Combatting Social Isolation, Anxiety, and Loneliness in Hospitalized Patients: A Quasi-Experimental Study.

OBJECTIVE: The objective of this study was to determine the effectiveness of an intervention related to social isolation and loneliness among hospitalized patients by improving: 1) social connectedness; 2) anxiety; and 3) loneliness and to evaluate experiences of the connection intervention. BACKGROUND: Social isolation and loneliness can lead to detrimental effects on morbidity/mortality and health indices. A connection intervention was developed by investigators using key strategies to promote connectedness, providing in-person contact for hospitalized patients to meet individual and self-care needs. METHODS: This quasi-experimental study was conducted in a Midwest adult academic health center. Social connectedness, anxiety, and loneliness were evaluated at baseline and postintervention using a paired-sample t test. Experience responses were analyzed using content analysis. RESULTS: There were no significant differences in social connectedness, anxiety, or loneliness when comparing baseline with postintervention. Experience themes included sharing personal stories back and forth, treating me as a person, mitigating loneliness, and finding benefit. CONCLUSION: Despite nonsignificant findings, participants found benefit in filling the social void of being an inpatient. Clinicians should ensure that holistic care is delivered to hospitalized inpatients. Inclusive patient-centered strategies targeted to decrease social isolation and loneliness among acute care inpatients should continue to be developed and tested.

Relative Temperature Maximum in Wound Infection and Inflammation as Compared with a Control Subject Using Long-Wave Infrared Thermography.

OBJECTIVE: The purpose of this retrospective case series was to determine whether a long-wave infrared thermography (LWIT, or thermal imaging) camera can detect specific temperature changes that are associated with wound infection and inflammation as compared with normal control subjects with similar anatomical wound locations. DESIGN: A retrospective, observational, collective, multiple case series of patients who underwent digital and thermal imaging of wounds in various states. SETTING: The subjects were selected from multiple sites including an outpatient wound care clinic, a wound care physician's office, a rehabilitation hospital, and a home healthcare organization. PATIENTS: Six subjects were selected for inclusion, including 2 each for the infection, inflammation, and normal control groups. MAIN OUTCOME MEASURE: The study collected relative temperature maximums as obtained and recorded by LWIT and digital imaging. MAIN RESULTS: In this case series, the authors demonstrate the use of an FDA-approved Scout (WoundVision, Indianapolis, Indiana) dual-imaging long-wave infrared and digital cameras to analyze images of wounds. In the 2 cases with clinically diagnosed wound infection, LWIT showed an elevation of temperature as evidenced by a maximum temperature differential between the wound and healthy skin of +4° C to 5° C. Also, LWIT was able to identify relative thermal changes of +1.5° C to 2.2° C in subjects presenting with clinical signs of inflammation. In addition, LWIT was able to show that the normal control subjects without diagnosis of infection or signs of inflammation had relative temperature differentials of +1.1° C to 1.2° C. Finally, LWIT could detect adequate treatment of infected wounds with antibiotics as evidenced by a return to normal temperature differences gradient of +0.8° C to 1.1° C, as compared with normal control subjects with wounds in the same anatomical location. CONCLUSIONS: Long-wave infrared thermography can collect and record objective data, including relative temperature maximums associated with infection, inflammation, and normal healing wounds.

A retrospective analysis of acoustic pressure wound therapy: effects on the healing progression of chronic wounds.

BACKGROUND: Small clinical studies suggest adjunctive use of acoustic pressure wound therapy (APWT) may enhance wound healing, even in challenging patients. This noncontact low-frequency, nonthermal ultrasound therapy for assisting with the debridement of necrotic tissue from challenging wounds is generally better tolerated by patients for whom treatment-related wound pain, anticoagulation, or medical instability precludes sharp, surgical, or mechanical debridement. OBJECTIVE: To evaluate changes in amount of devitalized tissue, amount and type of wound drainage, and wound surface area after administration of APWT. DESIGN: Retrospective chart review of 48 consecutive patients treated with adjunctive APWT at a single center between January 2006 and October 2007. METHODS: Paired comparisons of baseline versus posttreatment values for wound area, tissue characteristics, drainage, and pain were analyzed. Time, frequency, and duration of APWT and treatment-related adverse events were collected. RESULTS: APWT was administered a mean of 2.1 times per week for a mean of 4.1 minutes per session. Mean duration of therapy was 5.5 weeks. Median wound area was reduced by 92% from baseline to end of APWT (6.2 cm(2) to 0.2 cm(2),P < .0001). The proportion of wounds with >75% granulation tissue increased from 37% to 89% (P < .0001). The proportion of wounds without fibrin slough or eschar increased from 31% to 75% (P < .0001) and from 72% to 94% (P = .02), respectively. LIMITATIONS: Retrospective design, lack of control group, small sample population. CONCLUSION: As an adjunct to conventional wound management, APWT appears to improve parameters associated with wound healing, including increased tissue granulation, decreased necrotic tissue, and decreased wound area.