Post Traumatic Stress Disorder
Conditions
Brief summary
Relatives of patients in situation of withholding and withdrawing life-sustaining therapies often show post traumatic stress disorder (PTSD) (60%)\[1\]. This number is even greater when family members are active in this decision (81%) or when communication is not optimal between medical team and family members. There are several ways to assist families of patients in intensive care units \[2\], amongst them the use of a written document to explain the environment, therapies and possible outcomes. Here the investigators want to test the impact of a written document in the context of end-of-life conference in intensive care units. Specifically, this research addresses wether such written support could decrease 3-months post-traumatic stress disorder, anxiety and depression exhibited by the closest family member or the patient representative.
Interventions
OTHERExplaining withholding and withdrawing life-sustaining therapies along with a written document
The document describes the law and the role of family members and medical team in the decision.
OTHERExplaining withholding and withdrawing life-sustaining therapies following standard procedure
Sponsors
University Hospital, Grenoble
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
The study will enroll patient representant (family member or close friends designed by the family or pre-admission legal representant). Inclusion Criteria: * Medical team anticipates a decision to withhold and withdraw life-sustaining therapies to intensive care unit (ICU) discharge * verbal consent to participate * Able to communicate in French
Exclusion criteria
* representant of a patient \< 18 years old * representant of a patient whose stay in ICU lasted less than 48 hours * representant of a patient without social security
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of PTSD | 3 months | PTSD is assessed with Impact Event Scale (IES) on the family representative |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of depression | 3 months | Depression is assessed with Hospital Anxiety and Depression scale (HADS) on the family representative |
| Rate of anxiety | 3 months | Anxiety is assessed with Hospital Anxiety and Depression scale (HADS) on the family representative |
| Mean level of HADS (anxiety and depression subscales) | 3 months | — |
| Mean level of IES | 3 months | — |
| Length of the processus from decision to withhold and withdraw life-sustaining therapies to intensive care unit (ICU) discharge | An average of 6 days | — |
| Respectfulness of the law regarding withholding and withdrawing life-sustaining therapies | An average of 6 days | — |
| Rate of decision to withhold and withdraw life-sustaining therapies in different intensive care units from the hospital | ICU discharge (an average of 3 weeks) | — |
| Medical Doctor satisfaction with the processus | ICU discharge (an average of 3 weeks) | — |
| Description of the processus | ICU discharge (an average of 3 weeks) | — |
Countries
France
Outcome results
None listed