End Of Life in the Critically Ill patiEnt

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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End Of Life in the Critically Ill patiEnt

Conditions
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Terminal Illness, Intensive Care Unit Syndrome

Intervention / Treatment
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* Other: Assessment by caregivers of the quality of the end of life in intensive care units


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Assessment by caregivers of the quality of the end of life in intensive care units|Quality of the end of life in intensive care units perception will be explore from the side of the caregivers, trough the CAESAR scale.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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. | Depending of end-of-life duration, usually 6 hours. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 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 | Depending of end-of-life duration, usually 6 hours. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Critical care