Objective: This study sought to determine the prevalence of depression in HTLV-1 carriers and to explore the emotional experiences and issues they face.

Methods: A mixed method study was conducted among HTLV-1 carriers who received counseling in an outpatient clinic in Okinawa, Japan from June 2015 to June 2016. A descriptive qualitative study was conducted with HTLV-1 carriers. Depression accompanying HTLV-1 infection was evaluated using the Zung SelfRating Depression Scale (SDS). Semi-structured interviews were conducted, and the responses were analyzed qualitatively.

Results: A total of 22 HTLV-1 carriers participated in this study. Among the 20 participants who completed the SDS, 4 (20%) had depression. In the depression group, scores for agitation and loss of libido were higher compared to the other 18 items. Four main categories emerged from the interview transcripts: anxiety about onset of HTLV-1–associated disease, anxiety about disease transmission, self-healthcare management, and requests for counseling. All 22 interviewees reported feelings of anxiety about onset of HTLV-1–associated disease and having requested ongoing counseling. Anxiety about disease transmission included various sub-categories, and individuals with such anxiety needed counseling from nurses.

Conclusion: The study revealed that 20% of HTLV-1 carriers had depression. Respondents were anxious as to whether or not they will develop HTLV-1–associated disease, and were also concerned as to how they acquired the virus and if they are contagious. This highlights the need to establish a system for the provision of counseling services offered by healthcare professionals involved and experienced in the management of HTLV-1 infection and related disease.

The purpose of this study was to examine the management of patients on contact isolation due to infection with multidrug-resistant organisms (MDROs) and nurses' knowledge of infection control and transmission prevention. We sent 800 anonymous self-administered questionnaires to 53 hospitals; 681 nurses at 51 hospitals involved in the management of the isolated patients responded to the survey. Regarding the management of patients with MDRO infections on contact isolation, 67.7% of respondents stated that doctors comprised the largest number of medical personnel who explain the necessity of isolation, 74.2% responded that recipients of these explanations were patients and their family members, and 78.9% responded that they give explanations verbally. In addition, 46% of respondents proposed the need for visiting conditions and 11.9% responded that patients with MDRO infections receive rehabilitation at a functional training room. This suggests that many isolated patients with MDRO infections had few occasions to leave their room. Concerning nurses' knowledge of MDRO infection control and transmission prevention, the average rate of correct answers to 14 questions was 10.4. There were significantly more correct answers among a group of chief nurses, certified nurses, and specialist nurses who were trained in MDRO infection management and utilized their infection control and transmission prevention manual. This suggests the need to educate nurses in providing patients and their family members with clear, easyto-understand explanations, to prevent transmission of MDROs, and to consider the negative impact of contact isolation on the patients.