1. Grief Symptoms in Relatives Who Experienced Organ Donation Requests in the ICU
- Author
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Gaëlle Cheisson, Olivier Lesieur, Benjamin Zuber, Martial Ouendo, Sylvie Chevret, Anne Renault, Gérald Viquesnel, Marie Thuong, L Joseph, Pascale Le Maguet, Chaouki Mezher, Julien Charpentier, Anne Gaelle Si Larbi, Stanislas Kandelman, Stéphane Donati, Nicolas Pichon, Marion Galon, Sophie Marqué, Elie Azoulay, Jacques Duranteau, Nancy Kentish-Barnes, Laurent Martin-Lefevre, and Bernard Floccard
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Brain Death ,medicine.medical_specialty ,Time Factors ,Tissue and Organ Procurement ,media_common.quotation_subject ,Critical Care and Intensive Care Medicine ,Hospital Anxiety and Depression Scale ,Interviews as Topic ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Family ,Longitudinal Studies ,030212 general & internal medicine ,Organ donation ,Spouses ,media_common ,Psychiatric Status Rating Scales ,Brain dead ,business.industry ,Middle Aged ,medicine.disease ,Complicated grief ,Intensive Care Units ,030228 respiratory system ,Family medicine ,Adult Children ,Female ,Grief ,Decision process ,business - Abstract
Studies show that the quality of end-of-life communication and care have a significant impact on the living long after the death of a relative and have been implicated in the burden of psychological symptoms after the ICU experience. In the case of organ donation, the patient's relatives are centrally involved in the decision-making process; yet, few studies have examined the impact of the quality of communication on the burden of psychological symptoms after death.To assess the experience of the organ donation process and grief symptoms in relatives of brain-dead patients who discussed organ donation in the ICU.We conducted a multicenter longitudinal study in 28 ICUs in France. Participants were the relatives of brain-dead patients who were approached to discuss organ donation. Relatives were followed-up by phone at three time points: at 1 month, to complete a questionnaire describing their experience of the organ donation process; at 3 months, to complete the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised; and at 9 months, to complete the Impact of Event Scale-Revised and the Inventory of Complicated Grief.In total, 202 relatives of 202 patients were included, of whom 158 consented to and 44 refused organ donation. Interviews were conducted at 1, 3, and 9 months with 78%, 68%, and 58% of relatives, respectively. The overall experience of the organ donation process was significantly more burdensome for relatives of nondonors. They were more dissatisfied with communication (27% vs. 10%; P = 0.021), more often shocked by the request (65% vs. 19%; P 0.0001), and more often found the decision difficult (53% vs. 27%; P = 0.017). However, there were no significant differences in grief symptoms measured at 3 and 9 months between the two groups. Understanding of brain death was associated with grief symptoms; our results show a higher prevalence of complicated grief symptoms among relatives who did not understand the brain death process than among those who did (75% vs. 46.1%; P = 0.026).Experience of the organ donation process varied between relatives of donor versus nondonor patients, with relatives of nondonors experiencing lower-quality communication, but the decision was not associated with subsequent grief symptoms. Importantly, understanding of brain death is a key element of the organ donation process for relatives.
- Published
- 2018