RESUMEN
The aim of the study was to assess a Spanish adaptation of a method that determines the categorical capacity status of potential participants in research projects. The sample consisted of 120 subjects (40 general medicine inpatients, 40 psychiatric inpatients, and 40 healthy controls). The MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) interview and Mini-Mental State Examination (MMSE) were used. A feasibility study was carried out and reliability and validity calculations were made against the expert-judgment gold standard. The mean duration of the MacCAT-CR was 13 min. For the MacCAT-CR understanding, appreciation, reasoning, and expressing a choice subscales, the intraclass coefficient correlation (interrater reliability) was .93, .88, .90, and .50, respectively, and internal consistency (Cronbach's alpha) was .96, .94, and .95, respectively. Patients considered to be incompetent for expert-judgment obtained lower scores in the MacCAT-CR interview. The Spanish version of the MacCAT-CR is feasible, reliable, and valid for assessing the capacity of patients to give consent in research.
Asunto(s)
Investigación Biomédica/ética , Toma de Decisiones , Consentimiento Informado/psicología , Lenguaje , Competencia Mental , Pruebas Psicológicas/normas , Adulto , Anciano , Anciano de 80 o más Años , Comprensión , Ética en Investigación , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , España , Traducción , Adulto JovenRESUMEN
Fundamento y objetivo: Validar al español la entrevista MacArthur Competence Assessment Tool for Treatment (MacCAT-T), que valora la capacidad de los pacientes para consentir tratamiento examinando 4 áreas (comprensión, apreciación, razonamiento y expresión de una elección). Pacientes y método: La muestra se componía de 160 sujetos (80 ingresados en Medicina Interna, 40 ingresados en Psiquiatría y 40 controles sanos). Se utilizaron los instrumentos MacCAT-T y Mini-Mental State Examination (MMSE). Se llevó a cabo un estudio de factibilidad, cálculo de fiabilidad y validez (contragold standard del experto clínico). Resultados: La duración media de la entrevista MacCAT-T fue de 18 min. Respecto a la fiabilidad interobservador, el coeficiente de correlación intraclase fue para Comprensión = 0,98, Apreciación = 0,97, Razonamiento = 0,98 y Expresión de una elección = 0,91. La consistencia interna (alfa de Cronbach) fue: Comprensión = 0,87, Apreciación = 0,76 y Razonamiento = 0,86. Los pacientes considerados incapaces (gold standard) obtienen puntuaciones menores en todas las áreas de la MacCAT-T. Un rendimiento bajo en la MacCAT-T se relaciona con el deterioro cognitivo evaluado por MMSE. Conclusiones: La versión española de la MacCAT-T es fiable, factible y válida para la evaluación de la capacidad de los pacientes para consentir tratamiento (AU)
Background and objective: To validate the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) Spanish version, which assesses the mental capacity of patients to consent treatment, by examining 4 areas (Understanding, Appreciation, Reasoning and Expressing a choice). Patients and method: Sample: 160 subjects (80 Internal Medicine inpatients, 40 Psychiatric inpatients and 40 healthy controls). Instruments: MacCAT-T, Mini-Mental Status Examination (MMSE). Procedure: Feasibility study, reliability and validity calculations (against to gold standard of clinical expert). Results: Mean duration of the MacCAT-T interview was 18 min. Inter-rater reliability: Intraclass correlation coefficient for Understanding = 0.98, Appreciation = 0.97, Reasoning = 0.98, Expressing a choice = 0.91. Internal consistency (Cronbachs alpha): Understanding = 0.87, for Appreciation = 0.76, for Reasoning = 0.86. Patients considered to be incapable (gold standard) scored lower in all the MacCAT-T areas. Poor performance on the MacCAT-T was related to cognitive impairment assessed by MMSE. Conclusions: Spanish version of the MacCAT-T is feasible, reliable, and valid for assessing the capacity of patients to consent treatment (AU)
Asunto(s)
Humanos , Consentimiento Informado/estadística & datos numéricos , Toma de Decisiones , Psicometría/instrumentación , Reproducibilidad de los Resultados , Cooperación del Paciente , Estudios de Casos y Controles , Trastornos Mentales/terapiaRESUMEN
BACKGROUND AND OBJECTIVE: To validate the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) Spanish version, which assesses the mental capacity of patients to consent treatment, by examining 4 areas (Understanding, Appreciation, Reasoning and Expressing a choice). SAMPLE: 160 subjects (80 Internal Medicine inpatients, 40 Psychiatric inpatients and 40 healthy controls). INSTRUMENTS: MacCAT-T, Mini-Mental Status Examination (MMSE). PROCEDURE: Feasibility study, reliability and validity calculations (against to gold standard of clinical expert). RESULTS: Mean duration of the MacCAT-T interview was 18min. Inter-rater reliability: Intraclass correlation coefficient for Understanding=0.98, Appreciation=0.97, Reasoning=0.98, Expressing a choice=0.91. Internal consistency (Cronbach's alpha): Understanding=0.87, for Appreciation=0.76, for Reasoning=0.86. Patients considered to be incapable (gold standard) scored lower in all the MacCAT-T areas. Poor performance on the MacCAT-T was related to cognitive impairment assessed by MMSE. CONCLUSIONS: Spanish version of the MacCAT-T is feasible, reliable, and valid for assessing the capacity of patients to consent treatment.