S10.KL2 THE PSYCHOLOGICAL IMPACT OF BONE AND JOINT INFECTIONS, INCLUDING THE EFFECT OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS

Abstract

Introduction: Aside from a technical understanding, patients’ perceptions of, and the emotional associations they make with, their illness can influence the eventual outcome. We explored this in relation to bone and joint infections as these can have major impacts on patients in terms of reduced mobility, need for surgery and long-term antibiotic use. In particular we wanted

1. to assess how patients viewed their infections,

2. to see if infection with methicillin-resistant Staphylococcus aureus (MRSA) was different to non-MRSA infections, and

3. to explore the emotional associations of these infections.

Methods: We adapted the Illness Perception Questionnaire of Weinman (1996) for this purpose. We focused on three domains: consequences, control/cure, and emotional responses. We asked all patients with osteomyelitis, septic arthritis or prosthetic joint infection attending the Liverpool Hospital Infectious Diseases Outpatient Clinic between May and August 2005 to complete the questionnaire.

Results: Ninety-one patients completed the questionnaire. Thirty-nine had either MRSA infection or colonisation. Overall, most patients felt that their infection had made a major impact on their life (76%) or that their infection was very serious (79%). This negative response was independently associated with younger age and having MRSA (either infection or colonisation). Patients with prosthetic joint infections felt they had reduced sense of control and likelihood of cure.

Conclusions: Bone and joint infections have a major psychological impact on patients, especially the young, those with MRSA and those with prosthetic joint infections. Health care professionals should take account of these emotional responses in order to optimise their therapeutic relationship with patients.