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Ineffective communication during mechanical ventilation (MV) and critical illness is distressing to many patients. This study aimed to describe the scope of communication content of ventilated critically ill patients.We performed a prospective qualitative interview study in a multidisciplinary intensive care unit. Ten alert, orientated adult patients who previously underwent MV for at least 24 h and were able to speak at the time of interview were recruited. Semi-structured interviews with stimulated recall technique were conducted. A descriptive thematic analysis was performed of the patient-generated content using a free coding technique, where recurrent themes and subthemes were noted, coded and analyzed.Patients' communication content included medical discussions with clinicians; communication with family to provide advice or comfort, make requests and plans, express feelings and convey personal perspectives on medical care; and expression of their own psychoemotional needs.The scope of communication content of ventilated ICU patients was broad, extending far beyond task-focused subject matter. Content ranged from conveying symptom-related messages to active participation in medical discussions, to conversing with family about a range of complex multi-dimensional issues, to sharing their own psychoemotional experiences. These patient-centered needs should be recognized and addressed in communication strategies.Mechanically ventilated critically ill patients' scope of communication is broad.Ventilated patients want to communicate complex personal and psychoemotional issues.Communication during this non-vocal period can be frustrating.Communication strategies should recognize and address these needs.