Effect of a condolence letter on grief symptoms among relatives of patients who died in the ICU: a randomized clinical trial
2017
Kentish-Barnes, Nancy | Chevret, Sylvie | Champigneulle, Benoit | Thirion, Marina | Souppart, Virginie | Gilbert, Marion | Lesieur, Olivier | Renault, Anne | Garrouste-Orgeas, Maïté | Argaud, Laurent | Venot, Marion | Demoule, Alexandre | Guisset, Olivier | Vinatier, Isabelle | Troché, Gilles | Massot, Julien | Jaber, Samir | Bornstain, Caroline | Gaday, Véronique | Robert, René | Rigaud, Jean-Philippe | Cinotti, Raphaël | Adda, Melanie | Thomas, François | Calvet, Laure | Galon, Marion | Cohen-Solal, Zoé | Cariou, Alain | Azoulay, Élie | Hôpital Saint-Louis ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7) | Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé (CRESS - U1153) ; Université Paris Diderot - Paris 7 (UPD7)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)) ; Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM) | Service de biostatistiques et information médicale [Saint-Louis] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) | Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) | Centre hospitalier Victor Dupouy [Centre hospitalier d'Argenteuil] (CH Argenteuil) | Centre Hospitalier Sud Francilien | CH La Rochelle | Centre Hospitalier Régional Universitaire de Brest (CHRU Brest) | Centre hospitalier Saint-Joseph [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) | Hôpital Edouard Herriot [CHU - HCL] ; Hospices Civils de Lyon (HCL) | Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN) ; Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon) ; Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM) | CHU Pitié-Salpêtrière [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) | Hôpital Saint-André [Bordeaux] | Centre Hospitalier Départemental Les Oudairies | Centre Hospitalier de Versailles André Mignot (CHV) | Hôpital Européen Georges Pompidou [APHP] (HEGP) ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO) | Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) | Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS) | Groupe Hospitalier Intercommunal Le Raincy-Montfermeil | Centre Hospitalier René Dubos [Pontoise] | CIC Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402) ; Université de Poitiers = University of Poitiers (UP)-Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers [La Milétrie])-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM) | Centre hospitalier de Dieppe | Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes) | Hôpital Nord [CHU - APHM] | CHU Amiens-Picardie | CHU Gabriel Montpied [Clermont-Ferrand] ; CHU Clermont-Ferrand
International audience
اظهر المزيد [+] اقل [-]إنجليزي. PURPOSE: Family members of patients who die in the intensive care unit (ICU) may experience symptoms of stress, anxiety, depression, posttraumatic stress disorder (PTSD), and/or prolonged grief. We evaluated whether grief symptoms were alleviated if the physician and the nurse in charge at the time of death sent the closest relative a handwritten condolence letter.METHODS: Multicenter randomized trial conducted among 242 relatives of patients who died at 22 ICUs in France between December 2014 and October 2015. Relatives were randomly assigned to receiving (n = 123) or not receiving (n = 119) a condolence letter. The primary endpoint was the Hospital Anxiety and Depression Score (HADS) at 1 month. Secondary endpoints included HADS, complicated grief (ICG), and PTSD-related symptoms (IES-R) at 6 months. Observers were blinded to group allocation.RESULTS: At 1 month, 208 (85.9%) relatives completed the HADS; median score was 16 [IQR, 10-22] with and 14 [8-21.5] without the letter (P = 0.36). Although scores were higher in the intervention group, there were no significant differences regarding the HADS-depression subscale (8 [4-12] vs. 6 [2-12], mean difference 1.1 [-0.5 to 2.6]; P = 0.09) and prevalence of depression symptoms (56.0 vs. 42.4%, RR 0.76 [0.57-1.00]; P = 0.05). At 6 months, 190 (78.5%) relatives were interviewed. The intervention significantly increased the HADS (13 [7-19] vs. 10 [4-17.5], P = 0.04), HADS-depression subscale (6 [2-10] vs. 3 [1-9], P = 0.02), prevalence of depression symptoms (36.6 vs. 24.7%, P = 0.05) and PTSD-related symptoms (52.4 vs. 37.1%, P = 0.03).CONCLUSIONS: In relatives of patients who died in the ICU, a condolence letter failed to alleviate grief symptoms and may have worsened depression and PTSD-related symptoms. Trial registration Clinicaltrials.gov Identifier: NCT02325297.
اظهر المزيد [+] اقل [-]المعلومات البيبليوغرافية
تم تزويد هذا السجل من قبل Institut national de la recherche agronomique