Please select the eligibility criteria that correspond to the clinical trial below.
Title: ICU Diaries as a Therapeutic Intervention for Post Traumatic Stress Disorder Following Critical Illness
Brief Summary: The incidence of PTSD post ICU varies from unit to unit, however a significant number of patients have been shown to develop this disorder. Many patients do not recall their stay in ICU properly and yet can clearly recall nightmares, hallucinations or paranoid delusions, which may be very frightening for the patient to recall at a later stage. As yet, no interventional studies have had an impact on the development of PTSD in this population of patients. However, a recent observational multi-centre study suggested that those patients receiving a diary of their time in ICU had lower levels of symptoms of PTSD than those who did not. These results need to be verified in the form of a randomized study.


Options:
A: Inclusion Criteria:

* Patients staying on the ICU for at least 72 hours (with greater than 24 hours of artificial ventilation)

Exclusion Criteria:

* ICU stay \< 72 hours
* Too confused for informed consent
* Pre-existing psychotic illness
B: Patient inclusion criteria:

* age \>=18 and
* mechanical ventilation for more than 48 consecutive hours

Patient exclusions (pre-consent):

* current significant cognitive impairment (\>=3 errors on the Callahan scale) or lacks decisional capacity
* pre-existing significant cognitive impairment
* residence at location other than home before hospital admission
* need for a translator because of poor English fluency \[many study instruments are not validated in other languages\]
* expected survival \<3 months
* discharged to hospice (outpatient or inpatient)
* not liberated from mechanical ventilation at discharge

Additional patient exclusion criteria (present post-consent but pre-randomization):

* Patients will become ineligible if they become too ill to participate
* they develop significant cognitive disability, exhibit suicidality, they do not return home within 2 months after hospital discharge, or die.

Informal caregiver inclusion criteria:

* age \>=18 years
* person most likely to provide the most post-discharge care.

Exclusions for caregivers are:

* history of significant cognitive impairment
* English fluency poor enough to require a medical translator

Informal caregiver exclusion criteria present after consent but before randomization:

* no longer available
* become too ill to participate
* exhibit suicidality

A total of 200 patient-caregiver dyads (total cohort = 400) are targeted
C: Inclusion Criteria:

* Patients admitted with severe or multiple orthopedic trauma
* Patients who have received or will receive ≥1 surgical procedure for their orthopedic injuries
* Any major bone fractures that impairs mobility and/or participation in activities of daily living and self-care

Exclusion Criteria:

* Patients with a traumatic brain injury
* Patients with the inability to communicate effectively (e.g., at a level where self-report measures could be answered completely; such as medicated state or mechanically ventilated)
* Patients currently using psychotropic medications
* Patients with psychotic, suicidal or homicidal ideations.
D: Inclusion Criteria:

* Adults survivors of traumatic events

Exclusion Criteria:

* Traumatic brain injury
* Lifetime psychosis
* Life time (prior) PTSD
* Medical conditions forbidding SSRIs

Answer: A