Please select the eligibility criteria that correspond to the clinical trial below.
Title: Improving Family Outcomes With a Communication Intervention in the Pediatric ICU
Brief Summary: This project is evaluating the effect of a standardized communication intervention in the pediatric intensive care unit (PICU) on long-term distress of family members of children in the PICU for 5 days or longer. The study hypothesis is that intervention families will have lower (better) acute stress disorder scores when their child is discharged from the PICU and lower (better) post-traumatic stress disorder scores at 3-month follow-up, as compared to the control group families. The investigators will recruit 220 families (110 in each of the control and intervention groups). Families who are randomized to the intervention group will receive routine visits from members of the PACT (palliative care) team at least three times/week to address psychosocial needs, keep families informed about their child's health status, and offer emotional and instrumental support and resources. Families in the control group will receive usual care in the PICU. The intervention will end whenever the child is discharged from the PICU, which usually happens within 3 weeks of enrollment. The investigators will assess family outcomes at discharge from the PICU and 90 days after study enrollment. The investigators will conduct two additional activities to learn more about the processes of care for those in both the intervention and control groups. First, during the intervention, the investigators will recruit 30 families (15 in each group) and ask permission to audio-record the family care conferences to assess communication styles and gain greater insight into the differences in practice with or without the participation of the intervention team. The investigators will obtain additional consent from participants in these family conferences who are not otherwise enrolled in the study. Second, after completion of the 3-month follow-up interview, a sub-sample of a different 30 families (again, 15 in each group) will be invited to participate in qualitative interviews to debrief about their experience in the study and the intervention (for those in that group). This will be a one-time interview scheduled within 60 days of recruitment for this part of the project.


Options:
A: Inclusion Criteria:

Terminally ill cancer patients are they:

1. have a disease at a terminal stage which continues to progress with distant metastases and is unresponsive to current curative cancer treatment as judged by their oncologists
2. are cognitively competent
3. can communicate with data collectors
4. age ≧ 20
5. have a designated family caregiver who agrees to participate in the survey.

Family caregivers will be recruited if they are:

1. family members of cancer patients with a terminally ill disease as defined by this proposed study
2. identified by the patients as the persons primarily conduct the patient's care needs without receiving financial reimbursement for the care they provide
3. age≧20
4. who agree to participate and can communicate with data collectors.

Exclusion Criteria:

1. Patients or family caregivers who are not able to communicate coherently.
2. Only one party in the patient-family dyad agrees to participate.
B: Inclusion Criteria:

* 18 years of age or older
* Surrogate decision maker for ICU patient in one of 5 UPMC ICU's

Exclusion Criteria:

* Non-English Speaking
* Surrogate's loved one is for organ transplantation
* Not physically able to participate in family meeting
C: Inclusion Criteria:

* Clinicians who are palliative care providers (physicians and Advanced Practice Providers).
* Patients/family caregivers must be 18 - 100 years of age.
* Patients must have an advanced illness and be receiving palliative care.
* Family caregivers must be caring for a patient who has an advanced illness who is receiving palliative care.

Exclusion Criteria:

* Patients/family caregivers who do not speak English or require interpreter services will be excluded.
D: Inclusion Criteria:

* age 18 years or older
* actively involved in the life of the patient receiving care; and
* functionally fluent in English or Spanish.

Exclusion Criteria:

* discharge plan in place for patient before day 4
* previously received palliative care
* patient placed on extracorporeal membrane oxygenation (ECMO)
* no prior admission to ICU for same hospitalization

Answer: D