Do psychiatric patients improve their competency to consent to hospitalization after admission? A prospective study in an acute inpatient ward

Fraguas, David; García-Solano, Fernando; Chapela, E.; Terán, Sara; Peña, Juan José de la; Calcedo‐Barba, Alfredo

doi:10.1016/j.genhosppsych.2006.09.005

Cited by 16 publications

(10 citation statements)

References 14 publications

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“…Using the same tool, two independent studies in different psychiatric patient groups reported that 43.8%33 and 60%34 of the evaluated patients were likewise incompetent. Other studies assessing patients with different assessment tools reported incompetency rates of 24%,19 44.4%35 and 74% 36. Despite the higher rate in our study, together these results demonstrate that not all psychiatric patients are incompetent in decision making with respect to treatment.…”

Section: Discussioncontrasting

confidence: 65%

Comparing assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool

Şehiraltı

2013

J Med Ethics

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Our findings demonstrate those physicians, nurses and the patients' relatives have difficulty in identifying patients lacking decision-making competence. Therefore, an objective competence assessment tool should be used along with the assessments of physicians and nurses, both of whom can provide clinical data, as well as those of relatives, who can offer insights into the patient's moral values and expectations.

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Section: Discussioncontrasting

confidence: 65%

Comparing assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool

Şehiraltı

2013

J Med Ethics

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“…Several lines of evidence pointed out that a significant association exists between cognitive functioning and mental capacity, and patients with cognitive dysfunctions could be at higher risk of incapacity . In those psychiatric patients presenting with severe psychiatric symptoms, as do patients hospitalized for acute treatment, symptoms also appear to be negatively associated with decisional capacity .…”

mentioning

confidence: 99%

Mental Capacity in Patients Involuntarily or Voluntarily Receiving Psychiatric Treatment for an Acute Mental Disorder

Mandarelli

Tarsitani

Parmigiani

et al. 2014

Journal of Forensic Sciences

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Despite the growing amount of data, much information is needed on patients' mental capacity to consent to psychiatric treatment for acute mental disorders. The present study was undertaken to compare differences in capacity to consent to psychiatric treatment in patients treated voluntarily and involuntarily and to investigate the role of psychiatric symptoms, competency, and cognitive functioning in determining voluntariness of hospital admission. Involuntary patients were interviewed with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the 24-item Brief Psychiatric Rating Scale (BPRS), the Mini Mental State Examination (MMSE) and the Raven's Colored Progressive Matrices, and their data were compared with those for age- and sex-matched voluntary patients. Involuntary patients performed worse in all MacCAT-T subscales. Capacity to consent to treatment varied widely within each group. Overall, involuntary patients have worse consent-related mental capacity than those treated voluntarily, despite capacity to consent to treatment showing a significant variability in both groups.

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“…Such result is different from the results that BPRS scores are higher in the group of incompetence1 and that the Severity of Psychiatric Illness Scale and Acuity of Psychiatric Illness Scale scores were significantly low in the group of competence, when measuring the competence and incompetence to consent to hospitalization using the Competency Questionnaire 8. Carpenter et al14 reported that understanding and reasoning showed negative correlation with BPRS, when measuring consent ability with MacCAT-T.…”

Section: Discussionmentioning

confidence: 82%

Developing a Tool to Assess Competency to Consent to Psychiatric Hospitalization (KATOC): Reliability and Validity

Seo

Kim

MinKyu

2011

Psychiatry Investig

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ObjectiveThe justification of informed consent requires that a patient be provided with the information necessary for deciding treatment and able to use such information based on reasonable thinking. The clinical decision to consider anyone who has mental disorder as incompetence without objective assessment does not only encroach human rights of the persons with mental illness, but seriously prevent them from being recovered. Hence the objective assessment of competency is needed in mental health. Our study aimed to develop the Korean Tool of Competency to Consent to Psychiatric Hospitalization and to analyze the reliability and validity of this tool.MethodsTotally 98 patients with mental illness who were hospitalized in mental hospital, participated in this study. For the subjects a questionnaire composing of 22 questions of understanding, appreciation, reasoning and expression of a choice was used. To investigate validity of this tool, MMSE-K, insight test, estimated IQ, BPRS were conducted. Its reliability and usefulness were examined with Cronbach's alpha, ICC and ROC analysis respectively and criterion related validation performed.ResultsAs results, this tool shows that agreement between raters is relatively high and the confirmatory factor analysis for constructive validation shows that the tool is valid. Also, for criterion related validation, estimated IQ, insight and MMSE are significantly correlated to understanding, appreciation and reasoning. However competence to express a choice did not show any significant correlation with criterion variables, nor showed BPRS any significant correlation with sub-competences.ConclusionOur study developed the Korean Tool of Competency to Consent to Psychiatric Admission Treatment in the Mentally Ill, verified the reliability and validity of the tool and analyzed the optimum cutoff to distinguish between competence and incompetence in sub-competences. Korean Assessment Tool of Competency to Consent to Psychiatric Hospitalization (KATOC), analyzed the reliability and validity of this tool and presented the cutoff points by subarea. As a result, the reliability and validity of satisfactory levels were verified, the ROC analysis was implemented based on the clinical assessment and the cutoff points were found in understanding, appreciation, expression of a choice and reasoning. Such findings showed that the tool developed by researchers could be very favorably used in Korea.

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Do psychiatric patients improve their competency to consent to hospitalization after admission? A prospective study in an acute inpatient ward

Cited by 16 publications

References 14 publications

Comparing assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool

Comparing assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool

Mental Capacity in Patients Involuntarily or Voluntarily Receiving Psychiatric Treatment for an Acute Mental Disorder

Developing a Tool to Assess Competency to Consent to Psychiatric Hospitalization (KATOC): Reliability and Validity

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