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Guiding intensive care physicians' communication and behavior towards bereaved relatives: study protocol for a
Nancy Kentish-Barnes1, Sylvie Chevret2, Elie Azoulay3,2
1AP-HP, Saint Louis University Hospital, Medical Intensive Care Unit, Famiréa Group, 1 avenue Claude Vellefaux, Paris, France. nancy.kentish@aphp.fr.
Trials
|December 23, 2018
Summary
Physician-led support for families of intensive care unit (ICU) patients can reduce prolonged grief and post-ICU distress. This intervention aims to improve end-of-life communication and lessen the burden on bereaved relatives.
Area of Science:
- Critical Care Medicine
- Palliative Care
- Psychology
Background:
- End-of-life care in intensive care units (ICUs) presents significant challenges for intensivists and bereaved families.
- Relatives of non-surviving patients often experience prolonged grief, PTSD, anxiety, and depression.
- Effective support strategies are crucial to mitigate the psychological burden on grieving families.
Purpose of the Study:
- To evaluate a physician-driven, three-step intervention for families of ICU patients.
- To determine if this intervention reduces the post-ICU burden, specifically prolonged grief, in bereaved relatives 6 months after death.
- To assess improvements in end-of-life communication and other psychological outcomes.
Main Methods:
- A prospective, multicenter, cluster randomized controlled trial (COSMIC-EOL) involving 36 centers.
- Intervention group: three-step physician-driven support during the dying process.
- Control group: standard of care. Relatives followed up at 1, 3, and 6 months post-death.
Main Results:
- The study will provide data on the effectiveness of the physician-driven support intervention.
- Primary outcome: reduction in prolonged grief at 6 months post-death (PG-13).
- Secondary outcomes include quality of dying, communication, anxiety, depression, and PTSD.
Conclusions:
- The trial is expected to demonstrate a significant decrease in the ICU burden for bereaved relatives receiving the intervention.
- Findings will inform best practices for end-of-life care and support in critical care settings.
- This research highlights the potential of structured physician-led support to improve outcomes for grieving families.