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The Four Supports Study

A Randomized Trial of a Family Support Intervention in Intensive Care Units (The Four Supports Study) 

PI: Douglas B. White, MD, MAS, Director, Program on Ethics and Decision Making

Funding: National Institutes of Health - National Institute on Aging K23AG032875 Project period: 9/1/08 - 8/31/12

Project Overview

This is a single-center, randomized controlled trial of an intervention to support families of critically-ill patients. The intervention centers on the use of a Family Support Counselor to provide emotional, practical and communication support and tailored feedback to clinicians about families’ needs. 

Specific Aim 1

Evaluate the effectiveness of a multifaceted communication intervention to improve psychological outcomes among family members of critically ill patients, using a randomized, controlled trial design.

Hypothesis:  The intervention will result in significantly reduced symptoms of depression, post-traumatic stress disorder, and anxiety at three (3) months compared to families receiving usual care.

Specific Aim 2

Evaluate the effectiveness of the intervention to improve the quality of communication and decision-making between physicians and family members, using both quantitative and qualitative measures.

Hypothesis:  The intervention will result in increased quality of communication, increased family knowledge of key medical information, and lower physician-family conflict. 

Specific Aim 3

Evaluate the effect of the intervention on the family-reported patient centeredness of care.

Hypothesis:  Mortality will be similar in the two groups, but the intervention will result in higher family ratings of patient centeredness
of care.