Background: Ebola virus disease (EVD) is a rare disease with a high fatality rate. Outbreaks of Ebola are primarily confined to the African continent. The largest outbreak of EVD ever documented began in West Africa in 2014, and spread to multiple continents through returning infected healthcare workers. This raised questions regarding the readiness of healthcare workers in Canada to safely and willingly provide care to suspected or confirmed patients with EVD. Locally, physicians had undergone training to manage patients with suspected or confirmed EVD.
Objectives: To identify physicians' knowledge level, attitudes, and willingness to care for patients with suspected or confirmed EVD, and to evaluate the association between knowledge and confidence on willingness to provide care.
Methods: A cross-sectional, anonymous, online survey was emailed to 329 frontline physicians across 5 acute care hospitals in a Canadian city from June to October 2015. The survey measured physician demographics, knowledge regarding EVD, confidence, and willingness to provide care to patients with suspected or confirmed EVD. Ethics approval was provided by the University Research Ethics Board.
Results: Surveys were sent to 329 physicians with a response rate of 33% (n=108). A large proportion of respondents were adult emergency physicians (40%). Pediatricians comprised 40% of respondents including emergency physicians (19%), hospital pediatrics (14%), intensive care (5%), and infectious diseases (2%). Of the respondents, 76% had received Ebola training at a local hospital. Physicians reported their main source of information about EVD was from news articles (90%), physician colleagues (86%), and Ebola training (83%). Knowledge about EVD was not significantly associated with willingness to provide care. Willingness to provide care was strongly associated with self-reported confidence in providing care (OR=6.9, p<0.05) and self-reported agreement that appropriate training and precautions were provided (OR=3.3, p=0.013). The majority of physicians (82.8%) believed that more practice donning and doffing personal protective equipment (PPE) would increase confidence in providing direct care.
Conclusion: Ensuring physicians are provided appropriate training and precautions to provide direct care to patients may ensure greater willingness to provide care. Training for physicians should include adequate practice with PPE, which may increase confidence in providing care.
