• Medicina intensiva · Aug 2012

    [Is the critical patient competent for decision taking? Psychological and psychopathological reasons of cognitive impairment].

    • M D Bernat-Adell, R Ballester-Arnal, and R Abizanda-Campos.
    • Servicio de Medicina Intensiva, Hospital Universitario Asociado General de Castellón, España. bernat mar@gva.es
    • Med Intensiva. 2012 Aug 1;36(6):416-22.

    BackgroundEmotional factors may lead to cognitive impairment that can adversely affect the capacity of patients to reason, and thereby, limit their participation in decision taking.PurposesTo analyze critical patient aptitude for decision taking, and to identify variables that may influence competence.DesignAn observational descriptive study was carried out.SettingIntensive care unit.PatientsParticipants were 29 critically ill patients.Main VariablesSocial, demographic and psychological variables were analyzed. Functional capacities and psychological reactions during stay in the ICU were assessed.ResultsThe patients are of the firm opinion that they should have the last word in the taking of decisions; they prefer bad news to be given by the physician; and feel that the presence of a psychologist would make the process easier. Failure on the part of the professional to answer their questions is perceived as the greatest stress factor. Increased depression results in lesser cognitive capacity, and for patients with impaired cognitive capacity, participation in the decision taking process constitutes a burden. The variables anxiety and depression are significantly related to decision taking capacity.Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.

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