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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.

Abstract：

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.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Kentish-Barnes N,Chevret S,Champigneulle B,Thirion M,Souppart V,Gilbert M,Lesieur O,Renault A,Garrouste-Orgeas M,Argaud L,Venot M,Demoule A,Guisset O,Vinatier I,Troché G,Massot J,Jaber S,Bornstain C,Gaday V,Robert R

doi

10.1007/s00134-016-4669-9

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

473-484

issue

eissn

0342-4642

issn

1432-1238

pii

10.1007/s00134-016-4669-9

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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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.