2023-09-28 14:46:10 +00:00
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abstract: 'Background
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During the 2013-2016 West Africa Ebola outbreak, supportive care was the
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only non-experimental treatment option for patients with Ebola virus
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disease (EVD). However, providing care that would otherwise be routine
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for most clinical settings in the context of a highly contagious and
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lethal pathogen is much more challenging. The objective of this study
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was to document and deepen understanding of barriers to provision of
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supportive care in Ebola treatment units (ETUs) as perceived by those
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involved in care delivery during the outbreak.
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Methods
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This qualitative study consisted of 29 in-depth semi-structured
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interviews with stakeholders (decision-makers, physicians, nurses)
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involved in patient care delivery during the outbreak. Analysis
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consisted of interview debriefing and team-based transcript coding in
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NVivo10 software using thematic analysis.
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Findings
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Participants emphasized three interconnected barriers to providing
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high-quality supportive care during the outbreak: 1) lack of material
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and human resources in ETUs; 2) ETU organizational structure limiting
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the provision of supportive clinical care; and 3) delayed and poorly
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coordinated policies limiting the effectiveness of global and national
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responses. Participants also noted the ethical complexities of defining
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and enacting best clinical practices in low-income countries. They noted
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tension between, on one hand, scaling up minimal care and investing in
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clinical care preparedness to a level sustainable in West Africa and, on
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the other, providing a higher level of supportive care, which in
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low-resource health systems would require important investments.
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Conclusion
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Our findings identified potentially modifiable barriers to the delivery
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of supportive care to patients with EVD in West Africa. Addressing these
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in the inter-outbreak period will be useful to improve patient care and
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outcomes during inevitable future outbreaks. Promoting community trust
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and engagement through long-term capacity building of the healthcare
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work-force and infrastructure would increase both health system
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resilience and ability to handle other outbreaks of emerging diseases.'
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affiliation: 'Loignon, C (Corresponding Author), Univ Sherbrooke, Fac Med \& Hlth
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Sci, Sherbrooke, PQ, Canada.
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Loignon, Christine; Couturier, Francois; Benhadj, Lynda; Lamontagne, Francois, Univ
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Sherbrooke, Fac Med \& Hlth Sci, Sherbrooke, PQ, Canada.
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Nouvet, Elysee, Univ Western Ontario, Sch Hlth Studies, London, ON, Canada.
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Adhikari, Neill K. J.; Fowler, Rob A., Univ Toronto, Interdept Div Crit Care, Dept
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Crit Care Med, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada.
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Murthy, Srinivas, Univ British Columbia, Fac Med, Vancouver, BC, Canada.'
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article-number: e0201091
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author: Loignon, Christine and Nouvet, Elysee and Couturier, Francois and Benhadj,
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Lynda and Adhikari, Neill K. J. and Murthy, Srinivas and Fowler, Rob A. and Lamontagne,
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Francois
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author-email: Christine.Loignon@Usherbrooke.ca
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author_list:
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- family: Loignon
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given: Christine
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- family: Nouvet
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given: Elysee
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- family: Couturier
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given: Francois
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- family: Benhadj
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given: Lynda
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- family: Adhikari
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given: Neill K. J.
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- family: Murthy
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given: Srinivas
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- family: Fowler
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given: Rob A.
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- family: Lamontagne
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given: Francois
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da: '2023-09-28'
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doi: 10.1371/journal.pone.0201091
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files: []
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issn: 1932-6203
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journal: PLOS ONE
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keywords-plus: EPIDEMIC
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language: English
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month: SEP 5
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number: '9'
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number-of-cited-references: '32'
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orcid-numbers: 'Murthy, Srinivas/0000-0002-9476-839X
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Nouvet, Elysee/0000-0002-1607-3453
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Ansumana, Rashid/0000-0002-1973-7200
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Lamontagne, Francois/0000-0002-0360-3427'
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papis_id: 51a173f357f75adc2fcca1d5ad1b945d
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ref: Loignon2018barrierssupportive
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researcherid-numbers: 'Murthy, Srinivas/AAS-7243-2020
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'
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times-cited: '14'
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title: 'Barriers to supportive care during the Ebola virus disease outbreak in West
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Africa: Results of a qualitative study'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000443789900003
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usage-count-last-180-days: '0'
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usage-count-since-2013: '12'
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volume: '13'
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web-of-science-categories: Multidisciplinary Sciences
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year: '2018'
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