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Effect of a condolence letter on grief symptoms among relatives of patients who died in the ICU: a randomized clinical trial.
- Source :
-
Intensive Care Medicine . Apr2017, Vol. 43 Issue 4, p473-484. 12p. - Publication Year :
- 2017
-
Abstract
- <bold>Purpose: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CONDOLENCE notes
*GRIEF
*MENTAL depression
*ANXIETY
*POST-traumatic stress disorder
*PATIENTS
*PREVENTION of mental depression
*PREVENTION of post-traumatic stress disorder
*FAMILIES & psychology
*AGE distribution
*BEREAVEMENT
*COMPARATIVE studies
*EMPATHY
*INTENSIVE care units
*RESEARCH methodology
*MEDICAL cooperation
*MEDICAL personnel
*MULTIVARIATE analysis
*PSYCHOLOGICAL tests
*RESEARCH
*SEX distribution
*TIME
*ATTITUDES toward death
*EVALUATION research
*RANDOMIZED controlled trials
*PATIENTS' families
*ODDS ratio
ANXIETY prevention
WRITING
Subjects
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 43
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 121962398
- Full Text :
- https://doi.org/10.1007/s00134-016-4669-9