法医学心理健康实践中功能性心理能力评估：邓德拉姆能力阶梯验证研究。
An evaluation of functional mental capacity in forensic mental health practice: the Dundrum capacity ladders validation study.
机构信息
National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
Department of Psychiatry, Trinity College Dublin, Dublin 2, Ireland.
出版信息
BMC Psychiatry. 2018 Mar 27;18(1):78. doi: 10.1186/s12888-018-1658-2.
BACKGROUND
Because of the potential gravity of finding a person incompetent, assessment of mental capacity is challenging for clinicians. We aimed to test validity of a new structured professional judgement tool designed to assess functional mental capacity in three domains - finances, welfare and healthcare.
METHODS
Fifty-five male forensic psychiatric patients with Schizophrenia were interviewed using the Dundrum Capacity Ladders - a new semi-structured interview, and scores were assigned on a stratified scoring system, measuring ability to understand, reason, appreciate the personal importance of the decision at hand and communicate a decision. Data were also gathered pertaining to level of therapeutic security at the time of interview, diagnosis, neurocognitive function and a validated measure of real world function.
RESULTS
The results show that internal consistency and inter-rater reliability were high for all items. There were correlations between higher scores of functional mental capacity, neurocognitive function and measures of real world function in this population. Correlations were in the range 0.358 to 0.693, effect sizes that were moderate to high.
CONCLUSIONS
The DUNDRUM Capacity Ladders appear to be a valid measure of functional mental capacity in this population. Further prospective studies of functional mental capacity as a measure of recovery are now required.
背景
由于发现一个人无行为能力的潜在严重性，临床医生在评估其精神能力时面临挑战。我们旨在测试一种新的结构化专业判断工具的有效性，该工具旨在评估三个领域的功能性精神能力 - 财务、福利和医疗保健。
方法
使用新的半结构化访谈方法 - 邓德拉姆能力阶梯对 55 名患有精神分裂症的男性法医精神病患者进行访谈，并根据分层评分系统对得分进行分配，衡量理解、推理、评估手头决策的个人重要性以及沟通决策的能力。还收集了与访谈时的治疗安全性水平、诊断、神经认知功能和经过验证的现实世界功能衡量标准相关的数据。
结果
结果表明，所有项目的内部一致性和评分者间可靠性都很高。在该人群中，功能性精神能力、神经认知功能和现实世界功能的衡量标准之间存在相关性。相关性在 0.358 到 0.693 之间，效应大小为中等至较高。
结论
邓德拉姆能力阶梯似乎是该人群功能性精神能力的有效衡量标准。现在需要进一步进行前瞻性研究，以功能性精神能力作为衡量康复的标准。
Zotero 插件