The experience of quarantine for individuals affected by SARS in Toronto.

OBJECTIVE: The purpose of this study was to explore the experience of home quarantine during the severe acute respiratory syndrome (SARS) outbreak in Toronto in 2003. DESIGN: Qualitative descriptive design. SAMPLE: Stratified random sampling techniques were used to generate a list of potential participants, who varied in terms of gender and closeness of exposure to someone with suspected SARS (contact level). Twenty-one individuals participated in the study. MEASUREMENTS: All interviews were audiotaped and followed a semistructured interview guide. Participants were invited to describe their experience of quarantine in detail including their advice for Public Health. RESULTS: The experience followed a trajectory of stages beginning before quarantine and ending after quarantine. Despite individual differences, common themes of uncertainty, isolation, and coping intersected the data. CONCLUSIONS: Public Health has a dual role of monitoring compliance and providing support to people in quarantine. This study has implications for public health policy and practice in planning for future public health emergencies in terms of the information and the resources required to mount an effective response.

Risk perception and compliance with quarantine during the SARS outbreak.

PURPOSE: To explore the experience of being on quarantine for severe acute respiratory syndrome (SARS) with a focus on the relationship between perceived risk of contracting SARS and reported compliance with the quarantine order and protocols. DESIGN: Descriptive, qualitative. METHODS: Semi-structured interviews were conducted with people who had been quarantined during the SARS outbreak in Toronto in 2003. Data analysis was completed using an iterative and collaborative approach of reading and re-reading the transcribed interviews, identifying common themes, and comparing and contrasting the data. FINDINGS: To varying extents, participants wavered between fear and denial about their risk of contracting or spreading SARS. Reported compliance with the actual quarantine order was high. However, within households quarantine protocols were followed unevenly. CONCLUSIONS: This research indicates the need for greater credibility in public health communications to increase compliance with quarantine protocols and to contain outbreaks of new and deadly infectious diseases.

Self-concept as a "BMT patient", illness intrusiveness, and engulfment in allogeneic bone marrow transplant recipients.

OBJECTIVE: The experience of cancer and its treatment by bone marrow transplantation (BMT) can enhance the salience of one's status as a patient in the evolution of self-concept. Illness and the patient role can come to dominate the sense of self, resulting in feelings of hopelessness, helplessness, and distress ("engulfment"). Illness-induced lifestyle disruptions ("illness intrusiveness") introduce adaptive demands, challenging preexisting conceptions of self. Illness intrusiveness and engulfment may interact, leading affected individuals to construe themselves as highly similar to a prototypical "BMT patient". METHODS: Ninety allogeneic BMT outpatients completed the Illness Intrusiveness Ratings Scale, Modified Engulfment Scale, and a semantic differential measure of self-concept as a BMT patient in an interview context. RESULTS: Illness intrusiveness correlated significantly with engulfment (r=.58, P<.0001) and with self-concept as a BMT patient (r=.27, P<.016). Engulfment did not correlate significantly with self-concept as a BMT patient (r=.15). Multiple regression analysis, controlling for relevant covariates, indicated a significant Illness Intrusiveness x Engulfment interaction effect on self-concept as a BMT patient [F(1,84)=4.93, P<.029]. CONCLUSIONS: Self-concept as a BMT patient increases as cancer and its treatment introduce increasing lifestyle disruptions (illness intrusiveness). These effects are amplified when self-experience is dominated by disease and treatment and patients feel helpless, hopeless, and distressed (engulfment).