***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Management of MRSA infection includes immediate isolation of the patient . Long periods of isolation are considered to be psychologically detrimental , though little information is available about the impact of isolation as an infection control procedure . The purpose of this study is to examine the psychological well-being of spinal cord injured patients who are isolated as a result of being MRSA positive . Methods : A cross-sectional matched-control study of MRSA positive patients with MRSA negative patients was carried out at the National Spinal Injuries Centre , Stoke M and eville Hospital , Bucks , Engl and . Sixteen MRSA positive patients , aged 18 to 65 , and their matched controls completed a series of question naires to measure aspects of psychological impact . The measures used were functional independence , depression , anxiety , and the affective states of anger , vigour , fatigue and confusion . Findings : The MRSA positive spinal cord injured patients were only significantly more angry than the control group , although these isolated patients scored higher in all measures . Interpretations : In this spinal cord injured group the difference between the psychological well-being of isolated MRSA positive patients and non-isolated MRSA negative patients is not as great as might have been expected . Patients feel that rehabilitation is affected , but the situation may be improved by providing more space and a better view onto the ward BACKGROUND Contact isolation is a method used for limiting the spread of antimicrobial-resistant organisms when caring for patients . This policy has been linked to several adverse outcomes and less patient satisfaction . We assessed patient and caregiver underst and ing and satisfaction with the use of contact isolation . METHODS A prospect i ve survey of > 500 patients in contact isolation at our institution was performed during 2014 . Participants responded to a series of statements relating to contact isolation , using a 5-point Likert scale . Responses were assessed for overall positivity or negativity and further compared according to floor type or design ation . RESULTS Of the patients , 48.7 % responded to the survey ; 70 caregivers also responded . Patient and caregiver responses were similar and were positive overall . Most respondents felt safer because of the use of contact isolation and because it prevented infections . A smaller majority of respondents also thought the policy was adequately explained to them and adhered to by staff . CONCLUSIONS In the largest collection of respondents surveyed to date about contact isolation and its impact on them , the policy was viewed positively , both by patients and caregivers . There is still room for improvement in the area of patient education regarding the use of contact isolation OBJECTIVES Concerns have been raised that isolation pre caution s may have unintended consequences . The relationship between patient isolation and the 30-day risk of readmission or death among patients discharged from a general medicine ward was examined . METHODS A prospect i ve cohort study of adult patients discharged to the community from seven general internal medicine wards in Edmonton , Alberta , Canada , from October 2013 to November 2014 , was performed . Patients under contact , respiratory , or droplet pre caution s  were considered isolated . Covariates measured at discharge included the Charlson comorbidity score , LACE index , clinical frailty , depression , anxiety , health-related quality of life , and patient satisfaction . Outcomes were measured at 30 days by telephone follow-up and provincial electronic health record query . RESULTS Of 495 patients ( mean age 62 years , 51 % female ) , 75 ( 18 % ) were isolated during their admission . Isolated and non-isolated patients had similar lengths of stay ( 6.2 vs. 6.2 days ) , depression , anxiety , health-related quality of life , and satisfaction scores at discharge ( all p-values non-significant ) . At 30 days , 85 ( 17.2 % ) patients had been readmitted or had died ( 20.0 % of isolated patients vs. 16.7 % of non-isolated patients ; adjusted odds ratio 1.11 , 95 % confidence interval 0.57 - 2.18 ) . CONCLUSIONS In-hospital isolation does not appear to have an adverse impact on outcomes once patients are discharged from hospital Risk assessment is used to determine the need for isolation in single rooms . Limited availability of isolation rooms and /or operational needs may compromise this process . This article reports the results of a 12-month prospect i ve observational study of every infection control request for isolation in a 1100-bed teaching hospital . In addition , four point-prevalence surveys of the usage of single rooms were carried out . Data were collected on the incidence of new clinical meticillin-resistant Staphylococcus aureus ( MRSA ) isolates per ward and these were correlated with rates of isolation failures for MRSA cases . There were 845 requirements for patient isolation , of which 185 ( 22 % ) could not be met ( isolation failures ) . Three-quarters of the requirements for isolation were due to MRSA or Clostridium difficile . The proportion of isolation failures was consistent for most organisms and conditions but varied markedly between clinical specialities ( 0 - 57 % ) . Reasons for failure to isolate included no single rooms available , all single/isolation rooms occupied ( for both isolation and non-infection-control reasons ) , limitations on the use of single rooms in mixed-sex wards and patient-specific reasons . Only a minority of the available single rooms were occupied for infection control reasons ( 12 - 19 % ) . There was a statistically significant correlation between isolation failures and MRSA incidence ( Spearman 's rho 0.596 , P<0.001 ) . In only one case where a ward had > or=30 % of its beds provided in single rooms was there an instance of failure to isolate . In conclusion , insufficient capacity to isolate patients with potentially transmissible pathogens is common and may compromise infection control requirements . Either isolation capacity must be increased or evidence -based risk assessment must be applied to situations where dem and for isolation exceeds availability . Further information is needed on the consequences of isolation failure BACKGROUND Patients who are hospitalized and infected with multidrug-resistant bacteria are usually placed in contact isolation , which requires hospital personnel to gown and glove before patient examination . Contact isolation with active culture surveillance appears beneficial in preventing the spread of drug-resistant infections ; however , contact isolation may impede the ability to examine patients as a result of the additional effort required to gown and glove . We assessed whether patients who are hospitalized and placed under contact pre caution s  are examined less often by  second- and third-year medical residents ( ie , senior medical residents ) , and attending physicians during morning rounds . METHOD We conducted a prospect i ve cohort study on the inpatient medical services at 2 university-affiliated medical centers . We directly observed senior medical residents and attending physicians during morning rounds , and recorded the contact pre caution status of the patient and whether they were examined by either physician . RESULTS Of a total of 139 patients , 31 ( 22 % ) were in contact isolation . Senior medical residents examined 26 of 31 patients ( 84 % ) in contact isolation versus 94 of 108 patients ( 87 % ) not in contact isolation ( relative risk , 0.96 ; 95 % confidence interval , 0.81 - 1.14 ; P = .58 ) . In comparison , attending physicians examined 11 of 31 patients ( 35 % ) in contact isolation versus 79 of 108 patients ( 73 % ) not in contact isolation ( relative risk , 0.49 ; 95 % confidence interval , 0.30 - 0.79 ; P < .001 ) . DISCUSSION Attending physicians are about half as likely to examine patients in contact isolation compared with patients not in contact isolation Isolation  pre caution s  in patients with multi-drug resistant bacteria or other communicable infectious agents can be associated with adverse effects . The aim of this study was to assess satisfaction and psychological impact of patients hospitalized with isolation pre caution s  in comparison with controls . An observational prospect i ve cohort study was performed in five different medical and surgical departments in a 3,000-bed university hospital in Western France between March and July 2012 . Different scales were used to assess patient satisfaction ( qualitative scale ) and anxiety ( Spielberger scale ) , including 30 patients with isolation pre caution s and 60 matched patients without isolation pre caution s  over 45-hour interviews . Cases were significantly less satisfied than controls for healthcare workers ( HCW ) assistance in activities of daily life ( p < 0.001 ) , availability and relationships ( 17 % vs 5 % , p = 0.05 and 10 % vs 0 % , p = 0.02 , respectively ) . Sixty-seven percent of patients with isolation pre caution s were not satisfied about the quality of the information related to their infectious status control measures . The median score [ range ] of anxiety significantly was higher in patients with isolation pre caution s ( 52 [ 20–56 ] vs 31 [ 23–73 ] , p < 0.001 ) . Isolation pre caution s may have negative psychological effects , leading to anxiety , and may compromise patient satisfaction according to the availability and relationship with HCW . Professionals should be aware of adverse effects of isolation and inform patients more actively with regard to their infectious status and pre caution OBJECTIVE To determine the association between contact pre caution s and depression or anxiety as well as feelings of anger , sadness , worry , happiness , or confusion . DESIGN Prospect i ve frequency-matched cohort study . SETTING The University of Maryl and Medical Center , a 662-bed tertiary care hospital in Baltimore , Maryl and . 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 pre caution s 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 pre caution s was not associated with increased depression ( P=.42 ) or anxiety ( P=.25 ) on hospital day 3 . On hospital day 3 , patients under contact pre caution s 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 pre caution s  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 pre caution s. The use of contact pre caution s should not be restricted by the belief that contact pre caution s will produce more depression or anxiety This study was aim ed to assess the effects of contact isolation application on anxiety and depression levels  of the patients , the effects of certain sociodemographics and patient characteristics on anxiety and depression levels , and the thoughts of the isolated patients about contact isolation . This non-r and omized quasi-experimental study was carried out with 60 isolated and 57 non-isolated patients with hospital infection . The data were acquired from Hospital Anxiety and Depression Scale ( HADS-A ( anxiety ) and HADS-D ( depression ) ) and patient information form . There was no statistically significant difference between the anxiety and depression levels of the isolated and non-isolated patients . In the isolated patients , the depression points were higher in patients who were , women , received primary education and had lower income levels . Of the patients , 86.4 % of them told that they were happy to be in the isolation room . Contact isolation application did not affect anxiety and depression levels of the patients . However , personal attributes increased the development of depression . In contact isolated patients , personal attributes should be taken into consideration in nursing care planning to prevent development of depression OBJECTIVE Contact pre caution s decrease healthcare worker-patient contact and may impact patient satisfaction . To determine the association between contact pre caution s and patient satisfaction , we used a st and ardized interview for perceived issues with care . DESIGN Prospect i ve cohort study of in patients , evaluated at admission and on hospital days 3 , 7 , and 14 ( until discharged ) . At each point , patients underwent a st and ardized interview to identify perceived problems with care . After discharge , the st and ardized interview and Hospital Consumer Assessment of Healthcare Providers and Systems ( HCAHPS ) survey were administered by telephone . Responses were recorded , transcribed , and coded by 2 physician review ers . PARTICIPANTS A total of 528 medical or surgical patients not admitted to the intensive care unit . RESULTS A total of 528 patients were included in the primary analysis , of whom 104 ( 20 % ) perceived some issue with their care . On multivariable logistic regression , contact pre caution s were independently associated with a greater number of perceived concerns with care ( odds ratio , 2.05 [ 95 % confidence interval , 1.31 - 3.21 ] ; P < .01 ) , including poor coordination of care ( P = .02 ) and a lack of respect for patient needs and preferences ( P = .001 ) . Eighty-eight patients were included in the secondary analysis of HCAHPS . Patients under contact pre caution s did not have different HCAHPS scores than those not under contact pre caution s ( odds ratio , 1.79 
    Output:
    
The review indicates that isolation to contain the risk of infection has negative consequences for segregated patients .