Department of Psychiatry, Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland.
Department of Medicine, Midland Regional Hospital, Portlaoise, County Laois, Ireland.
QJM. 2018 Dec 1;111(12):881-885. doi: 10.1093/qjmed/hcy219.
The prevalence of mental incapacity for treatment decisions among medical and surgical hospital inpatients is poorly understood or not known in many countries, including Ireland.
To assess the prevalence of mental incapacity in hospital inpatients in Ireland.
Cross-sectional observational study of mental incapacity for treatment decisions.
We assessed mental capacity in 300 randomly selected hospital inpatients in 2 general hospitals in Dublin (urban) and Portlaoise (rural), in Ireland, using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T).
Mean MacCAT-T score was 14.80 (SD: 8.40) out of a possible maximum of 20 (with a higher score indicating greater mental capacity). Over one quarter of participants (27.7%; n = 83) lacked the mental capacity for treatment decisions; 1.7% (n = 5) had partial capacity and 70.7% (n = 212) had full capacity. Scores for each of the four sub-scales of the MacCAT-T were generally consistent across the four key areas of understanding, appreciation, reasoning and expressing a choice.
Mental incapacity for treatment decisions is common in medical and surgical hospital inpatients in Ireland. This issue both merits and requires greater attention in clinical practice, research and legislation.
在许多国家，包括爱尔兰，对于医疗和外科住院患者在治疗决策方面的精神能力不足的流行情况了解甚少或根本不了解。
评估爱尔兰住院患者中治疗决策精神能力不足的发生率。
治疗决策精神能力不足的横断面观察性研究。
我们使用 MacArthur 治疗能力评估工具（MacCAT-T）评估了爱尔兰都柏林（城市）和波托拉（农村）2 家综合医院的 300 名随机选择的住院患者的精神能力。
平均 MacCAT-T 评分为 14.80（SD：8.40），满分为 20 分（得分越高表示精神能力越强）。超过四分之一的参与者（27.7%；n=83）缺乏治疗决策的精神能力；1.7%（n=5）有部分能力，70.7%（n=212）有完全能力。MacCAT-T 的四个子量表的得分在理解、欣赏、推理和表达选择的四个关键领域中基本一致。
在爱尔兰的内科和外科住院患者中，治疗决策精神能力不足的情况很常见。这一问题不仅在临床实践、研究和立法中值得关注，而且需要更多关注。
