Information pamphlet given to relatives during the end-of-life decision in the ICU: An assessor-blinded, randomized controlled trial.

Abstract Background Symptoms of post-traumatic stress disorder (PTSD) are common in family members of patients who have died in the intensive care unit (ICU). Research question Could a pamphlet describing the role of relatives in the end-of-life decision decrease their risk of developing PTSD-related symptoms? Study design and Methods: In this assessor-blinded, randomized controlled trial, 90 relatives of adult patients for whom an end-of-life decision was anticipated were enrolled. Relatives were randomly assigned to receive, in addition to oral information, an information pamphlet explaining that the end-of-life decision is made by physicians (Group 1; n=45), or oral information alone (Group 2; n=45). PTSD-related symptoms were blindly assessed at 90 days after the patient’s death using the Impact of Event Scale (IES; scores range from 0, indicating no symptoms, to 75, indicating severe symptoms). Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS) score (range 0–21; higher scores indicate worse symptoms). Results On day 90, the number of relatives with PTSD-related symptoms was significantly lower in Group 1 than in Group 2: 18/45 versus 33/45 (P=0.001). The risk ratio of having PTSD-related symptoms in Group 2 compared with Group 1 was 1.8 [95% confidence interval, 1.2 to 2.7]. The mean IES and HADS scores were significantly reduced in Group 1 compared with Group 2: 28±10 versus 38±14 (P Interpretation An information pamphlet describing the relatives’ role during end-of-life decisions significantly reduced their risk of developing PTSD-related symptoms.