Lorcy Armelle, Gilca Rodica, Dubé Eve, Rochette Marie, De Serres Gaston
Infectious and immune diseases, CHU De Québec-Université Laval Research Centre, Quebec City, Quebec, Canada.
Enseignement Et Recherche En Ethnologie Amérindienne (EREA), Centre of the LESC (CNRS, UMR 7186), Paris, France.
Int J Circumpolar Health. 2020 Dec;79(1):1742564. doi: 10.1080/22423982.2020.1742564.
: The respiratory syncytial virus (RSV) is a major cause of hospitalisation in young Inuit children. Prophylaxis with palivizumab is routinely recommended for premature infants and those with severe pulmonary or cardiac diseases. In the fall 2016, the Quebec Ministry of Health expanded the criteria to include healthy full-term (HFT) newborns from Nunavik based on their high RSV hospitalisation rates.: The aim of this study was to describe the impact of this programme on Nunavik health services during the first RSV season after its implementation (2016-2017) by studying challenges, concerns and needs of healthcare workers (HCWs).: An ethnographic approach was used. Semi-structured interviews focusing on HCWs experiences, and opinions to improve the new programme were conducted with 20 HCWs involved in its implementation.: Main reported challenges and concerns were: additional work(over)load, lack of information and evidence about the need and efficacy of palivizumab in HFT newborns, communication issues between stakeholders, and ethical issues regarding the Inuit population.: The study revealed significant feasibility and acceptability issues. The programme was highly resource consuming. To address HCWs' concerns, evidence-based data regarding palivizumab effectiveness in HFT infants, as well as consultation and involvement of Inuit population are warranted.
呼吸道合胞病毒(RSV)是因纽特幼儿住院的主要原因。对于早产儿以及患有严重肺部或心脏疾病的患儿,常规推荐使用帕利珠单抗进行预防。2016年秋季,魁北克省卫生部扩大了标准,将努纳维克地区健康的足月儿纳入其中,因为他们的RSV住院率很高。本研究的目的是通过研究医护人员面临的挑战、担忧和需求,描述该项目在实施后的首个RSV季节(2016 - 2017年)对努纳维克地区医疗服务的影响。采用了人种志研究方法。对参与该项目实施的20名医护人员进行了半结构化访谈,重点了解他们的经历以及对改进新项目的意见。主要报告的挑战和担忧包括:额外的工作负担、缺乏关于帕利珠单抗在足月儿中的必要性和有效性的信息及证据、利益相关者之间的沟通问题以及与因纽特人群相关的伦理问题。该研究揭示了显著的可行性和可接受性问题。该项目资源消耗巨大。为解决医护人员的担忧,有必要提供关于帕利珠单抗在足月儿中有效性的循证数据,以及因纽特人群的咨询和参与。