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Centre for Policy on Ageing | |
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Decision-making capacity of elderly patients assessed through the vignette method
— imagination or reality? | | Author(s) | A Vellinga, J H Smit, E Van Leeuwen |
| Journal title | Aging & Mental Health, vol 9, no 1, January 2005 |
| Pages | pp 40-48 |
| Source | http://www.tandfonline.com |
| Keywords | Medical care ; Rights [elderly] ; Social ethics ; Evaluation ; Netherlands. |
| Annotation | This article evaluates whether providing realistic or hypothetical treatment information affects the decision-making capacity of older patients. Decision-making capacity was assessed by means of a clinical vignette that presented a choice about whether to undergo an endoscopic procedure. The following standards of decision-making capacity were evaluated qualitatively and quantitatively: ability to evidence a choice, to understand, to reason, and to appreciate a situation. When the vignette was presented as a hypothetical situation, cognitively impaired patients performed significantly poorer than non-impaired patients on all abilities associated with decision-making capacity (with the exception of evidencing a choice). The realistic situation showed the same pattern among cognitively impaired and non-impaired patients in their ability to understand and in the total vignette score. Both types of patients reasoned about and appreciated the realistic situation equally well. Qualitative analysis revealed that patients gave comparable answers in both hypothetical and realistic situations. The answers were not related to standards of decision-making capacity. Moreover, personal circumstances were taken as a reference point for making a decision, regardless of the situation. While the authors did not find any major differences between the hypothetical and realistic situations, their findings raise questions about the validity of hypothetical vignettes, especially when used with cognitively impaired people. (RH). |
| Accession Number | CPA-050203219 A |
| Classmark | LK: IKR: TQ: 4C: 76H |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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