Nancy Kentish-Barnes1, Zoé Cohen-Solal1, Virginie Souppart1, Marion Galon1, Benoît Champigneulle2, Marina Thirion3, Marion Gilbert4, Olivier Lesieur5, Anne Renault6, Maïté Garrouste-Orgeas7,8, Laurent Argaud9, Marion Venot10, Alexandre Demoule11,12, Olivier Guisset13, Isabelle Vinatier14, Gilles Troché15, Julien Massot16, Samir Jaber17, Caroline Bornstain18, Véronique Gaday19, René Robert20, Jean-Philippe Rigaud21, Raphaël Cinotti22, Mélanie Adda23, François Thomas24, Elie Azoulay1,25. 1. Famiréa Research Group, Assistance Publique - Hôpitaux de Paris, Saint-Louis University Hospital, Paris, France. 2. Medical Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Cochin University Hospital, Paris, France. 3. Intensive Care Unit, Victor Dupouy Hospital, Argenteuil, France. 4. Intensive Care Unit, Sud Francilien Hospital, Corbeil-Essonnes, France. 5. Intensive Care Unit, La Rochelle Hospital, La Rochelle, France. 6. Medical Intensive Care Unit, Cavale Blanche University Hospital, Brest, France. 7. French British Institute Hospital, Levallois-Perret, France. 8. Infection, Antimicrobials, Modelling, Evolution (IAME), UMR 1137, INSERM and Paris Diderot University, Department of Biostatistics - HUPNVS. - AP-HP, UFR de Médecine - Bichat University Hospital, Paris, France. 9. Medical Intensive Care Unit, Hospices Civils de Lyon, Edouard Herriot Hospital and Lyon Est University, Lyon, France. 10. Medical Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Saint-Louis University Hospital, Paris, France. 11. Medical Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, La Pitié-Salpêtrière University Hospital, Paris, France. 12. Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS1158, Paris, France. 13. Medical Intensive Care Unit, Saint André University Hospital, Bordeaux, France. 14. Intensive Care Unit, Les Oudairies Hospital, La Roche-sur-Yon, France. 15. Intensive Care Unit, Versailles Hospital, Versailles, France. 16. Cardio-surgical Intensive Care Unit, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France. 17. Surgical Intensive Care Unit, Saint Eloi University Hospital, and Inserm U-1046, Montpellier, France. 18. Intensive Care Unit, Le Raincy-Montfermeil Hospital, Montfermeil, France. 19. Intensive Care Unit, René-Dubos Hospital, Pontoise, France. 20. Medical Intensive Care Unit, Poitiers University Hospital and Poitiers University and Inserm CIC 1402, Poitiers, France. 21. Intensive Care Unit, Dieppe Hospital, Dieppe, France. 22. Surgical Intensive Care Unit, Hôtel Dieu University Hospital, Nantes, France. 23. Medical Intensive Care Unit, Assistance Publique - Hôpitaux de Marseille, Hôpital Nord University Hospital, Marseille, France. 24. Medical Intensive Care Unit, Sud Amiens University Hospital, Amiens, France. 25. Biostatistics and Clinical Epidemiology research (ECSTRA) team, U1153, INSERM, Paris Diderot Sorbonne University, Paris, France.
Abstract
OBJECTIVES: Family members of patients who die in the ICU often remain with unanswered questions and suffer from lack of closure. A letter of condolence may help bereaved relatives, but little is known about their experience of receiving such a letter. The objective of the study was to understand bereaved family members' experience of receiving a letter of condolence. DESIGN: Qualitative study using interviews with bereaved family members who received a letter of condolence and letters written by these family members to the ICU team. This study was designed to provide insight into the results of a larger randomized, controlled, multicenter study. SETTING:Twenty-two ICUs in France. SUBJECTS:Family members who lost a loved one in the ICU and who received a letter of condolence. MEASUREMENTS AND MAIN RESULTS: Thematic analysis was used and was based on 52 interviews and 26 letters. Six themes emerged: 1) a feeling of support, 2) humanization of the medical system, 3) an opportunity for reflection, 4) an opportunity to describe their loved one, 5) continuity and closure, and 6) doubts and ambivalence. Possible difficulties emerged, notably the re-experience of the trauma, highlighting the absence of further support. CONCLUSIONS: This study describes the benefits of receiving a letter of condolence; mainly, it humanizes the medical institution (feeling of support, confirmation of the role played by the relative, supplemental information). However, this study also shows a common ambivalence about the letter of condolence's benefit. Healthcare workers must strive to adapt bereavement follow-up to each individual situation.
RCT Entities:
OBJECTIVES: Family members of patients who die in the ICU often remain with unanswered questions and suffer from lack of closure. A letter of condolence may help bereaved relatives, but little is known about their experience of receiving such a letter. The objective of the study was to understand bereaved family members' experience of receiving a letter of condolence. DESIGN: Qualitative study using interviews with bereaved family members who received a letter of condolence and letters written by these family members to the ICU team. This study was designed to provide insight into the results of a larger randomized, controlled, multicenter study. SETTING: Twenty-two ICUs in France. SUBJECTS: Family members who lost a loved one in the ICU and who received a letter of condolence. MEASUREMENTS AND MAIN RESULTS: Thematic analysis was used and was based on 52 interviews and 26 letters. Six themes emerged: 1) a feeling of support, 2) humanization of the medical system, 3) an opportunity for reflection, 4) an opportunity to describe their loved one, 5) continuity and closure, and 6) doubts and ambivalence. Possible difficulties emerged, notably the re-experience of the trauma, highlighting the absence of further support. CONCLUSIONS: This study describes the benefits of receiving a letter of condolence; mainly, it humanizes the medical institution (feeling of support, confirmation of the role played by the relative, supplemental information). However, this study also shows a common ambivalence about the letter of condolence's benefit. Healthcare workers must strive to adapt bereavement follow-up to each individual situation.