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Medical patients' treatment decision making capacity: a report from a general hospital in Greece.

Bilanakis N, Vratsista A, Athanasiou E, Niakas D, Peritogiannis V - Clin Pract Epidemiol Ment Health (2014)

Bottom Line: Sixty-eight out of 134 patients (50.7%) were incompetent to decide upon their treatment.Physicians sometimes failed to recognize patients' incapacity.Rates of decision-making incapacity for treatment in medical inpatients are high, and incapacity may go unrecognized by treating physicians.

View Article: PubMed Central - PubMed

Affiliation: Psychiatric Department of General Hospital of Arta, Arta, Greece.

ABSTRACT
This study aimed to assess the decision-making capacity for treatment of patients hospitalized in an internal medicine ward of a General Hospital in Greece, and to examine the views of treating physicians regarding patients' capacity. All consecutive admissions to an internal medicine ward within a month were evaluated. A total of 134 patients were approached and 78 patients were interviewed with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) and the Mini Mental State Examination (MMSE) questionnaire. Sixty-eight out of 134 patients (50.7%) were incompetent to decide upon their treatment. The majority of them (n=56, 41.8%) were obviously incapable because they were unconscious, or had such marked impairment that they could not give their own names, and the rest (n=12, 8.9%) were rated as incompetent according to their performance in the MacCAT-T. Neurological disorders, old age and altered cognitive function according to MMSE were negatively correlated with decision making capacity. Physicians sometimes failed to recognize patients' incapacity. Rates of decision-making incapacity for treatment in medical inpatients are high, and incapacity may go unrecognized by treating physicians. Combined patient evaluation with the use of the MacCAT-T and MMSE, could be useful for the determination of incapable patients.

No MeSH data available.


Related in: MedlinePlus

The recruitment flowchart of the patients of the study.
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Figure 1: The recruitment flowchart of the patients of the study.

Mentions: The hospital's ethics committee approved the study protocol and after full explanation of the study, signed informed consent for participation in the survey was obtained from all participants or in cases of evident incapacity from a family member. The way that patients were included in the study is presented in the chart-flow (Fig. 1).


Medical patients' treatment decision making capacity: a report from a general hospital in Greece.

Bilanakis N, Vratsista A, Athanasiou E, Niakas D, Peritogiannis V - Clin Pract Epidemiol Ment Health (2014)

The recruitment flowchart of the patients of the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260233&req=5

Figure 1: The recruitment flowchart of the patients of the study.
Mentions: The hospital's ethics committee approved the study protocol and after full explanation of the study, signed informed consent for participation in the survey was obtained from all participants or in cases of evident incapacity from a family member. The way that patients were included in the study is presented in the chart-flow (Fig. 1).

Bottom Line: Sixty-eight out of 134 patients (50.7%) were incompetent to decide upon their treatment.Physicians sometimes failed to recognize patients' incapacity.Rates of decision-making incapacity for treatment in medical inpatients are high, and incapacity may go unrecognized by treating physicians.

View Article: PubMed Central - PubMed

Affiliation: Psychiatric Department of General Hospital of Arta, Arta, Greece.

ABSTRACT
This study aimed to assess the decision-making capacity for treatment of patients hospitalized in an internal medicine ward of a General Hospital in Greece, and to examine the views of treating physicians regarding patients' capacity. All consecutive admissions to an internal medicine ward within a month were evaluated. A total of 134 patients were approached and 78 patients were interviewed with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) and the Mini Mental State Examination (MMSE) questionnaire. Sixty-eight out of 134 patients (50.7%) were incompetent to decide upon their treatment. The majority of them (n=56, 41.8%) were obviously incapable because they were unconscious, or had such marked impairment that they could not give their own names, and the rest (n=12, 8.9%) were rated as incompetent according to their performance in the MacCAT-T. Neurological disorders, old age and altered cognitive function according to MMSE were negatively correlated with decision making capacity. Physicians sometimes failed to recognize patients' incapacity. Rates of decision-making incapacity for treatment in medical inpatients are high, and incapacity may go unrecognized by treating physicians. Combined patient evaluation with the use of the MacCAT-T and MMSE, could be useful for the determination of incapable patients.

No MeSH data available.


Related in: MedlinePlus