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Interest of Pain Assessment by the Family of Patients in Limiting and Stopping Active Treatment Process Admitted in ER. Study DOFAMILA

Conditions
Patient's Pain in Later Life
Registration Number
NCT02844972
Lead Sponsor
Hospices Civils de Lyon
Brief Summary

Decisions to limit and stop active therapeutics are common in the emergency unit. They are framed by the Leonetti law of 22 April 2005 recommending the refusal of unreasonable obstinacy and care of the patient's pain in later life. The pain assessment is an issue for these patients whose in majority, are not communicating. Moreover, no specific tool and the teams in charge, not knowing the patient make the recognition and treatment of pain symptoms very complex. This is the potential interest of directly involving the family or the person of confidence in this management , the first step being the detection and evaluation of pain.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Adults older than 18
  • non communicating patients admitted in emergency ward
  • unanimous decision of stopping and limiting active treatment according to Leonetti's law of April 22nd, 2005
  • Presence of a member of the patients family or one of his legal representative
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Exclusion Criteria
  • Children
  • no health insurance
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Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
simplified verbal scaleadmission time in ER (Day 1)

A simplified verbal scale with 5 levels used by caregivers and family to evaluate the intensity of pain, "painless", "little sore", "moderately painful", "very painful", "extremely painful".

Compare the pain assessment by the family or the person of trust and care teams within a population of non-communicating patients for whom a decision of limiting and stopping active treatment is taken emergency ward.

Secondary Outcome Measures
NameTimeMethod
Algoplus scaleat admission (Day 1)

Comparison of pain assessment between families and caregivers with support will be made using Algoplus scale defining a pain when the score is greater than 2.

Compare the pain assessment by the family or the person of trust and care teams with the support of a rating scale in a population of non-communicating patients for whom a decision of limiting or stopping active treatment in emergencies.

CAESAR scale3 weeks after admission

The experience of the family will be described based on the questionnaire adapted from CAESAR scale ( rating scale of the quality of the care of the dying in intensive care) .

Assess the feelings of nursing teams on the family involvement in the assessment of pain and not communicating patient discomfort for which is a determination of limiting or stopping active treatment in emergencies.

PAINAD scaleat admission (Day 1)

Comparison of pain assessment between families and caregivers with support will be made using PAINAD scale rated from 0 to 10, defining the intensity of pain.

Compare the pain assessment by the family or the person of trust and care teams with the support of a rating scale in a population of non-communicating patients for whom a decision of limiting or stopping active treatment in emergencies

simplified verbal scale24 hours after the decision of limiting or stopping active treatment in emergencies

A simplified verbal scale with 5 levels used by caregivers and family to evaluate the intensity of pain, "painless", "little sore," "moderately painful", "very painful", "extremely painful ".

Compare the pain assessment by the family or the person of trust and care teams within a population of non-communicating patients 24 hours after the decision of limiting or stopping active treatment in emergencies

Trial Locations

Locations (1)

ER unit Hospital Edouard Herriot, Hospices Civils de Lyon

🇫🇷

Lyon, France

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