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. 2021 Jun;159(6):2301-2308.
doi: 10.1016/j.chest.2021.01.072. Epub 2021 Feb 5.

Information Pamphlet Given to Relatives During the End-of-Life Decision in the ICU: An Assessor-Blinded, Randomized Controlled Trial

Sylvaine Robin  1 , Cyrielle Labarriere  2 , Guillaume Sechaud  1 , Geraldine Dessertaine  1 , Jean-Luc Bosson  3 , Jean-Francois Payen  4
Affiliations

Information Pamphlet Given to Relatives During the End-of-Life Decision in the ICU: An Assessor-Blinded, Randomized Controlled Trial

Sylvaine Robin et al. Chest. 2021 Jun.

Abstract

Background: Symptoms of posttraumatic stress disorder (PTSD) are common in family members of patients who have died in the ICU.

Research question: Could a pamphlet describing the role of relatives in the end-of-life decision decrease their risk of developing PTSD-related symptoms?

Study design and methods: In this assessor-blinded, randomized controlled trial, 90 relatives of adult patients for whom an end-of-life decision was anticipated were enrolled. Relatives were randomly assigned to receive oral information as well as an information pamphlet explaining that the end-of-life decision is made by physicians (Group 1; n = 45) or oral information alone (Group 2; n = 45). PTSD-related symptoms were blindly assessed at 90 days following the patient's death by using the Impact of Event Scale (scores range from 0 [indicating no symptoms] to 75 [indicating severe symptoms]). Anxiety and depression symptoms were assessed by using the Hospital Anxiety and Depression Scale score (range, 0-21 [higher scores indicate worse symptoms]).

Results: On day 90, the number of relatives with PTSD-related symptoms was significantly lower in Group 1 than in Group 2: 18 of 45 vs 33 of 45 (P = .001). The risk ratio of having PTSD-related symptoms in Group 2 compared with Group 1 was 1.8 (95% CI, 1.2-2.7). The mean Impact of Event Scale and Hospital Anxiety and Depression Scale scores were significantly reduced in Group 1 compared with Group 2: 28 ± 10 vs 38 ± 14 (P < .001) and 13 ± 5 vs 17 ± 8 (P = .023), respectively.

Interpretation: An information pamphlet describing the relatives' role during end-of-life decisions significantly reduced their risk of developing PTSD-related symptoms.

Clinical trial registration: ClinicalTrials.gov; No.: NCT02329418; URL: www.clinicaltrials.gov).

Keywords: end-of-life; family; intensive care; pamphlet; posttraumatic stress disorders; treatment, withdrawing; treatment, withholding.

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  • When the Words Serve As Drugs.
    Mistraletti G, Giannini A. Mistraletti G, et al. Chest. 2021 Jun;159(6):2137-2138. doi: 10.1016/j.chest.2021.02.061. Chest. 2021. PMID: 34099119 No abstract available.

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