住院患者精神障碍流行病学状况及其相关危险因素:横断面研究  

Prevalence of mental incapacity in medical inpatients and associated risk factors:Cross sectional study

作　　者：RaymontV. BingleyP.W. BuchananA. 黄卫东 

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第3期5-5,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background Although mental incapacity is becoming increasingly important in cl inical practice, little information is available on its frequency in medical inp atients. We aimed to estimate the prevalence of mental incapacity in acutely adm itted medical inpatients; to determine the frequency that medical teams recognis ed patients who did not have mental capacity; and to identify factors associated with mental incapacity. Methods Over an 18 month period, we recruited 302 cons ecutive acute medical inpatients. Participants were assessed with the MacArthur competence tool for treatment and by clinical interview. Cognitive impairment wa s measured by the mini mental state examination. Findings 72 (24%) patients we re severely cognitively impaired, unconscious, or unable to express a choice and were automatically assigned to the incapacity group. 71 (24%) refused to parti cipate or could not speak English. Thus, 159 patients were interviewed. Of these , 31%(95%CI 24 38) were judged not to have mental capacity. For the total sam ple (n=302), we estimated that at least 40%did not have mental capacity. Clinic al teams rarely identified patients who did not have mental capacity: of 50 pati ents interviewed, 12 (24%) were rated as lacking capacity. Factors associated with mental incapacity were increasing age and cognitive impairment. Interpretat ion Mental incapacity is common in acutely ill medical inpatients, and clinician s tend not to recognise it. Screening methods for cognitive impairment could be useful in detecting those with doubtful capacity to consent.Background Although mental incapacity is becoming increasingly important in cl inical practice, little information is available on its frequency in medical inp atients. We aimed to estimate the prevalence of mental incapacity in acutely adm itted medical inpatients; to determine the frequency that medical teams recognis ed patients who did not have mental capacity; and to identify factors associated with mental incapacity. Methods Over an 18 month period, we recruited 302 cons ecutive acute medical inpatients. Participants were assessed with the MacArthur competence tool for treatment and by clinical interview. Cognitive impairment wa s measured by the mini mental state examination. Findings 72 (24%) patients we re severely cognitively impaired, unconscious, or unable to express a choice and were automatically assigned to the incapacity group. 71 (24%) refused to parti cipate or could not speak English. Thus, 159 patients were interviewed. Of these , 31%(95%CI 24 38) were judged not to have mental capacity. For the total sam ple (n=302), we estimated that at least 40%did not have mental capacity. Clinic al teams rarely identified patients who did not have mental capacity: of 50 pati ents interviewed, 12 (24%) were rated as lacking capacity. Factors associated with mental incapacity were increasing age and cognitive impairment. Interpretat ion Mental incapacity is common in acutely ill medical inpatients, and clinician s tend not to recognise it. Screening methods for cognitive impairment could be useful in detecting those with doubtful capacity to consent.

关 键 词：精神障碍 流行病学状况 横断面研究 认知功能损害 入院患者 临床实践 意识障碍 临床观察 疑似患者 临床医疗 

分 类 号：R749[医药卫生—神经病学与精神病学]