Department of Anesthesia and Critical Care, France Université Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France.
Department of Anesthesia and Critical Care, Annecy Genevois Hospital, Annecy, France.
Chest. 2021 Jun;159(6):2301-2308. doi: 10.1016/j.chest.2021.01.072. Epub 2021 Feb 5.
Symptoms of posttraumatic stress disorder (PTSD) are common in family members of patients who have died in the ICU.
Could a pamphlet describing the role of relatives in the end-of-life decision decrease their risk of developing PTSD-related symptoms?
In this assessor-blinded, randomized controlled trial, 90 relatives of adult patients for whom an end-of-life decision was anticipated were enrolled. Relatives were randomly assigned to receive oral information as well as an information pamphlet explaining that the end-of-life decision is made by physicians (Group 1; n = 45) or oral information alone (Group 2; n = 45). PTSD-related symptoms were blindly assessed at 90 days following the patient's death by using the Impact of Event Scale (scores range from 0 [indicating no symptoms] to 75 [indicating severe symptoms]). Anxiety and depression symptoms were assessed by using the Hospital Anxiety and Depression Scale score (range, 0-21 [higher scores indicate worse symptoms]).
On day 90, the number of relatives with PTSD-related symptoms was significantly lower in Group 1 than in Group 2: 18 of 45 vs 33 of 45 (P = .001). The risk ratio of having PTSD-related symptoms in Group 2 compared with Group 1 was 1.8 (95% CI, 1.2-2.7). The mean Impact of Event Scale and Hospital Anxiety and Depression Scale scores were significantly reduced in Group 1 compared with Group 2: 28 ± 10 vs 38 ± 14 (P < .001) and 13 ± 5 vs 17 ± 8 (P = .023), respectively.
An information pamphlet describing the relatives' role during end-of-life decisions significantly reduced their risk of developing PTSD-related symptoms.
ClinicalTrials.gov; No.: NCT02329418; URL: www.clinicaltrials.gov).
在 ICU 死亡患者的家属中，创伤后应激障碍（PTSD）的症状很常见。
描述亲属在临终决策中的作用的小册子是否可以降低他们出现 PTSD 相关症状的风险？
在这项评估员设盲、随机对照试验中，纳入了 90 名预计将面临临终决策的成年患者的亲属。亲属被随机分配接受口头信息以及解释临终决策由医生做出的信息小册子（第 1 组，n=45）或单独接受口头信息（第 2 组，n=45）。在患者死亡后 90 天，使用事件影响量表（评分范围为 0 [表示无症状]至 75 [表示严重症状]）盲法评估 PTSD 相关症状。使用医院焦虑和抑郁量表评分（范围为 0-21 [得分越高表示症状越差]）评估焦虑和抑郁症状。
第 90 天，第 1 组出现 PTSD 相关症状的亲属人数明显少于第 2 组：45 人中 18 人 vs 45 人中 33 人（P=0.001）。第 2 组发生 PTSD 相关症状的风险比第 1 组高 1.8（95%CI，1.2-2.7）。与第 2 组相比，第 1 组的事件影响量表和医院焦虑和抑郁量表评分均值显著降低：28±10 vs 38±14（P<0.001）和 13±5 vs 17±8（P=0.023）。
描述亲属在临终决策中角色的信息小册子显著降低了他们出现 PTSD 相关症状的风险。
ClinicalTrials.gov；编号：NCT02329418；网址：www.clinicaltrials.gov）。
