Communication with bereaved family members after death in the ICU: the CATHARTIC randomised clinical trial

Le résumé fourni par la source

Family members of critically ill patients who die during intensive care unit (ICU) treatment may be at elevated risk of anxiety, depression, complicated grief, and post-traumatic stress-like symptoms compared with the relatives of patients dying outside of the critical care setting.[1][2][3][4] Such psychological morbidity may be associated with decreased quality of life, functional impairment, and possibly greater mortality within the group of affected relatives.5,6 Accordingly, bereavement services have been proposed [7][8][9][10] to support the emotional needs of family members.Interventions such as viewing of the body, mementoes, storytelling, ICU diaries, sympathy letters, phone calls and follow-up meetings have all been reported in the literature; [11][12][13][14][15] however, there is no evidence from randomised clinical trials to support any intervention.8,10,11,16 Given this, a randomised trial was conducted to gather estimates of the effect of family-centred bereavement services, particularly to evaluate the impact of a telephone call from an ICU staff member.The primary hypothesis was that some bereavement support (either a semi-structured, short telephone call or a condolence letter) compared with no communication would alleviate symptoms of anxiety and depression at 6 months in relatives of patients who have died in the ICU. Participants and methods Study design and oversightThis was a single-centre, randomised, three parallel-group trial within a sample of patient relatives identified at the Royal Melbourne Hospital, Melbourne, Australia, which has a 42-bed, university-associated, adult ICU supporting several state referral services, including trauma and oncology.The protocol was approved by the Melbourne Health's Human Research Ethics Committee before commencement of the study (HREC Ref. No. HREC/52855/MH-2019; HREC approval date, 23 May 2019), and the trial was registered before enrolment (Australia New Zealand Clinical Trials Registry: ACTRN12619000917134).

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