All studies
RecruitingNAINTERVENTIONAL

Impact of a Protocol for Announcing Decision of Withholding and Withdrawing Life-sustaining Treatments on the Stress of the Relatives in the Emergency Departments

This study is looking at how to make difficult conversations in emergency departments better for families when a decision is made to stop life support for a loved one. When someone is very ill and doctors decide that further treatment won't help, it's a very stressful time, made harder by the fast-paced and sometimes unsuitable environment of an emergency room. This research will test a new way of training doctors and nurses. The training involves role-playing different scenarios and having families who have been through similar experiences help teach the staff. The main goal is to see if this new training can help reduce the stress and emotional impact on families when they hear these difficult announcements.

At a glance

Status
Recruiting
Phase
NA
Sponsor
Hospices Civils de Lyon
Enrolment target
538
Start
19 Jan 2024
Estimated completion
19 Jan 2026

What is this study about?

Imagine the emergency room – it's a busy, sometimes chaotic place. Doctors and nurses there sadly see death quite often. For many patients who pass away in the emergency room, the medical team has made a tough decision to stop or limit treatments because they know those treatments won't help anymore. This kind of conversation, where doctors explain that life support will be withdrawn, is incredibly hard for families. It often happens very quickly, in a stressful environment, and families aren’t prepared.

This study is designed to help improve how these conversations happen. We know from past research that when families hear news like this, especially in an emergency setting, it can cause a lot of stress, anxiety, and even lead to bigger emotional problems like Post-Traumatic Stress Disorder (PTSD). However, there isn't much information about how these announcements specifically affect families in the emergency room. We also know that good communication from medical staff can really make a difference in reducing these difficult feelings for families.

So, what's new here? This study is testing a special training program for doctors and nurses in the emergency department. This training will teach them a specific way to talk to families about stopping life support. It will involve practicing these conversations through role-playing, and importantly, it will also involve 'partner families' – real families who have been through similar experiences – to help teach and provide insights. The main idea is that if medical staff are better prepared and more confident in having these conversations, it will help reduce the stress and emotional impact on families during an incredibly difficult time.

Key takeaways

  • This study focuses on improving support for families during difficult end-of-life decisions in emergency rooms.
  • It tests new training for medical staff, including role-playing and input from experienced families.
  • The goal is to reduce stress and emotional impact on families when life-support decisions are discussed.
  • The study acknowledges the current difficulties and high stress for families in these emergency situations.
  • It explores how better communication from healthcare professionals can make a significant difference.

Who may be eligible?

This study is looking for two main groups of people to take part: family members and caregivers.

For family members, you could be included if you are a close relative, family member, or a 'trusted person' (someone the patient chose to make decisions) who is over 18 years old. You must be present in the emergency department when a doctor first tells you about the decision to limit or stop treatments for your loved one. The announcement must not have been made entirely over the phone, and you need to be able to understand and write in French. Certain people cannot take part, such as pregnant or breastfeeding women, those in legal detention, under psychiatric care, or those who cannot give their own consent due to legal protective measures.

For caregivers, this includes doctors and nurses working in the participating emergency departments. They also need to be over 18 years old and available to participate in the training.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

  1. Are you a close family member or a 'trusted person' present when this announcement was made?
  2. Are you 18 years old or older?
  3. Was the initial announcement made in person (not entirely by phone)?
  4. Are you able to understand and communicate in French for interviews?
  5. Are you not currently pregnant or breastfeeding?
  6. Are you not under any legal protection or psychiatric care that would prevent you from consenting?
Answer every question to see your result.

What does participation involve?

This study involves different things for different groups. For family members, if you meet the criteria, you would be invited to share your experience through an interview. This interview would help the researchers understand the impact of the announcement on you. For the medical staff, participation would involve taking part in a special training program. This training includes role-playing scenarios about discussing decisions to limit or stop life-sustaining treatments, and also learning from 'partner families' who have been through these experiences. The study aims to look at how this training changes things in the emergency department over time.

Potential risks and benefits

The main benefit of this study is the potential to improve how difficult news is shared with families in emergency departments. If the training works, it could significantly reduce stress, anxiety, and the risk of longer-term emotional problems for families during an already devastating time. For medical staff, it could improve their confidence and skills in handling these sensitive situations. There are no direct physical risks for participants. The main potential risk for families is the emotional discomfort of discussing a very difficult experience. However, the study aims to reduce, not increase, distress. Remember, you can choose to stop participating at any time.

Locations (9)

  • CHU Angers
    Verified postcode
    Angers, France· Recruiting
  • CH de Bourg-en-Bresse
    Verified postcode
    Bourg-en-Bresse, France· Recruiting
  • CHU de Clermont-Ferrand
    Verified postcode
    Clermont-Ferrand, France· Recruiting
  • CHU de Grenoble
    Verified postcode
    Grenoble, France· Recruiting
  • Groupement hospitalier centre, Hospices Civils de Lyon
    Verified postcode
    Lyon, France· Recruiting
  • Groupement hospitalier nord, Hospices Civils de Lyon
    Verified postcode
    Lyon, France· Recruiting
  • Groupement hospitalier sud, Hospices Civils de Lyon
    Verified postcode
    Lyon, France· Recruiting
  • CHU de Toulouse
    Verified postcode
    Toulouse, France· Recruiting
  • CH de Villefranche
    Verified postcode
    Villefranche-sur-Saône, France· Recruiting

Common questions

What does 'withdrawing life-sustaining treatments' mean?

This means medical decisions to stop or not start treatments that are keeping someone alive, because doctors believe those treatments are no longer helping or are causing more harm.

Why is this study needed?

Talking about stopping life support in an emergency room is very hard. This study wants to find a better way for staff to communicate, hoping to reduce stress for families during a difficult time.

What is 'human simulation'?

Human simulation is like role-playing. Medical staff practice difficult conversations with actors or other staff pretending to be family members, so they can improve their skills in a safe environment.

What are 'partner families'?

These are families who have personal experience with a loved one having life support decisions made in an emergency setting. They help teach medical staff by sharing their own insights and experiences.

Will taking part guarantee better care for my family?

While the study aims to improve care for all families in the long run, taking part does not guarantee specific individual benefits or changes to your loved one's care or your own experience during the study.

How to find out more

Marion MD DOUPLAT

Always speak to your GP or specialist before deciding to take part in a study.

Interested in taking part?

Register your interest

Share your details and the research team for "Impact of a Protocol for Announcing Decision of Withholding …" will contact you if you may be eligible. Always speak to your GP before agreeing to take part.

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