Quality of Dying in the Intensive Care Unit: Validation of the CAESAR Scale

Study Overview
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Brief Summary
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The purpose of the study is to evaluate the quality of the dying process in french ICUs (assessed by the CAESAR scale) and to compare physicians', nurses' and relatives perceptions and experiences, with a one-year follow-up of bereaved relatives. Our hypothesis is that perception of the quality of dying may impact on relatives' experience of bereavement (anxiety, depression, complicated grief, posttraumatic stress disorder (PTSD)).

Detailed Description
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Seventy percent of all deaths occur in the hospital environment, and amongst them 20% occur in intensive care units (ICU). In France, no studies have evaluated the quality of the end-of-life process from both the professional and the lay perspective. The CAESAR scale has been developed from literature reviews and qualitative interviews with relatives, physicians and nurse to assess quality of dying in ICU. Our hypothesis is that perception of the quality of dying may impact on relatives' experience of bereavement (anxiety, depression, complicated grief, PTSD).

Official Title
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End-of-life in French Intensive Care Units: Perception of the Quality of Dying and Experience of Physicians, Nurses and Relatives. Validation of the CAESAR Scale

Conditions
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Anxiety, Depression, Posttraumatic Stress Disorder

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients Deceased in the ICU after at least 48 hours of ICU stay At least one visit of a relative in the ICU Exclusion Criteria: no French-speaking relative

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ICU staff and relatives<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CAESAR score | Score on the 32-item CAESAR scale assessing quality of end-of-life process | Within 3 weeks after patient's death | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Job strain of the physicians and nurses in charge of the patient | Score on the Job strain, a validated scale assessing stress in work environment | within 3 weeks following patient's death | 
| Anxiety and depression | Anxiety and depression of the relative, assessed by the Hospital Anxiety and Depression Scale (HADS) | 3 months after patient's death | 
| Post Traumatic Stress Disorder | PTSD of relatives assessed by Inventory of Event Scale revised (IES-R) | 3 months after patient's death | 
| Complicated Grief | Complicated grief assessed by the Inventory of Complicated Grief (ICG) scale | 6 months after patients' death | 
| PTSD | PTSD assessed by IES-R | 6 months after patient's death | 
| PTSD | PTSD assessed by IES-R | 12 months after patient's death | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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PTSD