title: [Assessment of competence of predialysis chronic kidney disease stage 5 patients to make treatment decisions: preliminary report].
abstract: The competence to consent to treatment of 26 adults with stage 5 predialysis chronic kidney disease (CKD) (16 males, 10 females, age; 58 +/- 11 years, creatinine clearance; 10.1 +/- 3.9 mL/min)was assessed using two kinds of format: the MacArthur Competence Assessment Tool-Treatment (MacCAT-T) and mini-mental-state examination (MMSE). The MacCAT-T revealed poor ability for understanding(3.72 +/- 1.11 points; perfect score, 6 points), appreciating (2.88 +/- 0.88 points; perfect score, 4 points)and reasoning(4.30 +/- 2.11 points; perfect score, 8 points). The MMSE revealed poor performance on the attentional task. The level of attentional deficit was significantly related to both poor ability for understanding and reasoning (r = 0.432, p = 0.031 and r = 0.542, p = 0.014, respectively). These results suggest that the competence of predialysis CKD stage 5 patients to consent to treatment is impaired partly via an attentional deficit.
authors.affiliation: Research Division of Dialysis and Chronic Kidney Disease, Tohoku University Graduate School of Medicine, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Terawaki
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Sato
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Miura
authors.forename: Keiko
authors.initials: K
authors.lastname: Saito
authors.forename: Naoko
authors.initials: N
authors.lastname: Mifune
authors.forename: Wataru
authors.initials: W
authors.lastname: Shoji
authors.forename: Hironao
authors.initials: H
authors.lastname: Sato
authors.forename: Ayano
authors.initials: A
authors.lastname: Yokota
authors.forename: Akira
authors.initials: A
authors.lastname: Sugiura
authors.forename: Masashi
authors.initials: M
authors.lastname: Iwabuchi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Miyata
authors.forename: Yaeko
authors.initials: Y
authors.lastname: Murata
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nakayama
authors.forename: Junpei
authors.initials: J
authors.lastname: Suzuki
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakamura
authors.forename: Sadayoshi
authors.initials: S
authors.lastname: Ito
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Ueno
mesh_terms: D000368:Aged; D001288:Attention; D003956:Dialysis; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007258:Informed Consent; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales