Please select the eligibility criteria that correspond to the clinical trial below.
Title: Health System Intervention to Improve Communication About End-of-Life Care for Vulnerable Patients
Brief Summary: The purpose of this study is to improve care delivered to patients with serious illness by enhancing communication among patients, families, and clinicians in the outpatient setting. We are testing a new way to help patients share their preferences for talking about end-of-life care with their clinicians and families. To do this we created a simple, short feedback form. The form is designed to help clinicians understand what patients would like to talk about. The goal of this research study is to show that using a feedback form is possible and can be helpful for patients and their families.


Options:
A: Inclusion Criteria:

* Clinically confirmed diagnosis of stroke either Cerebral Infarct (ICD I63), Cerebrovascular Haemorrhage (ICD161) or Stroke, not specified as haemorrhage or infarction (ICD I64).
* Patients over 18 years old (≥ 18 years old)
* Had a diagnosis of stroke within the last 4-8 months (Stroke diagnosis ≥ 4months to ≤ 8 months)

Exclusion Criteria:

* Diagnosis of a Transient Ischaemic Attack (ICD G45)
* Diagnosis of a Subarachnoid Haemorrhage (ICD I60)
B: Inclusion criteria

* Age 18 years and up
* Attends a participating primary health care center in the region
* Diagnosis of mild/moderate depressive disorder (new episode)
* No change in possible antidepressant maintenance therapy during the preceding 1 month
* Provided written informed consent

Exclusion criteria

* Antidepressant medication initiated or changed during the preceding 1 month
* Patient diagnosed with major depressive disorder (BDI-II \>28)
* Patients diagnosed of severe mental psychiatric disorder (i.e. bipolar disorder, antisocial personality disorder, psychosis, substance use disorder or other serious mental disorder)
* Suicidal ideation or intentions
* Inability to speak and understand Swedish language well enough to take part in the activities required in the study.
* Cognitive impairment that makes it impossible to take part in the activities required in the study
* Does not provide written informed consent to participation in the study
C: Inclusion Criteria:

* Patients with HNC
* To be treated curatively (all sites, stage of disease, treatments).

Exclusion Criteria:

* Patients treated with palliative intent
* Patients with a recurrence.
* Patients with a history of cognitive impairment, psychoses or dementia
D: Inclusion Criteria:

* Eligible primary clinicians will include all clinicians who provide ongoing primary or specialty care to eligible patient populations. This will include primary care physicians (family medicine and internal medicine), oncologists, pulmonologists, cardiologists, gastroenterologists, nephrologists, neurologists, hepatologists, and geriatricians. Primary clinicians may also include nurse practitioners and physician assistants playing a "primary role" with eligible patients. A "primary role" denotes any clinician for whom having a discussion about end-of-life care with eligible patients would be indicated
* Eligible interprofessional team members will include nurses, social workers and other clinicians who are part of an enrolled primary clinician's clinic team.
* Eligible patients will be those under the care of a participating clinician who are 18 years of age or older, have had 2 or more visits with the primary clinician in the last 18 months, and meet diagnostic criteria. Diagnostic criteria include: 1) metastatic cancer or inoperable lung cancer; 2) chronic obstructive pulmonary disease with FEV1 values \<35% predicted or oxygen dependence or restrictive lung disease with a TLC \< 50% predicted; 3) New York Heart Association Class III or IV heart failure; 4) Child's Class C cirrhosis or MELD score of \>17; 5) dialysis-dependent renal failure and either diabetes or a serum albumin of \< 2.5; or, 6) older than 75 years with at least one life-limiting chronic illness or older than 90 years. Additional criteria include: PAH w. 6MWD \<250m, restrictive lung disease (IPF, ILD) w/ TLC \<50%, and cystic fibrosis with FEV1 \< 30%. Eligible patients will also be English-speaking and have no significant dementia or cognitive impairment that would limit his/her ability to complete questionnaires.
* Eligible family members will be identified by the patient, with the criterion that the patient would want the family member involved in medical decision-making for the patient if he/she was not able. For the purpose of this study, "family member" is not confined to legal next-of-kin or immediate family member. Any family member, friend, or caregiver is eligible who is English-speaking and has no dementia or delirium limiting his/her ability to complete questionnaires.

Exclusion Criteria:

* Reasons for exclusion for all subject groups include: legal or risk management concerns; and physical or mental limitations preventing ability to complete research activities.

Answer: D