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STRESS From in Charge Relative Facing the Announcement of Decisions Limiting or Stopping Treatments in Emergency Room During the COVID-19 Epidemic

Not Applicable
Conditions
Anxiety
Covid19
Post Traumatic Stress Disorder
Interventions
Other: Post traumatic, Anxiety and depression evaluation
Registration Number
NCT04785807
Lead Sponsor
Hospices Civils de Lyon
Brief Summary

In the context of the COVID-19 pandemic, the emergency reception services had to be radically reorganized. In this tense environment, professionals must face ethical dilemmas, make referral decisions and prioritize patients. Due to the limited number of visits to many hospitals, interactions with relatives and families of patients are mainly conducted by phone. These limitations will continue as long as the context of uncertainty over the course of the pandemic persists. Limitation or discontinuation of treatment (LDT) announcements were therefore also impacted and the exceptional situation related to COVID-19 reinforces the difficulties encountered by professionals in usual time (place of announcement, inappropriate lack of time, etc.). Thus, LDTs are most often done over the phone without the families being able to go to the hospital. Because of this, these announcements can be more traumatic. Investigators have already highlighted in a recent study the lack of communication between caregivers and families in the context of LDT announcements and the context of COVID 19 exacerbated these aspects given the limitations of visits.

The investigators therefore propose to study the experiences of families who are notified of a decision to limit or stop treatment by phone in the emergency room during the COVID-19 crisis.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
140
Inclusion Criteria
  • Age over 18 years old.
  • Person of trust designated in writing or contact person if designated by the family or primary caregiver or failing that the family member or person of trust of an adult patient deemed unfit to receive the information (advanced dementia (lower MMS) to 10), disturbance of consciousness). Only one person per family will be included.
  • having been informed of a LAT decision in the emergency room by telephone during the pandemic
  • Having consented to participate in the study
  • Affiliated with social security
Read More
Exclusion Criteria
  • Person of trust, family or close friend unable to understand or write in French.
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Evaluation armPost traumatic, Anxiety and depression evaluation-
Primary Outcome Measures
NameTimeMethod
Post traumatic syndrome evaluated thanks to the Revised impact event scale (IES-R)30 days after limitation or discontinuation of treatment announcement

The primary endpoint is the evaluation of Post traumatic syndrome among the family member or person of trust of a patient who received a limitation or discontinuation of treatment, 30 days after this announcement. The post traumatic syndrome will be evaluated thanks to the Revised impact event scale (IES-R) giving a score going from 0 to 88. The greater the score, the worse the outcome is.

Secondary Outcome Measures
NameTimeMethod
Depression level at day 7, assessed using the Hospitalized Anxiety and Depression Scale7 days after inclusion

Evaluation of Depression among the family member or person of trust of a patient who received a limitation or discontinuation of treatment 7 days after this announcement, using the Hospitalized Anxiety and Depression Scale, giving two scores (one for anxiety, one for depression) going from 0 to 21. The greater the score, the worse the outcome is.

Anxiety level at day 30, assessed using the Hospitalized Anxiety and Depression Scale (HADS)30 days after inclusion

Evaluation of Anxiety among the family member or person of trust of a patient who received a limitation or discontinuation of treatment 30 days after this announcement, using the Hospitalized Anxiety and Depression Scale, giving two scores (one for anxiety, one for depression) going from 0 to 21. The greater the score, the worse the outcome is.

Description of clinical factors30 days after inclusion

In order to determine anxiety and depression risk factors, the factors linked to the patient (COVID infection, death) will be described.

Anxiety level at day 7, assessed using the Hospitalized Anxiety and Depression Scale-(HADS)7 days after inclusion

Evaluation of Anxiety among the family member or person of trust of a patient who received a limitation or discontinuation of treatment, 7 days after this announcement. Anxiety will be assessed using the Hospitalized Anxiety and Depression Scale, giving two scores (one for anxiety, one for depression) going from 0 to 21. The greater the score, the worse the outcome is.

Depression level at day 30, assessed using the Hospitalized Anxiety and Depression Scale (HADS)30 days after inclusion

Evaluation of Depression among the family member or person of trust of a patient who received a limitation or discontinuation of treatment, 30 days after this announcement. Anxiety will be assessed using the Hospitalized Anxiety and Depression Scale, giving two scores (one for anxiety, one for depression) going from 0 to 21. The greater the score, the worse the outcome is.

Description of socio-demographic factors30 days after inclusion

In order to determine anxiety and depression risk factors, the individual socio-demographic factors such as recourse to psychological support, consumption of psychoactive substances (caffeine, tobacco, psychotropic drugs, anxiolytics) will be described.

Trial Locations

Locations (3)

Service des urgences, H么pital Edouard Herriot, Hospices Civils de Lyon

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Lyon, France

service des urgences, H么pital de la Croix-Rousse, Hospices Civils de Lyon

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Lyon, France

Service d'Accueil des Urgences, H么pital Lyon Sud, Hospices Civils de Lyon

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Pierre-B茅nite, France

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