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<a href="http://doi.org/10.1056/NEJMoa063446" target="_blank" rel="noreferrer">http://doi.org/10.1056/NEJMoa063446</a>
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Title
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A communication strategy and brochure for relatives of patients dying in the ICU
Publisher
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The New England Journal Of Medicine
Date
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2007
Subject
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Female; Humans; Male; Intensive Care Units; Aged; Middle Aged; Professional-Family Relations; Communication; 80 and over; bereavement; Terminally Ill/psychology; Family/psychology; ICU Decision Making; Stress Disorders; Depression/epidemiology; Pamphlets; Anxiety/epidemiology; Post-Traumatic/epidemiology/prevention & control; Visitors to Patients/psychology
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Lautrette A; Darmon M; Megarbane B; Joly LM; Chevret S; Adrie C; Barnoud D; Bleichner G; Bruel C; Choukroun G; Curtis JR; Fieux F; Galliot R; Garrouste-Orgeas M; Georges H; Goldgran-Toledano D; Jourdain M; Loubert G; Reignier J; Saidi F; Souweine B; Vincent F; Barnes NK; Pochard F; Schlemmer B; Azoulay E
Description
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BACKGROUND: There is a need for close communication with relatives of patients dying in the intensive care unit (ICU). We evaluated a format that included a proactive end-of-life conference and a brochure to see whether it could lessen the effects of bereavement. METHODS: Family members of 126 patients dying in 22 ICUs in France were randomly assigned to the intervention format or to the customary end-of-life conference. Participants were interviewed by telephone 90 days after the death with the use of the Impact of Event Scale (IES; scores range from 0, indicating no symptoms, to 75, indicating severe symptoms related to post-traumatic stress disorder [PTSD]) and the Hospital Anxiety and Depression Scale (HADS; subscale scores range from 0, indicating no distress, to 21, indicating maximum distress). RESULTS: Participants in the intervention group had longer conferences than those in the control group (median, 30 minutes [interquartile range, 19 to 45] vs. 20 minutes [interquartile range, 15 to 30]; P<0.001) and spent more of the time talking (median, 14 minutes [interquartile range, 8 to 20] vs. 5 minutes [interquartile range, 5 to 10]). On day 90, the 56 participants in the intervention group who responded to the telephone interview had a significantly lower median IES score than the 52 participants in the control group (27 vs. 39, P=0.02) and a lower prevalence of PTSD-related symptoms (45% vs. 69%, P=0.01). The median HADS score was also lower in the intervention group (11, vs. 17 in the control group; P=0.004), and symptoms of both anxiety and depression were less prevalent (anxiety, 45% vs. 67%; P=0.02; depression, 29% vs. 56%; P=0.003). CONCLUSIONS: Providing relatives of patients who are dying in the ICU with a brochure on bereavement and using a proactive communication strategy that includes longer conferences and more time for family members to talk may lessen the burden of bereavement. (ClinicalTrials.gov number, NCT00331877.)
2007
Identifier
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<a href="http://doi.org/10.1056/NEJMoa063446" target="_blank" rel="noreferrer">10.1056/NEJMoa063446</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2007
80 And Over
Adrie C
Aged
Anxiety/epidemiology
Azoulay E
Backlog
Barnes NK
Barnoud D
Bereavement
Bleichner G
Bruel C
Chevret S
Choukroun G
Communication
Curtis JR
Darmon M
Depression/epidemiology
Family/psychology
Female
Fieux F
Galliot R
Garrouste-Orgeas M
Georges H
Goldgran-Toledano D
Humans
ICU Decision Making
Intensive Care Units
Joly LM
Jourdain M
Journal Article
Lautrette A
Loubert G
Male
Megarbane B
Middle Aged
Pamphlets
Pochard F
Post-Traumatic/epidemiology/prevention & control
Professional-family Relations
Reignier J
Saidi F
Schlemmer B
Souweine B
Stress Disorders
Terminally Ill/psychology
The New England Journal Of Medicine
Vincent F
Visitors to Patients/psychology