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Psychosocial Impact Of Chronic Infections And Hospitalisation
Published on: October 20, 2025
Psychosocial Impact of Chronic Infections and Hospitalizations
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Michelle Ann George

Master of Science in Health Psychology, King's College London

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Huma Shaikh

Bachelor of Science in Biology, The Open University, UK

Introduction 

A chronic infection1 is an infection caused by a microorganism such as a bacterium, virus, fungus, or parasite, that remains in the body for a long period, usually months, years, or even a lifetime.2,3 Some examples include HIV, Hepatitis B and C, Tuberculosis, Lyme disease, chronic pulmonary aspergillosis, and Epstein-Barr virus. In comparison to acute infections, these cases are frequently more difficult to treat and may not respond well to standard antibiotic or antiviral treatments.2,3 Thus, several chronic infections lead to hospitalisations for many reasons such as admission for treatment, disease progression, sepsis,4 secondary infections,5 co-existing health conditions,6 and antibiotic resistance.7 For many patients, being admitted to the hospital can be an emotionally difficult and stressful event.8 Because chronic infections are communicable (contagious), patients are frequently isolated in hospitals, which causes increased psychological distress and, as a result, lower immune responses.9 Thus, it is important to outline the psychosocial impact of chronic infection and hospitalisation. 

The invisible wounds: Psychological impact 

Studies have shown the various psychological and emotional impacts of developing a chronic infection and being hospitalised. Chronic infections and prolonged hospitalisations place a psychological burden on people, often leading to emotional challenges and mental disturbances. These challenges are often overlooked when, in reality, they exacerbate the disease.9 

Emotional distress 

Research investigating infections like tuberculosis10,11 and hepatitis12 shows increased levels of depression, anxiety, and mental distress in hospitalised patients. Patients in hospitals experience distress due to their symptoms, such as pain, nausea, shortness of breath, feelings of anxiety about the future and severity of the disease, feelings of helplessness, and disruption in their daily routine.13 In more severe cases, individuals may develop trauma, particularly those who have undergone intense medical interventions and life-threatening health episodes.14 This is distressing not only to the patient but to their families and caregivers.15 What makes it more challenging for the patient is being socially isolated from them.16 Immobility (not being able to move), feelings of inadequacy and reduced sleep are other psychological factors affecting patients’ emotional well-being.8 

Cognitive load

Being in a hospital can be quite overwhelming with several things going on in the same environment. Patients might have difficulty adjusting to an unfamiliar environment, eating cold or tasteless food, experiencing loud noises, being awoken at night by nurses, being in pain, etc. 

Hospital environments can cause a lot of confusion,17 especially when one is battling a chronic infection. Moreover, receiving medical information and making healthcare decisions would be particularly challenging for vulnerable populations such as older adults and those with cognitive decline.18 This increases the risk of falls, delirium, longer hospital stays, reduced nutritional intake, and dehydration.18 

Social impact 

Social isolation 

Chronic infections can also impact one’s personal, professional and financial life. Research shows isolation in hospital environments is associated with depression, anxiety, feelings of loneliness, fear and anger.19, 20 Relationships with family, friends and partners are often strained, especially when they take on caregiver roles.21 Although patients who receive support from their loved ones experience lower social challenges than ones who don’t.22 

Studies also show that healthcare professionals spend less time with these patients, increasing the risk for medical errors and adverse events such as disease progression and complications.19 

Stigma

Patients with infectious diseases such as HIV experience a lot of discrimination and stigma from partners, family, and friends, which consequently affects their mental health.23 Surprisingly, research shows a significant level of discrimination and stigma from healthcare workers treating these patients, leading to patients’ poor adherence to treatment, delayed care and refusal of services from healthcare workers.24 This would affect the progression of the infection and lead to healthcare-related trauma for the patient, risking refusal to seek out medical care in the future. Patients also experience self-stigma, which leads to decreased self-esteem and confidence.24 Moreover, many patients with HIV also experience discrimination in their workplace, leading to further emotional and mental issues.30 

Financial burden 

Frequent hospitalisations due to chronic infections also impact one’s finances, especially if a patient gets readmitted or has severe progression of illness, which leads to longer hospital stays.25 Financial burden begins from covering the process of identification of the illness (consultations), non-medical, medical (hospitalisation, medications) and indirect costs (travel).26 Moreover, many individuals face a loss of income due to the inability to work or frequent hospital visits.27,28 Depression is associated with socioeconomic factors such as financial status in patients with tuberculosis.11 Thus, it makes it emotionally difficult to come back into the workforce after hospital discharge. Combining medication costs with lost income, many patients from low to middle-income countries experience a catastrophic healthcare expenditure.29 

Strategies and support systems to mitigate this impact

Strategies for the patient 

Whether you are a patient or caring for a loved one, being in a hospital can be a stressful period in one’s life. It is important to prioritise self-care tips and provide oneself with healthy coping strategies to navigate difficult times.

Personal strategies 

It is easy to neglect your well-being when in a hospital, especially if daily routines are disrupted. Incorporating stress-reduction activities such as deep breathing, mindfulness meditation activities and guided imagery can help reduce some of that stress. Practising controlled breathing exercises could minimise symptoms of anxiety and depression while also strengthening one’s mobility (ability to move around).31 Mindfulness meditation relieves anxiety and stress while also improving physiology by regulating blood pressure and heart rate32 and enhancing immune function, which is vital for those fighting a chronic infection.33 Guided imagery is a relaxation technique where one pictures or imagines scenes, pictures, objects or events associated with calmness. Interestingly, studies have shown that it can help with pain relief,34 sleep quality,35 and overall stress reduction.36 Other activities like listening to music, watching fun movies or shows, and engaging in humour are proven to alleviate anxiety when hospitalised.37 

Social support 

As much as social support reduces feelings of loneliness and isolation in patients, it is also one of the most crucial factors for healing in patients. A study done on individuals with HIV showed that patients with a low level of social support had more pain, worse physical functioning, more difficulties in their daily activities, higher stress related to their health and worse emotional states.38 Also, research has shown that having friends and family around can help people with tuberculosis commit to their treatment.39 Moreover, a vital form of social support needed is help at home for people recovering from hospitalisation, and those who did not have this were at a higher risk of hospital readmission.40

Psychological interventions 

In other cases, someone who was hospitalised might benefit more from professional mental health help. Some therapies, like Cognitive Behavioural Therapy, might help with decreasing depression, stigma, and quality of life in HIV/AIDS.41 It helps one to adjust to a new environment, increases motivation to get better, and increases optimism. Prolonged hospital stays can also impact families. Providing caregivers, families and friends with counselling, services, engaging them in the treatment and care plans, and ensuring they feel supported throughout the journey. 

Institutional-level changes 

There are only a number of strategies that a patient can employ for their psychological and social needs. The responsibility largely falls on our healthcare systems to identify distress and needs in their patients. A holistic model of mental health needs to be implemented where patients admitted for physical health concerns are also monitored for emotional, social, and financial necessities. Hence, there is a need for multidisciplinary teams to work together to ensure the well-being of a patient.

Psychoeducation 

Psychoeducation will help especially for those fighting infections that are stigmatised in our society such as HIV, hepatitis, and certain sexually transmitted infections. For patients, providing accurate and empathetic information about the disease will help them understand it without any judgment towards themselves. Moreover, they will be more likely to seek support, medical care, and stick to their treatment.42 More importantly, psychoeducation should target healthcare workers, family, friends and the workplace to reduce discrimination and unconscious biases during treatment. Patients are more likely to engage in treatment and communication during hospital stays if they feel respected and supported. 

Summary 

Chronic infections are infections that last for a prolonged period of time, often requiring hospital admission. Unlike acute infections, these are harder to treat and pose various psychosocial challenges. Some psychological issues include anxiety, depression, stress about the illness, and hospital trauma. These are made worse by pain, inability to move, isolation and the hospital environment. Older adults tend to be confused and find it difficult to process medical information when in stressful environments. Socially, chronic infections can lead to stigma, strained relationships, and reduced care when caregivers experience burnout. Moreover, financial burdens, due to medical costs, income loss and inability to work, make the hospital stay stressful. To mitigate these impacts, patients can engage in personal strategies like meditation, deep breathing, journaling and listening to music. Social support during these times is crucial in achieving positive physical and mental health outcomes. Counselling and other psychological interventions can help with cases of depression, anxiety and trauma for both patients and their loved ones. Hospitals must adopt a holistic approach to patient care, incorporating psychoeducation to correctly inform healthcare workers of chronic infections.

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Michelle Ann George

Master of Science in Health Psychology, King's College London

Michelle is an aspiring Health Psychologist with experience in clinical research trials and delivery of psychological interventions. She is passionate about the role of psychological theory in improving physical health outcomes, especially in chronic conditions such as diabetes, cancer, kidney disease, and multiple sclerosis. She aims to improve the lives of individuals with illness through patient centred research and behaviour change strategies.

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