The HELLP concept - relatives of deceased donors need the Help Earlier in parallel with Loss of a Loved Person.

ABSTRACT

BACKGROUND: Adequate communication with donors' relatives in the intensive care unit can crucially increase the number of donations and can influence the relatives' grief reaction and depression. The aim of this quantitative investigation was to explore how communication in the ICU about brain death and consent to donation affected family members' psychological condition. MATERIAL/METHODS: The self-completed questionnaire, which the donors' relatives filled in 3-6 months after donation consisted of demographic data, participants' knowledge, opinions about and attitudes toward donation, communication in the ICU regarding brain death and donation, and 2 psychometric inventories the Hungarian-translated version of the Revised Grief Experience Inventory and the Hungarian adaptation of the Shortened Version of the Beck Depression Inventory. RESULTS: Before organ recovery, 100% of the 29 participants supported donation, but 24.1% considered donation for transplantation to be unhelpful, and 41.4% doubted that the diagnosis was reliable after donation. Bereavement and depression did not correlate with age, marital status or degree of religiousness. Females had higher "physical distress" and more severe depression. The psychological reaction was lower amongst relatives with higher education. Depressive symptoms occurred in 72.4% of participants. Individuals who did not have confidence in the brain death diagnosis had more intense grief reaction (p=0.020) and more serious depressive symptoms (p=0.002). CONCLUSIONS: To decrease the negative psychological impact of donation, relatives need the Help Earlier in parallel with the Loss of Loved Person. The first step of the "HELLP" concept is to establish adequate communication; consequently, the physicians' education about communication is essential.