Tissue and Organ Procurement Clinical Trial
— CARE-M3Official title:
Experience of Relatives and Caregivers of Death in ICU After the Withdrawal of Life-sustaining Therapies, Associated With an Organ Procurement Procedure (Controlled Donation After Circulatory Death).
Verified date | February 2024 |
Source | Assistance Publique - Hôpitaux de Paris |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Controlled donation after circulatory death (cDCD) refers to organ donation (OD) from patients whose death is defined using circulatory criteria and from whom circulatory death occurs after a planned withdrawal of life-sustaining therapies (WLST) in intensive care units (ICUs). During cDCD, the patient is still alive while OD process is being discussed and organized. Caregivers can be particularly uncomfortable in this scenario. In the specific context of cDCD, developing knowledge on the perceptions and experiences of relatives and ICU caregivers regarding OD is crucial but remains poorly investigated. Investigators propose to conduct a prospective multicentric observational research to better understand relatives' and ICU caregivers' experience of cDCD. Better understanding their perceptions and experiences will enable to develop interventions to support and guide them throughout this practice.
Status | Active, not recruiting |
Enrollment | 367 |
Est. completion date | May 20, 2025 |
Est. primary completion date | May 20, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 70 Years |
Eligibility | Inclusion Criteria: Any situation of anticipated death of a patient in Intensive Care Unit ICU due to circulatory arrest: - For which a decision to withdraw Life-Sustaining Therapies LST was taken under the Claeys-Leonetti law, notified to relatives and accepted by relatives - With a first evaluation by the hospital coordination of organ and tissue removal identifying the patient at the end of life as a potential donor: patient identified under the age of 70, with no absolute contraindication to organ removal in the context of an M3 procedure - For which Organ Donation OD has been discussed with the relatives, whether the OD finally occurred. - Relative and/or caregiver who has given non-objection to the use of the data. Exclusion Criteria: - None |
Country | Name | City | State |
---|---|---|---|
France | APHP - Lariboisière hospital - réanimation chirurgicale | Paris |
Lead Sponsor | Collaborator |
---|---|
Assistance Publique - Hôpitaux de Paris | Agence de La Biomédecine, Fondation de France |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Hetero-evaluation of the relative using the IES-R scale | Hetero-evaluation of the relative with the IES-R score (Impact of. Event Scale - Revised score). Assessment is performed by telephone interview with an experienced psychologist. This scale measures the risk for the relative of exhibiting symptoms of post-traumatic stress disorder. | 3 months after patient's death | |
Primary | Self-report of the caregiver using the STAI inventory | The caregiver self-assess by responding confidentially to a questionnaire: the STAI inventory (State-Trait Anxiety Inventory). This questionnaire measures their risk of developing anxiety relating to the event. | within 72 hours following the patient's death | |
Secondary | Hetero-evaluation of the relative using the HADS anxiety-depression scales | Hetero-evaluation of the relative with the Hospital Anxiety and Depression scales (HADS). Assessment is performed by telephone interview with an experienced psychologist. It measures symptoms of anxiety and depression. | 3 months after patient's death | |
Secondary | Hetero-evaluation of the relative using the CAESAR end-of-life quality scale | Hetero-evaluation of the relative with the CAESAR end-of-life quality scale which assess the quality of end-of-life care in intensive care. Assessment is performed by telephone interview with an experienced psychologist. | 3 months after patient's death | |
Secondary | Hetero-evaluation of the relative using the questionnaire survey | Assessment is performed by telephone interview with an experienced psychologist.
It consists in a questionnaire of around sixty questions assessing the following themes: progress of the end-of-life process, solicitation / discussion around organ donation, understanding of the process, end-of-life experience, support, relationship with caregivers, questions a posteriori. |
3 months after patient's death | |
Secondary | Hetero-evaluation of the relative using the HADS anxiety-depression scales | Hetero-evaluation of the relative with the Hospital Anxiety and Depression scales (HADS). Assessment is performed by telephone interview with an experienced psychologist. It measures symptoms of anxiety and depression. | 6 months after patient's death | |
Secondary | Hetero-evaluation of the relative using the IES-R scale | Hetero-evaluation of the relative with the IES-R score (Impact of. Event Scale - Revised score). Assessment is performed by telephone interview with an experienced psychologist. This scale measures the risk for the relative of exhibiting symptoms of post-traumatic stress disorder. | 6 months after patient's death | |
Secondary | Hetero-evaluation of the relative using the PG-13 scale | Hetero-evaluation of the relative with the PG-13 scale (Prolonged Grief Disorder) which measures complicated mourning. Assessment is performed by telephone interview with an experienced psychologist. | 6 months after patient's death | |
Secondary | Semi-structured interview with relative | 20 relatives are selected among the included relatives to undergo a semi-structured interview conducted by an experienced psychologist in order to understand the experience of loved ones, the meaning given to the procedure, the impact of this procedure on the grieving process. These interviews will be carried out by phone call 6 months after the death within a maximum period of 12 months. | from 6 to 12 months after patient's death | |
Secondary | Self-evaluation of the caregiver by questionnaire survey | A 29-question questionnaire is completed confidentially by the caregiver. The questionnaire addresses the following topics: perception and experience of the withdrawal of life-sustaining therapies (WLST), decision-making process; perception and experience of implementing the decision; perception and experience of soliciting families; experience of the dying process; experience of the role played and involvement of different caregivers during the different stages of the process; difficulties encountered and regrets; elements of satisfaction; aspects to improve. | within 72 hours following the patient's death | |
Secondary | Semi-structured interview with caregiver | 20 caregivers (10 medical staff and 10 paramedical staff and / or until saturation) are selected among the included caregivers in Ile de France to undergo a semi-structured interview conducted by an experienced psychologist. | from 6 to 12 months after patient's death |
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