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