Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Trial of an Interdisciplinary Communication Intervention to Improve Patient and Family Outcomes in the Intensive Care Unit
Brief Summary: The purpose of this study is to improve care in the Intensive Care Unit (ICU) by focusing on communication with family members of patients who are too sick to make decisions about their own care while they are in the ICU. The randomized trial will test the efficacy of a communication intervention designed to improve communication between families and clinicians through the use of a facilitator. Outcome evaluation occurs at the level of the individual family with surveys completed by families and clinicians.


Options:
A: Inclusion Criteria:

* Patients, family members, clinicians attending ICU family conferences, and nurses evaluating the quality of care.
* All ICU patients are eligible if they meet the age criteria, have been in the ICU for at least 12 hours, have acute respiratory failure requiring mechanical ventilation at the time of enrollment, and have an APACHE II score/SOFA score or other diagnosis that predicts a 30-50% or greater risk of mortality.
* Eligible family members and/or friends may include any of the following: legal guardians, durable power of attorney for healthcare, spouses, adult children, parents, siblings, domestic partners, other relatives, and friends; if they meet the age criteria, and understand English well enough to complete informed consent and study materials.
* Eligible clinicians include those who are present during a family conference and may include physicians, nurses, nurse practitioners, physician assistants, social workers, respiratory therapists, and clergy.
* All critical care nurses are eligible to participate in the evaluation if they have provided care to a patient on or before the shift in which he or she died or was discharged from the ICU.

Exclusion Criteria:

* Legal or risk management concerns (as determined by the attending physician or via hospital record designation);
* Psychological illness or morbidity; and
* Physical or mental limitations preventing ability to complete questionnaires.
* Patients will be excluded if they do not have at least one family member who is eligible and willing to participate in the study.
* A patient who is readmitted to the ICU, if the patient was enrolled and discharged previously, will not be eligible.
* Post-operative patients who have been admitted to the ICU after a scheduled surgery without complications will be excluded. These patients may meet other eligibility criteria (ventilation, APACHE scores, etc.) within the first 12 to 48 hours of admission, but will usually improve quite rapidly after that period.
B: Inclusion Criteria:

* Mechanically ventilated ≥ 7 days
* Mechanically ventilated without \> 96 hour interruption
* Age ≥ 21 years
* ICU MD does not expect patient will die within 72 hours
* ICU MD does not expect patient will be liberated from the ventilator within 72 hours.

Exclusion Criteria:

* Previous admission to study ICU this hospitalization Mechanically ventilated at outside hospital for \> 7 days before transfer
* Chronic Neuromuscular (NM) Disease
* Trauma
* Burn
* Previous palliative care consultation in this hospitalization
* No family or other surrogate decision-maker
* Family not available
* Surrogate lacks English proficiency
* Physician refused permission for research staff to approach the family
C: Inclusion Criteria:

* Presenting to the emergency department of Emory University School of Medicine/Grady Memorial Hospital for rape in the past 72 hours
* Meets DSM-IV diagnostic criterion A in which both of the following are present: (i) The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury or a threat to the physical integrity of self or others (ii) The person's response involved intense fear, helplessness, or horror
* Speaks and understands spoken English
* Can see the assessment forms, hear instructions, and function at an emotional and intellectual level sufficient to allow accurate completion of all assessment instruments
* No significant traumatic injuries, as determined by the physician

Exclusion Criteria:

* Current or history of mania, schizophrenia, or other psychoses
* Current (past month) prominent suicidal ideation or recent (past 3 months) parasuicidal behavior or other self-injurious behavior, such as low lethality cutting
* Current (past month) substance dependence; people who meet criteria for current substance abuse but not dependence, or past dependence and have been in remission for at least 1 month are eligible.
* Experienced a loss of consciousness for more than 5 minutes as a result of injuries sustained during the trauma
* Intoxicated, altered, or highly distressed to the degree that accurate completion of the study assessments or participation in study procedures is not possible
* Blood alcohol level above .08, determined by breathalyzer in the emergency department
* Not alert, oriented, and coherent
* In severe pain, active labor, or respiratory distress or hemodynamically compromised in any way
D: Inclusion Criteria:

* Score ≥3 on PTSD automated screening algorithm
* Score ≥35 on PTSD checklist (PCL-C)

Exclusion Criteria:

* Non-English speaking
* Under 14 years of age
* Patients in need of acute psychiatric intervention (e.g., suicide attempt, psychosis)
* Suffered head, spinal cord, or other sever injuries that prevent participation in the inpatient ward interview.

Answer: A