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Complicated grief after death of a relative in the intensive care unit. | LitMetric

AI Article Synopsis

  • A study across 41 ICUs examined the prevalence and causes of complicated grief among relatives of 475 deceased patients, finding that 52% of those evaluated at 6 months showed symptoms of complicated grief.
  • The research utilized assessments at multiple time points, including the Inventory of Complicated Grief and scales for anxiety, depression, and PTSD symptoms.
  • Key factors contributing to complicated grief included treatment refusal by patients, the manner of death, and the quality of communication between medical staff and relatives, suggesting areas for potential improvement in end-of-life care.

Article Abstract

An increased proportion of deaths occur in the intensive care unit (ICU). We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months. Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives). End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements.

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Source
http://dx.doi.org/10.1183/09031936.00160014DOI Listing

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