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Cited by 347Grief, Bereavement, and Mental HealthPalliative Care and End-of-Life IssuesDeath, Funerary Practices, and Mourning

Complicated grief after death of a relative in the intensive care unit

Open access
Kentish-Barnes, Nancy, Chaize, Marine, Seegers, Valérie, Legriel, Stéphane, Cariou, Alain, Jaber, Samir, Lefrant, Jean-Yves, Floccard, Bernard +30 more·2015·European Respiratory Journal
DOI 10.1183/09031936.00160014
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Abstract

An increased proportion of deaths occur in the intensive care unit (ICU). We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months. Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives). End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements.

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  • The circumstances of ICU family surrogates heighten their risk of anxiety, depression, PTSD, Prolonged Grief Disorder, and decisional regret about the care the patient received.

    “These circumstances heighten surrogates' risk of anxiety, depression, Posttraumatic Stress Disorder (PTSD), Prolonged Grief Disorder, and decisional regret about the care that the patient received (2-10).”

    From EMPOWER: A Multi-Site Pilot Trial to Reduce Distress in Surrogate Decision-Makers in the ICU (2024) · cites this paper as [6]

    The Introduction and Discussion report anxiety, depression, PTSD symptoms, and a high frequency of complicated-grief symptoms among relatives of patients who died in the ICU. The paper does not establish a diagnosis of Prolonged Grief Disorder or address decisional regret about the patient's care (searched: “decisional regret,” “regret,” and “surrogate decision-making”). (LLM, conf=0.87)

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  • Mourners who had not had a chance to say farewell to a person who had died in an intensive care unit were two to three times more likely to develop PGD.

    “One study revealed that mourners who had not had a chance to say farewell to a person who had died in an intensive care unit were two to three times more likely to develop PGD (Kentish-Barnes et al., 2015).”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Kentish-Barnes et al., 2015

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Research works printed but not linked: 2

  1. [27]27. Zisook S, Simon NM, Reynolds CF 3rd, et al. Bereavement, complicated grief, and DSM, part 2: complicated grief. J Clin Psychiatry 2010; 71: 1097-1098.
  2. [55]55. Parkes CM. Bereavement in adult life. BMJ 1998; 316: 856-859.

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Authors
Kentish-Barnes, N., Chaize, M., Seegers, V., Legriel, S., Cariou, A., Jaber, S., Lefrant, J.-Y., Floccard, B., Renault, A., Vinatier, I., Mathonnet, A., Reuter, D., Guisset, O., Cohen-Solal, Z., Cracco, C., Seguin, A., Durand-Gasselin, J., Éon, B., Thirion, M., Rigaud, J.-P., Philippon-Jouve, B., Argaud, L., Chouquer, R., Adda, M., Dedrie, C., Georges, H., Lebas, E., Rolin, N., Bollaert, P.-E., Lecuyer, L., Viquesnel, G., Léone, M., Chalumeau-Lemoine, L., Garrouste, M., Schlemmer, B., Chevret, S., Falissard, B., & Azoulay, É.
ORCID
Venue
European Respiratory Journal
Publisher
European Respiratory Society (ERS)
Published
2015-01-22
Volume
45
Issue
5
Pages
1341-1352
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
DOI
10.1183/09031936.00160014
OpenAlex
W2119413684
Semantic Scholar
60c7ab9c8b5f31be024e7c0246725e321502c6a5
Cited by
347
References
64
Citations by year
2026: 17 · 2025: 26 · 2024: 50 · 2023: 42 · 2022: 42 · 2021: 46 · 2020: 57 · 2019: 19 · 2018: 14 · 2017: 12 · 2016: 12 · 2015: 9
FWCI
19.31
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Funders
French Minstry of Health
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
Keywords
complicated grief, ICU mortality, bereaved families, prevalence, end-of-life communication, physician-family communication, loneliness, post-traumatic stress disorder, anxiety and depression, treatment refusal, farewell
MeSH terms
Adult, Anxiety, Communication, Critical Care, Death, Depression, Family, Female, Grief, Humans, Intensive Care Units, Intubation, Male, Prospective Studies, Severity of Illness Index, Stress Disorders, Post-Traumatic, Treatment Refusal, Principal Component Analysis

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