine to modern personal protective equipment and knowledge about disease control. The underlying need for care in isolation could be multidrug resistant organisms or immunosuppression. Aim: The aim of this review was to explore patient´s experience of care in isolation due to somatic disease. Method: The study was conducted as a literature review with an inductive content analysis. During the literature search 11 qualitative studies corresponding to the aim of this study was chosen. Analysis of the quality of the studies were conducted. The results were analysed and compiled in themes and subthemes. Results: Patients described isolation policies as a form of imprisonment and in terms of negative experiences. Discrepancies in practice of isolation measures amongst health care workers contributed to patients’ apprehension and worry. The isolation room could both be seen as a prison and a safe haven. It represented a feeling of safety and disengagement from demands from the outside. The relationship between the patient and the health care worker was important for the experience of care in isolation. Patients described feelings of loneliness and contact with friends and family had major impact both through visits but also by phone or computer. To find acceptance or meaning made it easier to cope with the period of loneliness. Conclusion: To be cared for in isolation is a global phenomenon and it has major impact on the daily life of the affected persons. Attitudes, work procedures amongst the health care workers and their personal treatment towards the patients may have a positive or negative impact on the patients experience of isolation. Friends and family carry out an important role in alleviating loneliness and new technology for example videocalls may offer whole new opportunities to be able to interact socially with others during time spent in isolation. / Bakgrund: Nutida isoleringsvård har utvecklats och växt fram under århundraden alltsedan tiden då fartyg låg i karantän fram till dagens kunskap om smittskydd och tillgång till skyddsutrustning. Den bakomliggande orsaken till isoleringsvård kan bland annat vara antibiotikaresistenta bakterier eller immunsuppression. Syfte: Syftet med denna litteraturstudie var att beskriva hur patienter med somatisk sjukdom upplever isoleringsvård. Metod: Studiedesign var litteraturstudie där analysen genomfördes med induktiv ansats. I artikelsökningar påträffades 11 kvalitativa originalartiklar som svarade till studiens syfte. Kvalitets- och resultatanalys av inkluderade studier gjordes och ett sammanställt resultat med teman och subteman utarbetades. Resultat: Isoleringsrutiner upplevdes som en form av fångenskap och beskrevs i negativa ordalag. Oro och ängslan upplevdes bland patienter när sjukvårdpersonal gjorde avsteg från isoleringsrutinerna. Rummet kunde upplevas som ett fängelse och begränsande men även som en fristad där eget rum, en upplevd trygghet och befrielsen från omgivningens krav sågs som positivt. Relationen mellan patient och personal var av betydelse för hur tiden i isoleringsvård upplevdes. Patienter uttryckte känslor av ensamhet och kontakten med anhöriga spelade en stor roll både genom direktkontakt men även via telefon och dator. Meningsskapande eller att finna acceptans inför situationen gjorde det lättare att hantera tiden i ensamhet. Slutsats: Isoleringsvård förekommer världen över och det har stor påverkan på individens dagliga liv. Bemötande, attityder och arbetssätt hos sjukvårdspersonal kan ha både positiv och negativ inverkan på patientens upplevelse av vårdformen. Närstående har en viktig roll i att lindra ensamheten och teknik såsom videosamtal öppnar helt nya möjligheter till social interaktion under tiden i isoleringsvård.

Made available in DSpace on 2015-07-22T20:49:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-12-31 / O objetivo do presente trabalho foi verificar os efeitos de dois diferentes agentes estressores sociais (isolamento social e aumento da densidade populacional) aplicados por diferentes períodos a camundongos, sobre parâmetros comportamentais indicadores de aprendizado, memória, ansiedade, depressão e função motora, avaliados simultaneamente, buscando correlacioná-los entre si e com alterações na concentração plasmática de corticosterona. O aprendizado, a memória, a ansiedade e a função motora foram quantificados pelo modelo da esquiva discriminativa em labirinto em cruz elevado, enquanto a depressão foi estimada pelo teste do nado forçado. Em conjunto, nossos resultados mostraram que dois tipos opostos de perturbações sociais (isolamento social e aumento da densidade populacional) promoveram efeitos agudos notavelmente diferentes sobre parâmetros indicativos de aprendizado, ansiedade, depressão e função motora, exibindo os mesmos efeitos somente em parâmetros indicativos de memória, inibida em ambos os casos. A persistência dessas perturbações sociais levou inicialmente à tolerância de todos os efeitos agudos, com exceção da hiperatividade locomotora induzida pelo isolamento social. Um prolongamento ainda maior das perturbações sociais culminou, por fim, em um padrão idêntico de alterações comportamentais caracterizado por déficit de retenção, diminuição da ansiedade e da depressão e hiperatividade locomotora. Essas três últimas alterações podem na verdade refletir um aumento da impulsividade dos animais. Nenhum dos efeitos comportamentais produzidos pelo aumento da densidade populacional foi acompanhado por modificações na concentração plasmática de corticosterona. Por outro lado, alterações bidirecionais nessa concentração (aumento, agudamente, seguido por tolerância e posteriormente por diminuição) foram verificados nos camundongos isolados socialmente. As alterações na concentração de corticosterona apresentaram considerável correlação com o parâmetro indicativo de depressão após o isolamento social agudo. Além disso, o comportamento depressivo induzido pelo isolamento social agudo foi abolido pela metirapona, um inibidor de síntese de corticosterona, e mimetizado pela administração de corticosterona. Nenhuma outra evidência de correlação foi verificada para os demais parâmetros comportamentais. Esses resultados permitem as seguintes conclusões: 1. O isolamento social e o aumento da densidade populacional são perturbações sociais que produzem efeitos comportamentais distintos quando submetidos agudamente a camundongos sendo, entretanto, igualmente efetivas em promover déficits de memória. 2. A maioria dos efeitos comportamentais agudos promovidos por essas perturbações sociais são rapidamente toleradas. 3. O isolamento social foi uma perturbação social mais efetiva que o aumento da densidade populacional em ativar o eixo hipotálamo-pituitária-adrenal. 4. O aumento da concentração plasmática de corticosterona promovido pelo isolamento social agudo (12 horas) é determinante para o comportamento depressivo apresentados pelos animais, mas não pelos simultâneos déficits de retenção e hiperatividade locomotora. 5. A exposição prolongada dos animais tanto ao isolamento social como à densidade populacional promove o desenvolvimento de uma série de alterações comportamentais comuns aos dois tipos de perturbação social as quais, entretanto, são acompanhadas por alterações distintas do eixo hipotálamo-pituitária-adrenal. / The present study aimed to investigate the effects of two different social stressful procedures (social isolation and crowding) on behavioral parameters related to learning, memory, anxiety, depression and motor function. Mice were exposed to the above mentioned social stresses for different time periods and the behavioral parameters were simultaneously evaluated for each animal. In addition, plasma corticosterone levels were measured (in other animals) in an attempt to correlate them with the evaluated behavioral parameters, wich were quantified by the plus-maze discriminative avoidance task (learning, memory, anxiety, and motor function) and by the forced swim test (depressive-like behavior). Our results showed that acute exposure to both types of social stresses induced markedly distinct effects on behavioral parameters related to learning, anxiety, depression and motor function. Conversely, they produced the same effects (impairment) on memory parameters. Continued exposure to the social stress procedures employed led to tolerance of all the behavioral alterations, except social isolation-induced hyperactivity. Long-term exposure to either social isolation or crowding led to an identical pattern of behavioral effects: memory deficit, decreased anxiety level, depressive-like behavior and hyperlocomotion. These three latter behavioral effects may be related to an impulsivity enhancement. None of the behavioral effects induced by crowding was accompanied by modifications in plasma corticosterone levels. Conversely, bi-directional alterations in corticosterone levels were observed in social isolated mice (increase, tolerance and decrease in the levels were verified during progressive time exposure). Plasma corticosterone levels were considerably correlated with depressive-like behavior in social isolated mice. In addition, acute social isolation-induced depressive-like behavior was abolished by metyrapone (a drug that inhibits the synthesis of corticosterone) and induced by corticosterone injection. No other evidence of correlation was verified among the other behavioral parameters. / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2014-06-11T19:33:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-07-25Bitstream added on 2014-06-13T20:45:11Z : No. of bitstreams: 1 testa_v_me_botfm.pdf: 447728 bytes, checksum: 686d72f8568cbe2beb42af5f4212d35d (MD5) / Hospital Das Clinicas da Faculdade de Medicina de Botucatu / Secretaria de Saúde do Estado de São Paulo / Dentre as doenças hematológicas, as leucemias podem ter formas graves e fatais, que mesmo bem estudadas do ponto de vista morfológico, genético e biológico, ainda requerem muitos estudos elucidativos quanto à sua real etiologia. O Transplante de Medula Óssea é uma modalidade de terapia que vem sendo usada em doenças hematológicas malignas ou não, tumores e doenças genéticas e até metabólicas. Uma vez feita a opção pelo transplante, inicia-se a busca pelo doador de medula que pode ser proveniente do núcleo familiar (doador aparentado) ou mediante a doação de voluntários (doadores não aparentados).A presente pesquisa foi desenvolvida em uma Unidade de Transplante de Medula Óssea e utilizou da metodologia qualitativa para a sua realização, tendo como objetivo identificar as representações de indivíduos acerca da sua experiência em situação de isolamento para Transplante de Medula Óssea.A organização dos dados foi realizada com base no Discurso do Sujeito Coletivo (DSC) e os mesmos foram discutidos à luz de um Quadro Teórico que abrangeu aspectos psicossociais, necessidades humanas básicas e educação em saúde. A questão norteadora foi: O que significa para você estar isolado nesta unidade durante este período?.Fizeram parte deste estudo dez indivíduos e, através de seus discursos foram identificados 12 temas: o medo da morte; a falta da família; o espaço físico; a saída do ambiente de isolamento; a falsa expectativa quanto à duração do tratamento; a crença em Deus como fonte de esperança; a preocupação com o doador; as dificuldades financeiras para a realização do tratamento; a vontade de viver; a preocupação com a imagem; o sentimento de revolta; a sexualidade. Destaca-se que o espaço físico é um elemento importante para esses indivíduos, pois a situação de isolamento pode gerar Resumo sentimentos de solidão... / Among hematological diseases, leukemias can take severe and fatal forms which, although well studied from the morphologic, genetic and biological viewpoints, still require further clarifying studies as regards their actual etiology. Bone Marrow Transplantation is a type of therapy that has been used for treating malignant and non-malignant hematological diseases, tumors, genetic and even metabolic diseases. Once a decision has been made for transplantation, the search for a bone marrow donor is begun. Such donor may be a family member (related donor) or a volunteer (unrelated donor). This study was developed at a Bone Marrow Transplantation Unit and used the qualitative methodology. It aimed at identifying the representations of individuals as regards their experience in an isolation situation for Bone Marrow Transplantation. Data organization was performed on basis of the Collective Subject Discourse (CSD) and discussed in light of a Theoretical Framework which included psychosocial aspects, basic human needs and health care education. The guiding question was: What does being isolated in this unit during this period mean to you?. Ten individuals participated in the study, and through their discourse, 12 topics were identified: fear of death; missing one’s family; physical space; leaving the isolation environment; the false expectation as regards treatment duration; belief in God as a source of hope; concern about the donor; financial difficulties to undergo treatment; the will to live; concern about one’s image; the feeling of resentment; sexuality. Physical space is pointed out as an important element to these individuals for the isolation situation can generate feelings of loneliness, insecurity and various types of fear which are worsened by the lack of contact with other meaningful people, such as other patients. Physical space should Abstract be more welcoming... (Complete abstract click electronic access below)

Inom sjukvården finns det två former av isolering. Smittskyddsisolering är till för att hindra smittspridning när en person blir smittad av en infektion som kan vara farlig för allmänheten och skyddsisolering används när en person är extra infektionskänslig, exempelvis efter cytostatikabehandling för cancer. Syftet med studien var att beskriva hur patienter upplever isoleringsvård inom den somatiska slutenvården. Vald metod var en litteraturstudie där åtta kvalitativa artiklar användes. Sex teman identifierades i resultatet: Behov av anhöriga, Behov av stöd från sjuksköterskan, Känsla av instängdhet, Behov av kontroll, Behovet av information och Känslan av frihet. Studien visade att isolering leder till känslor av ensamhet, känslan av övergivenhet, psykisk ohälsa och skam. Det visade sig att behovet av medmänsklig kontakt och information var av stor betydelse för patienter för att kunna hantera sin tid under isolering. Många beskrev att det inte bara var negativt att ha ett eget rum utan det gav känslor av ro och underlättade vid besök. Att ha tillgång till tv, telefon och internet var för patienterna olika sätt för att få stimulans och få tiden att gå, som annars kunde kännas långsam. Sjuksköterskan var ett viktigt stöd och en källa till medmänsklighet. Att ha ett fönster med utsikt över omgivningen gjorde upplevelsen mer uthärdlig för flertalet av patienterna.

Bakgrund:Redan på 1960-talet rapporterades det om antibiotikaresistens i form av meticillinresistenta staphylococcus aureus, MRSA. Denna grupp av bakterie är anmälningspliktig enligt Smittskyddslagen (SFS 2004:168) sedan år 2000. Att MRSA är ett stort problem på sjukhus över hela världen beror på överdriven antibiotikaanvändning. Som bärare av MRSA finns det restriktioner kring hygien som patienter ska förhålla sig till i sjukvårdsmiljö samt i hemmet.  Syfte:Att studera hur personer med MRSA upplever sin situation i vården och i samhället. Metod:Litteraturöversikt med 10 artiklar. Sökningarna är utförda i PubMed samt förekomst av sekundära sökningar.  Resultat:Det framkom att patienter inte får tillräcklig information om vad bärarskap av MRSA innebär, ofta på grund av att vårdpersonalen har bristande kunskap då nationella riktlinjer saknas. Patienter upplever stigmatisering, utanförskap och en känsla av att vara pestsmittad på grund av bemötandet från vårdpersonal samt uppfattningar från närstående och arbetskollegor.Resultatet presenteras i form av kategorierna stigmatisering, bristande kunskap hos vårdpersonal, bristande kunskap hos patienter, upplevelsen av vårdpersonalens bemötande, att diagnostiseras med MRSA ochupplevelsen av att bära på MRSA i det vardagliga livet. Slutsats:Personer som bär på MRSA känner sig stigmatiserade, nedprioriterade i vårdsammanhang samt att informationen som finns att tillgå är bristfällig och kan skilja sig från län till län. / Background: As early as in the 1960s antibiotic resistance was reported in the form of methicillin resistant staphylococcus aureus, MRSA. According to the diseases act this group of bacteria has been mandatory to report since the year 2000. The worldwide problem of MRSA in hospitals derives from excessive use of antibiotics. Patients that are carriers of MRSA have to relate to restrictions on hygiene both in the healthcare environment and in their own homes. Aim: To study how people with MRSA experience their situation in healthcare and in society. Method:Literature review with 10 articles. The searches are executed in PubMed and the occurrence of secondary searches. Result: The study shows a lack of information given to the MRSA carrying patients. This lack of information is related to the fact that national guidelines are missing which in turn has led to the health personnels lack of knowledge. Patients experience stigma, alienation and a feeling of being infected with plague because of the treatment from health personnel and the perception from relatives and colleagues.The result is presented with the categories stigma, insufficient knowledge of health professionals, insufficient knowledge of patients, the experience of treatment from health professionals, to be diagnosed with MRSA and the experience of being an MRSA-carrier in the everyday life.  Conclusion:MRSA carriers feel stigmatized, that they have a lower priority in care context and also that the information available is inadequate and may differ from county to county