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Depression, Anxiety, and Moods of Hospitalized Patients under Contact Precautions

Published online by Cambridge University Press:  02 January 2015

Hannah R. Day
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Eli N. Perencevich*
Affiliation:
Carver College of Medicine, University of Iowa, Iowa City, Iowa Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
Anthony D. Harris
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland Veterans Affairs Maryland Health Care System, Baltimore, Maryland
Ann L. Gruber-Baldini
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Seth S. Himelhoch
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Clayton H. Brown
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland Veterans Affairs Maryland Health Care System, Baltimore, Maryland
Daniel J. Morgan
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland Veterans Affairs Maryland Health Care System, Baltimore, Maryland
*
University of Maryland School of Medicine, 685 West Baltimore Street, MSTF 334, Baltimore, MD 21201 ([email protected])

Abstract

Objective.

To determine the association between contact precautions and depression or anxiety as well as feelings of anger, sadness, worry, happiness, or confusion.

Design.

Prospective frequency-matched cohort study.

Setting.

The University of Maryland Medical Center, a 662-bed tertiary care hospital in Baltimore, Maryland.

Participants.

A total of 1,876 medical and surgical patients over the age of 18 years were approached; 528 patients were enrolled from January through November 2010, and 296 patients, frequency matched by hospital unit, completed follow-up on hospital day 3.

Results.

The primary outcome was Hospital Anxiety and Depression Scale (HADS) scores on hospital day 3, controlling for baseline HADS scores. Secondary moods were measured with visual analog mood scale diaries. Patients under contact precautions had baseline symptoms of depression 1.3 points higher (P < .01) and anxiety 0.8 points higher (P = .08) at hospital admission using HADS. Exposure to contact precautions was not associated with increased depression (P = .42) or anxiety (P = .25) on hospital day 3. On hospital day 3, patients under contact precautions were no more likely than unexposed patients to be angry (20% vs 20%; P = .99), sad (33% vs 38%; P = .45), worried (51% vs 46%; P = .41), happy (58% vs 67%; P = .14), or confused (23% vs 24%; P = .95).

Conclusions.

Patients under contact precautions have more symptoms of depression and anxiety at hospital admission but do not appear to be more likely to develop depression, anxiety, or negative moods while under contact precautions. The use of contact precautions should not be restricted by the belief that contact precautions will produce more depression or anxiety.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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