老年精神分裂症住院患者认知功能与决策能力的关系：初步研究,Neuropsychiatric Disease and Treatment

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老年精神分裂症住院患者认知功能与决策能力的关系：初步研究
Neuropsychiatric Disease and Treatment ( IF 2.5 ) Pub Date : 2022-04-15 , DOI: 10.2147/ndt.s357067
Norio Sugawara _{1,

2,

3} , Norio Yasui-Furukori _{1,

3} , Sonoko Yamada ₃ , Mei Aoki ₃ , Yoshitaka Takeuchi _{1,

4} , Kensuke Miyazaki ₅ , Kazutaka Shimoda ₁

Affiliation

背景：精神疾病患者的决策能力是临床护理环境中一个重要且有争议的问题。本研究的目的是（1）评估老年精神分裂症住院患者的决策能力水平，以及（2）确定他们的能力下降是否与认知障碍的特定方面有关。
方法：采用横断面设计，我们招募了 48 名被诊断为精神分裂症的老年住院患者（平均年龄 ± 标准差：60.0 ± 14.0 岁）。参与者接受了麦克阿瑟治疗能力评估工具 (MacCAT-T) 和日本版精神分裂症认知简要评估 (Japanese-BACS) 的评估。
结果：发现 MacCAT 的理解总结得分与日语-BACS 的注意力和语言流利度分量表得分呈显着正相关，与年龄和病程呈负相关。此外，欣赏和推理总结得分与年龄呈显着负相关。在具有逐步选择程序的线性回归模型中，年龄、性别和语言流利度子量表得分与理解总结得分相关。
结论：慢性精神分裂症住院患者普遍较差的认知表现表明，他们治疗的知情同意过程可能会基于认知需求对这些患者施加压力。精神科医生有必要评估个人的决策能力并增加患者对治疗过程的参与。

"点击查看英文标题和摘要"

Relationship Between Cognitive Functions and Decision-Making Capacity in Older Institutionalized Patients with Schizophrenia: A Preliminary Study

Background: Decision-making capacity for patients with psychiatric disorders is an important and controversial issue in clinical care settings. The aim of this study was to (1) evaluate the level of decision-making capacity of older institutionalized patients suffering from schizophrenia and (2) determine whether their diminished capacity is associated with specific aspects of cognitive impairment.
Methods: Using a cross-sectional design, we recruited 48 older institutionalized patients (mean age ± standard deviation: 60.0 ± 14.0 years) who were diagnosed with schizophrenia. Participants underwent the assessments by the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) and the Japanese version of the Brief Assessment of Cognition in Schizophrenia (Japanese-BACS).
Results: The understanding summary scores of the MacCAT were found to have a significant positive correlation with the attention and verbal fluency subscale scores of the Japanese-BACS and negative correlations with age and duration of illness. In addition, the appreciation and reasoning summary scores had a significant negative correlation with age. In a linear regression model with a stepwise selection procedure, age, sex, and verbal fluency subscale scores were associated with understanding summary scores.
Conclusion: The generally poor cognitive performance of inpatients with chronic schizophrenia indicated that the informed consent process for their treatment might pressure these patients on the basis of cognitive demands. It is necessary for psychiatrists to assess individual decision-making capacity and to increase their patients’ involvement in the treatment process.

更新日期：2022-04-14

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