title: [Is the critical patient competent for decision taking? Psychological and psychopathological reasons of cognitive impairment].
abstract: BACKGROUND
  Emotional factors may lead to cognitive impairment that can adversely affect the capacity of patients to reason, and thereby, limit their participation in decision taking.
  
  
  OBJECTIVE
  To analyze critical patient aptitude for decision taking, and to identify variables that may influence competence.
  
  
  METHODS
  An observational descriptive study was carried out.
  
  
  METHODS
  Intensive care unit.
  
  
  METHODS
  Participants were 29 critically ill patients.
  
  
  METHODS
  Social, demographic and psychological variables were analyzed. Functional capacities and psychological reactions during stay in the ICU were assessed.
  
  
  RESULTS
  The 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.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Asociado General de Castellón, España. bernat mar@gva.es
authors.forename: M D
authors.initials: MD
authors.lastname: Bernat-Adell
authors.forename: R
authors.initials: R
authors.lastname: Ballester-Arnal
authors.forename: R
authors.initials: R
authors.lastname: Abizanda-Campos
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D016638:Critical Illness / Q000523:psychology*; D003657:Decision Making / Q000941:ethics / Q000502:physiology*; D003863:Depression / Q000523:psychology; D004644:Emotions; D006801:Humans; D007258:Informed Consent; D007297:Inpatients / Q000523:psychology*; D007406:Interview, Psychological; D008297:Male; D016743:Mental Competency / Q000523:psychology / Q000592:standards; D008875:Middle Aged; D010348:Patient Care Team; D057240:Patient Preference; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011581:Psychological Tests; D012959:Socioeconomic Factors; D013030:Spain; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014342:Truth Disclosure