Coping by relatives of critical care patients

OBJECTIVE: To describe the coping strategies used by the relatives of patients hospitalized in an intensive care unit. METHODS: This is a descriptive study that uses a convenience sample and both qualitative and quantitative methods. The study was conducted at a tertiary university hospital in Brazil. Participants included 41 relatives who were selected during the first 96 hours of patient hospitalization in the intensive care unit. RESULTS: The participants reported that they more frequently used Coping Strategies Based on the Stressor, followed by Religiosity/Fantasy Thinking and Seeking for Social Support. There was a statistically significant relationship (P <.01) between the use of the strategy Seeking for Social Support and elevated Acute Physiology, Age, and Chronic Health Evaluation 11 scores. Qualitative analysis allowed a clearer understanding of the relation between the patient`s condition and changes in the coping strategies used by the patient`s relatives. CONCLUSION: This study describes the coping strategies used by patients` relatives during the early hospitalization period. This investigation allowed for a better understanding of the relatives` psychologic aspects and their relation with the patient`s clinical condition. The results shall assist the design of specific interventions directed at facilitating positive coping responses on the part of relatives. (Heart Lung (R) 200 38:217-227.)

Rationale and design of a randomized placebo-controlled trial assessing the effects of etiologic treatment in Chagas` cardiomyopathy: The BENznidazole Evaluation For Interrupting Trypanosomiasis (BENEFIT)

Background Benznidazole is effective for treating acute and chronic (recently acquired) Tryponosoma cruzi infection (Chagas` disease). Recent data indicate that parasite persistence plays a pivotal role in the pathogenesis of chronic Chagas` cardiomyopathy. However, the efficacy of trypanocidal therapy in preventing clinical complications in patients with preexisting cardiac disease is unknown. Study Design BENEFIT is a multicenter, randomized, double-blind, placebo-controlled clinical trial of 3,000 patients with Chagas` cardiomyopathy in Latin America. Patients are randomized to receive benznidazole (5 mg/kg per day) or matched placebo, for 60 days. The primary outcome is the composite of death; resuscitated cardiac arrest; sustained ventricular tachycardia; insertion of pacemaker or cardiac defibrillator; cardiac transplantation; and development of new heart failure, stroke, or systemic or pulmonary thromboembolic events. The average follow-up time will be 5 years, and the trial has a 90% power to detect a 25% relative risk reduction. The BENEFIT program also comprises a substudy evaluating the effects of benznidazole on parasite clearance and an echo substudy exploring the impact of etiologic treatment on left ventricular function. Recruitment started in November 2004, and >1,000 patients have been enrolled in 35 centers from Argentina, Brazil, and Colombia to date. Conclusion This is the largest trial yet conducted in Chagas` disease. BENEFIT will clarify the role of trypanocidal therapy in preventing cardiac disease progression and death.