Decision-Making Competence Assessment Tool

2010 ◽  
Author(s):  
Melissa L. Finucane ◽  
Christina M. Gullion
Keyword(s):  
Decision Making ◽  
Assessment Tool ◽  
Competence Assessment

scholarly journals How Do We Assess Patient Skills in a Competence-Based Program? Assessment of Patient Competences Using the Spanish Version of the Prolapse and Incontinence Knowledge Questionnaire and Real Practical Cases in Women with Pelvic Floor Disorders

2021 ◽  
Vol 18 (5) ◽  
pp. 2377
Author(s):  
Beatriz Sánchez-Sánchez ◽  
Beatriz Arranz-Martín ◽  
Beatriz Navarro-Brazález ◽  
Fernando Vergara-Pérez ◽  
Javier Bailón-Cerezo ◽  
...  
Keyword(s):  
Decision Making ◽  
Pelvic Floor ◽  
Discriminant Validity ◽  
Pelvic Floor Disorders ◽  
Assessment Tool ◽  
Pelvic Organ ◽  
Assessment Tools ◽  
Measurement Properties ◽  
Competence Assessment ◽  
Knowledge Questionnaire

Therapeutic patient education programs must assess the competences that patients achieve. Evaluation in the pedagogical domain ensures that learning has taken place among patients. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) is a tool for assessing patient knowledge about urinary (UI) and pelvic organ prolapse (POP) conditions. The aim of this study was to translate the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) into Spanish and test its measurement properties, as well as propose real practical cases as a competence assessment tool. The cross-cultural adaptation was conducted by a standardized translation/back-translation method. Measurement properties analysis was performed by assessing the validity, reliability, responsiveness, and interpretability. A total of 275 women were recruited. The discriminant validity showed statistically significant differences in the PIKQ scores between patients and expert groups. Cronbach’s alpha revealed good internal consistency. The test–retest reliability showed excellent correlation with UI and POP scales. Regarding responsiveness, the effect size, and standardized response mean demonstrated excellent values. No floor or ceiling effects were shown. In addition, three “real practical cases” evaluating skills in identifying and analyzing, decision making, and problem-solving were developed and tested. The Spanish PIKQ is a comprehensible, valid, reliable, and responsive tool for the Spanish population. Real practical cases are useful competence assessment tools that are well accepted by women with pelvic floor disorders (PFD), improving their understanding and their decision-making regarding PFD.

scholarly journals Validation of the French Version of the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) in a French Sample of Individuals with Schizophrenia: Validation de la version française de l’instrument d’évaluation des compétences MacArthur-traitement (MacCAT-T) dans un échantillon français de personnes souffrant de schizophrénie

2020 ◽  
pp. 070674372096644
Author(s):  
Stéphane Raffard ◽  
Cindy Lebrun ◽  
Yasmine Laraki ◽  
Delphine Capdevielle
Keyword(s):  
Decision Making ◽  
Factor Analysis ◽  
Assessment Tool ◽  
Competence Assessment ◽  
Rater Reliability ◽  
French Version ◽  
Capacity To Consent ◽  
Decision Making Capacity ◽  
Consent To Treatment ◽  
High Degree

Background: Assessing an individual’s capacity to consent to treatment is a complex and challenging task for psychiatrists and health-care professionals. Diminished capacity to consent to pharmacological treatment is a common concern in individuals with schizophrenia. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) is the most common tool used in individuals with schizophrenia to evaluate the decision-making abilities for judgments about competence to consent to treatment. This instrument assesses patients’ competence to make treatment decisions by examining their capacities in 4 areas: understanding information relevant to their condition and the recommended treatment, reasoning about the potential risks and benefits of their choices, appreciating the nature of their situation and the consequences of their choices, and expressing a choice. Despite its importance, there is no French version of this scale. Furthermore, its factor structure has never been explored, although validated measures are strongly needed to further detect deficits in patients’ decision-making abilities. The goal of this study was thus to empirically validate a French version of the MacCAT-T in a French sample of individuals with schizophrenia. Method: In this cross-sectional study, we included 125 inpatients with a diagnosis of schizophrenia from the University Department of Adult Psychiatry in Montpellier. The MacCAT-T was administered to patients by a trained psychologist. Patients were also assessed for severity of symptoms, insight into illness, and depressive and anxiety symptoms. Inter-rater reliability and psychometric properties including internal consistency, construct validity, and discriminant and divergent validity were also investigated. Results: The MacCAT-T’s internal consistency was high (Cronbach α of 0.91). A high degree of inter-rater reliability was found for all the areas of the MacCAT-T (intraclass correlation coefficient range, 0.92 to 0.98). Exploratory factor analysis revealed a 2-factor model. The factor analysis explained 50.03% of the total score variation. Component 1 included all subparts of “understanding.” Component 2 included all subparts of “appreciation” and “reasoning” and was therefore labeled “reflexivity.” After Bonferroni corrections, decision-making capacity was positively associated with insight and the severity of psychotic symptoms but not with sociodemographic variables except for education. Conclusions: The MacCAT-T demonstrated a high degree of inter-rater reliability and strong psychometric properties. The French version of the MacCAT-T is a valid instrument to assess the decision-making capacity to consent to treatment in a French sample of individuals with schizophrenia.

scholarly journals Unwell in hospital but not incapable: cross-sectional study on the dissociation of decision-making capacity for treatment and research in in-patients with schizophrenia and related psychoses

2018 ◽  
Vol 213 (2) ◽  
pp. 484-489 ◽  
Author(s):  
Benjamin Walter Jack Spencer ◽  
Tania Gergel ◽  
Matthew Hotopf ◽  
Gareth S. Owen
Keyword(s):  
Decision Making ◽  
Odds Ratio ◽  
Assessment Tool ◽  
Legal Framework ◽  
Cross Sectional Study ◽  
Competence Assessment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Decision Making Capacity ◽  
Mental Capacity Act

BackgroundConsent to research with decision-making capacity for research (DMC-R) is normally a requirement for study participation. Although the symptoms of schizophrenia and related psychoses are known to affect decision-making capacity for treatment (DMC-T), we know little about their effect on DMC-R.AimsWe aimed to determine if DMC-R differs from DMC-T in proportion and associated symptoms in an in-patient sample of people with schizophrenia and related psychoses.MethodCross-sectional study of psychiatric in-patients admitted for assessment and/or treatment of schizophrenia and related psychoses. We measured DMC-R and DMC-T using ‘expert judgement’ clinical assessment guided by the MacArthur Competence Assessment Tool for Clinical Research, the MacArthur Competence Assessment Tool for Treatment and the legal framework of the Mental Capacity Act (2005), in addition to symptoms of psychosis.ResultsThere were 84 participants in the study. Half the participants had DMC-R (51%, 95% CI 40–62%) and a third had DMC-T (31%, 95% CI 21–43%) and this difference was statistically significant (P < 0.01). Thought disorder was most associated with lacking DMC-R (odds ratio 5.72, 95% CI 2.01–16.31, P = 0.001), whereas lack of insight was most associated with lacking DMC-T (odds ratio 26.34, 95% CI 3.60–192.66, P = 0.001). With the exception of improved education status and better DMC-R, there was no effect of sociodemographic variables on either DMC-R or DMC-T.ConclusionsWe have shown that even when severely unwell, people with schizophrenia and related psychoses in in-patient settings commonly retain DMC-R despite lacking DMC-T. Furthermore, different symptoms have different effects on decision-making abilities for different decisions. We should not view in-patient psychiatric settings as a research ‘no-go area’ and, where appropriate, should recruit in these settings.Declaration of interestNone.

scholarly journals Evaluating Voting Competence in Persons with Alzheimer Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Pietro Tiraboschi ◽  
Erica Chitò ◽  
Leonardo Sacco ◽  
Marta Sala ◽  
Stefano Stefanini ◽  
...  
Keyword(s):  
Decision Making ◽  
Alzheimer Disease ◽  
Prime Minister ◽  
Assessment Tool ◽  
Disease Stage ◽  
Competence Assessment ◽  
Decision Making Capacity ◽  
The Us ◽  
Italian Context ◽  
Structured Questionnaire

Voting by persons with dementia raises questions about their decision-making capacity. Methods specifically addressing voting capacity of demented people have been proposed in the US, but never tested elsewhere. We translated and adapted the US Competence Assessment Tool for Voting (CAT-V) to the Italian context, using it before 2006 elections for Prime Minister. Consisting of a brief questionnaire, this tool evaluates the following decision-making abilities: understanding nature and effect of voting, expressing a choice, and reasoning about voting choices. Subjects' performance was examined in relation to dementia severity. Of 38 subjects with Alzheimer's disease (AD) enrolled in the study, only three scored the maximum on all CAT-V items. MMSE and CAT-V scores correlated only moderately (; ) with one another, reflecting the variability of subjects' performance at any disease stage. Most participants (90%), although performing poorly on understanding and reasoning items, scored the maximum on the choice measure. Our results imply that voting capacity in AD is only roughly predicted by MMSE scores and may more accurately be measured by a structured questionnaire, such as the CAT-V. Among the decision-making abilities evaluated by the CAT-V, expressing a choice was by far the least affected by the dementing process.

scholarly journals Decisional capacity to consent to treatment and research in patients affected by Mild Cognitive Impairment. A systematic review and meta-analysis

2021 ◽  
pp. 1-14
Author(s):  
Giovanna Parmigiani ◽  
Antonio Del Casale ◽  
Gabriele Mandarelli ◽  
Benedetta Barchielli ◽  
Georgios D. Kotzalidis ◽  
...  
Keyword(s):  
Decision Making ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Competence Assessment ◽  
Decisional Capacity ◽  
Capacity To Consent ◽  
Decision Making Capacity ◽  
Consent To Treatment

ABSTRACT Objectives: To perform a meta-analysis of clinical studies on the differences in treatment or research decision-making capacity among patients with Mild Cognitive Impairment (MCI), Alzheimer’s disease (AD), and healthy comparisons (HCs). Design: A systematic search was conducted on Medline/Pubmed, CINAHL, PsycINFO, Web of Science, and Scopus. Standardized mean differences and random-effects model were used in all cases. Setting: The United States, France, Japan, and China. Participants: Four hundred and ten patients with MCI, 149 with AD, and 368 HCs were included. Measurements: The studies we included in the analysis assessed decisional capacity to consent by the MacArthur Competence Assessment Tool for Treatment (MAcCAT-T), MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), Capacity to Consent to Treatment Instrument (CCTI), and University of California Brief Assessment of Capacity to Consent (UBACC). Results: We identified 109 potentially eligible studies from 1672 records, and 7 papers were included in the meta-analysis. The meta-analysis showed that there was significant impairment in a decision-making capacity in MCI patients compared to the HCs group in terms of Understanding (SMD = −1.04, 95% CI: −1.31 to −0.77, P < 0.001; I2 = 52%, P = 0.07), Appreciation (SMD = −0.51, 95% CI: −0.66 to −0.36, P < 0.001; I2 = 0%, P = 0.97), and Reasoning (SMD = −0.62, 95% CI: −0.77, −0.47, P < 0.001; I2=0%, P =0.46). MCI patients scored significantly higher in Understanding (SMD = 1.50, 95% CI: 0.91, 2.09, P = 0.01, I2 = 78%, P = 0.00001) compared to patients affected by AD. Conclusions: Patients affected by MCI are at higher risk of impaired capacity to consent to treatment and research compared to HCs, despite being at lower risk compared to patients affected by AD. Clinicians and researchers need to carefully evaluate decisional capacity in MCI patients providing informed consent.

scholarly journals Diminished capacities to make treatment decision for COVID-19 vaccination in schizophrenia

2022 ◽  
Author(s):  
Stephane Raffard ◽  
Sophie Bayard ◽  
Margot Eisenblaetter ◽  
Philippe Tattard ◽  
Jerome Attal ◽  
...  
Keyword(s):  
Decision Making ◽  
High Risk ◽  
Assessment Tool ◽  
Treatment Decision ◽  
Poor Performance ◽  
Mental Capacity ◽  
Psychotic Symptoms ◽  
Competence Assessment ◽  
Make Treatment Decision ◽  
Vaccination Rates

Abstract Recent evidence suggests that schizophrenia patients are at high risk for severe COVID-19 and should be prioritized for vaccination. However, impaired decision-making capacities could negatively affect the uptake of COVID-19 vaccination in this population. Competence to consent to COVID-19 vaccination was assessed in 80 outpatients with schizophrenia. Using the MacArthur Competence Assessment Tool for Treatment, 56.3% of the sample were classified as having diminished mental capacity. Poor performance was associated with lower vaccination rates, poorer cognition and higher level of psychotic symptoms. Developing interventions for enhancing informed consent for vaccination is urgent within this population.

MacArthur Competence Assessment Tool–Criminal Adjudication

1998 ◽  
Author(s):  
Randy K. Otto ◽  
Norman G. Poythress ◽  
Robert A. Nicholson ◽  
John F. Edens ◽  
John Monahan ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Competence Assessment

Interventi psicologici a sostegno dell'imprenditoria femminile: evidenze empiriche di efficacia nel contesto italiano

RISORSA UOMO ◽  
2013 ◽  
pp. 455-470
Author(s):  
Annamaria Di Fabio ◽  
Letizia Palazzeschi ◽  
Francesca Camilli ◽  
Antonio Raschi
Keyword(s):  
Decision Making ◽  
Social Policy ◽  
Self Efficacy ◽  
Career Decision ◽  
Control Group ◽  
Competence Assessment ◽  
Career Decision Making ◽  
The Social ◽  
Experimental Group

The present work aims to evaluate the effectiveness of a competence assessment intervention for professional enterprising effected with entrepreneurs of the agriculture and textile craft sectors and carried out within the project Guidance Paths (Percorsi di orientamento), a three-year project supported by the Italian Ministry of Labour and the Social Policy. The study used an experimental group (55 participants) that received a competence assessment intervention and a control group (37 participants). The results showed a decrease in career decision-making difficulties and an increase in career decision- making self-efficacy in the experimental group suggesting the effectiveness of competence assessment for entrepreneurship of women.

scholarly journals Determining when impairment constitutes incapacity for informed consent in schizophrenia research

2007 ◽  
Vol 191 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Scott Y. H. Kim ◽  
Paul S. Appelbaum ◽  
Jeffrey Swan ◽  
T. Scott Stroup ◽  
Joseph P. McEvoy ◽  
...  
Keyword(s):  
Roc Analysis ◽  
Operating Characteristic ◽  
Assessment Tool ◽  
Ethics Committees ◽  
Competence Assessment ◽  
Evidence Based ◽  
Research Ethics Committees ◽  
Predictive Values ◽  
Risks And Benefits ◽  
Capacity Determination

BackgroundAlthough people with schizophrenia display impaired abilities for consent, it is not known how much impairment constitutes incapacity.AimsTo assess a method for determining the categorical capacity status of potential participants in schizophrenia research.MethodExpert-judgement validation of capacity thresholds on the sub-scales of the MacArthur Competence Assessment Tool – Clinical Research (MacCAT–CR) was evaluated using receiver operating characteristic (ROC) analysis in 91 people with severe mental illness and 40 controls.ResultsThe ROC areas under the curve for the understanding, appreciation and reasoning sub-scales of the MacCAT–CR were 0.94 (95% CI 0.88–0.99), 0.85 (95% CI 0.76–0.94) and 0.80 (95% CI 0.70–0.90). These findings yielded negative and positive predictive values of incapacity that can guide the practice of investigators and research ethics committees.ConclusionsBy performing such validation studies for a few categories of research with varying risks and benefits, it might be possible to create evidence-based capacity determination guidelines for most schizophrenia research.

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