End Of Life in the Critically Ill patiEnt

French Society for Intensive Care514 enrolled

Overview

The purpose of this multicentric study is to evaluate the perception of the quality of the end of life in intensive care units seen from the side of the caregivers, trough the CAESAR scale.

More than 20% of deaths occur in hospital after a stay in intensive care units; up to half of them happens as result of a treatment limitation. Ensuring end-of-life quality is important, not only because is a moral duty of all caregivers, but also to prevent negative effects in close relatives of dead patients. In an assessment of quality of in-hospital deaths involving 3793 patients, only 35% of the deaths were judged to be of acceptable quality by the nurses. Assessment tools have been developed recently on this topic. Most studies have focused on the perception of end-of-life quality by close relatives, particularly through the CAESAR scale in the most recent one. The main purpose of this multicentric study is to evaluate the perception of the quality of the end-of-life in intensive care units seen from the side of the caregivers, in relation to the new French legislative framework.

Study Type

OBSERVATIONAL

Enrollment

514

Conditions

Terminal Illness Intensive Care Unit Syndrome

Interventions

Assessment by caregivers of the quality of the end of life in intensive care unitsOTHER

Quality of the end of life in intensive care units perception will be explore from the side of the caregivers, trough the CAESAR scale.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Caregivers of intensive care unit whose patient has recently deceased Exclusion Criteria: * Refusal of participation by caregivers * Refusal of participation by family of deceased patient * Patient in cardiac arrest at the time of ICU admission. * Age of deceased patient was under 18 years * Patient in brain death

Locations (112)

Outcomes

Primary Outcomes

15 items questionnaire CAESAR

The CAESAR scale assesses perceptions of palliative stage of patient's pathology, of patient's comfort, of presence and care of close relatives, with a score for each item ranging from 1 (traumatic experience) to 5 (soothing). The purpose of our study is to assess the perception of end-of-life quality seen from the caregivers' side, using the CAESAR scale.

Time frame: Depending of end-of-life duration, usually 6 hours.

Secondary Outcomes

Variables associated with the perception by caregivers of end-of-life quality

Evaluate the variables associated with the perception by caregivers of end-of-life quality: proportion of treatment limitations, frequencies of conflicts between close relatives of dead patients and caregivers, frequencies end-of-life deep sedations, detailed description of current sedation practices, proportion of treatments, monitoring and blood tests maintained after treatment limitation during end-of-life .

Time frame: time needed for the enrollment of caregivers of 5 to 15 consecutive deceased patients per center (depending on the size of the center): usually 1 month

Analogic visual scale (0 to 10)

Analogic visual scale on end-of-life quality seen from the caregiver's side

Time frame: Depending of end-of-life duration, usually 6 hours.

Data from ClinicalTrials.gov

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