Post Traumatic Stress Disorder Clinical Trial
Official title:
Psychological Impact in a Relative, Following the Announcement of the Death of a Loved One After Cardiac Arrest and the Early Request for Organ Donation: an Observational, Prospective Study
The fight against the scarcity of grafts is a major public health issue in France. Despite a
very good success rate of transplants from brain-dead donors or living donors, the waiting
time for transplantation continues to increase, leading to morbidity and mortality, as well
as medical costs. Since 2005, the BioMedicine Agency has implemented a protocol authorizing
kidney and liver samples taken from deceased donors after cardiac arrest (DDAC). This type of
sampling has become a common practice in several regions of France and Europe. In case of
DDAC, the sampling protocol poses a significant temporal constraint, since the patient must
be taken within 6 hours after the cardiac arrest. This constraint leads to a specific
organization of the announcement of the death and the request for non-opposition to the levy.
The brutal loss of a loved one is a potentially traumatic experience for family members. The
manifestations of the pathological components of mourning such as post-traumatic stress
disorder, anxio-depressive syndrome, pathological bereavement, are often expressed early in
the first year after the death of the loved one. Families of organ donor patients probably
represent a population at high risk for the expression of psychiatric conditions such as
post-traumatic stress disorder or pathological bereavement. The limited time available to
prepare relatives to make a decision could promote the expression of psychiatric morbidity in
the short or medium term. The data on this new transplantation procedure and its
psychological consequences are insufficient, and we consider that if a state of
post-traumatic stress occurred in more than 50% of parents, the procedure of announcement
would be reviewed. The purpose of this study is to test this hypothesis.
Most of the work on relatives of potential organ donors has focused on procedures for brain
death. Most of this work has focused on characterizing the determinants of acceptance or
refusal of organ donation in the family. The literature relating to the follow-up of
relatives of a patient after organ donation is very poor: very few studies have focused on
the psychological consequences and / or the psychological state of this population in the
period post-death. In addition, very few qualitative and quantitative studies make it
possible to evaluate the appearance of psychopathological manifestations related to the
announcement of death simultaneously with a request for organ removal. This research,
therefore, will make it possible to estimate the possible psychological impact on the
bereaved family as well as an assessment of the psychological state. A mixed methodology
(quantitative and qualitative) will make it possible to highlight explanatory factors of the
quantitative results.
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