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The Korean Journal of Health Psychology

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Vol.14 No.3

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Developing a Tool to Assess Competency to Consent to Treatment in the Mentally Ill Patient: Reliability and Validity

The Korean Journal of Health Psychology / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2009, v.14 no.3, pp.579-596
https://doi.org/10.17315/kjhp.2009.14.3.007







& (2009). Developing a Tool to Assess Competency to Consent to Treatment in the Mentally Ill Patient: Reliability and Validity. The Korean Journal of Health Psychology, 14(3), 579-596, https://doi.org/10.17315/kjhp.2009.14.3.007

Abstract

This study aimed to develop the Korean tool of competency to consent to psychiatric treatment and to analyze the reliability and validity of this tool. Also the developed tool's efficiency in determining whether a patient possesses treatment consent competence was checked using the Receiver Operating Characteristic curve and the relevant indices. A total of 193 patients with mental illness, who were hospitalized in a mental hospital or were in community mental health center, participated in this study. We administered a questionnaire consisting of 14 questions concerning understanding, appreciation, reasoning ability, and expression of a choice to the subjects. To investigate the validity of the tool, we conducted the K-MMSE, insight test, estimated IQ, and BPRS. The tool's reliability and usefulness were examined via Cronbach's alpha, ICC, and ROC analysis, and criterion related validation was performed. This tool showed that internal consistency and agreement between raters was relatively high(ICC .80~.98, Cronbach‘s alpha .56~.83)and the confirmatory factor analysis for constructive validation showed that the tool was valid. Also, estimated IQ, and MMSE were significantly correlated to understanding, appreciation, expression of a choice, and reasoning ability. However, the BPRS did not show significant correlation with any subcompetences. In ROC analysis, full scale cutoff score 18.5 was suggested. Subscale cutoff scores were understanding 4.5, appreciation 8.5, reasoning ability 3.5, and expression of a choice 0.5. These results suggest that this assessment tool is reliable, valid and efficient diagnostically. Finally, limitations and implications of this study were discussed.

keywords
informed consent, consent competency to treatment, mental illness, ROC analysis, informed consent, consent competency to treatment, mental illness, ROC analysis, 동의, 치료동의능력, ROC, 고지된 동의, 정신장애인

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