A key lesson from the west Africa (2014–16) Ebola disease epidemic was that outbreak responses fail when they respond to patients through a narrow clinical lens without considering the broader community and social context of care. Here, in the second of two Series papers on the modern landscape of Ebola disease, we review progress made in the last decade to improve patient-centred care. Although the biosafety imperatives of treating Ebola disease remain, recent advances show how to mitigate these so that patients are cared for in a safe and dignified manner that encourages early treatment-seeking behaviour and provides support after the return of patients to their communities. We review advances in diagnostics, including faster Ebola disease detection via real-time RT-PCR, and consider design improvements in Ebola disease treatment units that enhance patient safety and dignity. We also review advances in care provision, such as the integration of palliative care and mobile communication into routine care, and address how greater access to research is possible through harmonised clinical trials. Finally, we discuss how strengthened community engagement and psychosocial programmes are addressing stigma and providing holistic support for survivors.

中文翻译：

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将治疗嵌入更强大的护理系统


西非 （2014-16） 埃博拉病流行的一个关键教训是，如果疫情应对通过狭隘的临床视角对患者做出反应，而不考虑更广泛的社区和社会护理背景，那么疫情应对就会失败。在这里，在关于埃博拉疾病现代形势的两篇系列论文的第二篇中，我们回顾了过去十年在改善以患者为中心的护理方面取得的进展。尽管治疗埃博拉疾病的生物安全必要性仍然存在，但最近的进展表明了如何减轻这些要求，以便以安全和有尊严的方式照顾患者，从而鼓励早期寻求治疗的行为，并在患者返回社区后提供支持。我们回顾了诊断技术的进展，包括通过实时 RT-PCR 更快地检测埃博拉疾病，并考虑改进埃博拉疾病治疗室的设计，以提高患者的安全和尊严。我们还回顾了护理提供方面的进展，例如将姑息治疗和移动通信整合到常规护理中，并讨论了如何通过协调临床试验增加研究机会。最后，我们讨论了加强社区参与和社会心理计划如何解决耻辱感并为幸存者提供全面支持。