Alexander Mutsonziwa

PhD candidate

Colonised and isolated: A qualitative meta-synthesis of patients’ experiences of being infected with multiple drug resistant organisms and subsequently source isolated

Supervisor: Jennifer Green


The aim of this study is to identify, compare and synthesise findings from related studies on patient’s experiences of being colonised with multi-drug resistant organisms (MDROs) and consequently isolated. The rapidly changing worldwide growth of antibiotic resistant ‘super bugs’ as well as the evolution of new mutant viruses, is resulting in source isolation becoming a common intervention in most clinical arenas (Larson, Cohen, Ross & Behta 2010). Being colonised with bacteria and isolated can be an extremely frightening and anxiety provoking experience (Morgan, Diekama, Sepkowitz & Perencevich 2009). This presents a challenge for all health workers to develop a deeper and concerted understanding of what it is like for people who are infected with MDROs and consequently source isolated.

A review of the literature revealed nine related qualitative studies on this topic, yet there remains a limited understanding of the meanings derived from this work. In order to overcome the problem of these papers remaining isolated works and to make their findings more accessible to clinicians, researchers and policy makers, this study synthesises their findings.

These papers were synthesised using a version of Noblit and Hare’s (1988) meta-ethnographic approach. Forty-three themes and concepts were accrued from the identified nine primary studies. The meta-synthesis procedure yielded seven major themes namely: Being left in the dark, Feeling shut off, Stigma of being colonised by infective organisms, Feeling dirty and dumped, Feeling angry and Fear of infecting others and accepting isolation management.

This project will further expand on the meta-synthesis and findings of the study.

Significance

The prevalence of multi-drug resistant organisms among hospitalised patients is being reported with increasing frequency and there are no signs of slowing down (Abad, Fearday & Safdar 2010). As a result, this study has the potential to generate findings which may increase clinicians’ knowledge on how patients feel when infected with MDROs and consequently isolated. This is important, since the demand for accountability of the health workers to the patients and general public has dramatically increased.

The process of analysing and synthesising findings from a number of qualitative studies in an interpretive fashion has the potential to generate concerted recommendations for informing nursing practice. Potentially, inferences drawn from this study may be applied to other forms of isolation in the clinical arena.