Psychological outcomes of MRSA isolation in spinal cord injury rehabilitation

• Published in: Spinal cord series and cases Vol. 6; no. 1; p. 63
• Main Authors: Gillett, Jenna L., Duff, Jane, Eaton, Rebecca, Finlay, Katherine
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 14-07-2020; Nature Publishing Group
• Subjects: 631/477; 692/308/409; 692/700/1750; 692/700/784; Activities of Daily Living - psychology; Anatomy; Biomedical and Life Sciences; Biomedicine; Drug resistance; Human Physiology; Humans; Inpatients; Length of Stay - statistics & numerical data; Male; Methicillin-Resistant Staphylococcus aureus - pathogenicity; Neurochemistry; Neuropsychology; Neurosciences; Outcome Assessment, Health Care; Pain; Patient Discharge - statistics & numerical data; Psychological aspects; Rehabilitation; Retrospective Studies; Spinal cord injuries; Spinal Cord Injuries - complications; Spinal Cord Injuries - psychology; Spinal Cord Injuries - rehabilitation; Staphylococcus infections
• ISSN: 2058-6124; 2058-6124
• DOI: 10.1038/s41394-020-0313-6

Study design
Retrospective secondary analysis with a quantitative, matched-pairs design. Patients isolated due to methicillin-Resistant
Staphylococcus aureus
(MRSA) were matched with controls without MRSA infection admitted to a multi-bedded ward, based on: gender, injury level, injury severity (AIS grade), age at the time of injury and year of admission.
Objectives
Determine the implications of MRSA-related infection isolation on spinal cord injury patients’ anxiety, depression, appraisals of disability, perceived manageability and pain intensity. Hypotheses predicted patients who were isolated due to MRSA during inpatient stay would demonstrate poorer psychological health outcomes at discharge in comparison with non-isolated matched controls.
Setting
National Spinal Injuries Centre, England, UK.
Methods
Secondary analyses were conducted on pre-existing data based on patients’ first admission for primary rehabilitation. Psychometric scales were used to measure outcome variables. Assessments were repeated at the time of admission and discharge.
Results
Nonparametric longitudinal analyses using the nparLD package in R were conducted. Relative treatment effects demonstrated that there were no significant differences between groups across all outcome measures. There was a significant effect of time (admission vs discharge) on perceived manageability and pain intensity, indicating improved outcomes at discharge. There was no difference in the overall length of stay between the isolated and non-isolated groups.
Conclusions
Isolation experienced by rehabilitation inpatients with spinal cord injury with MRSA had no effect on a series of psychological outcomes. Engaging with rehabilitation had a positive impact in reducing pain unpleasantness and increasing perceived manageability of spinal cord injury, irrespective of infection isolation.