[Evaluation of the capacity of elderly patients to make decisions about their health]. / Evaluación de la capacidad de toma de decisiones sobre su salud en pacientes ancianos.

OBJECTIVE: To assess the decision-making capacity and variables related to this, in elderly patients in a home care program. MATERIAL AND METHODS: A cross-sectional study was conducted on 130 patients assigned to home care program or in social welfare residences of an urban health centre. Demographic variables, as well as comorbidities, social support, institutionalisation, number of drugs used, degree of dependence (Barthel Index), cognitive function (Pfeiffer) were collected. The primary endpoint was the capacity for decision-making about their health assessed using the Aid to Capacity Evaluation (ACE) tool. RESULTS: There was a prevalence of 58.5% capacity. There was an association between ability and independence for activities of daily living (odds ratio (OR): 12.214; Confidence interval 95% (95% CI): 3.90 to 32.29, P <.0001) and function intellectual intact (OR: 282.750, 95% CI 34.0 to 2351.2, P <.0001). Numeric variables associated with the capacity for decision-making that had a more important effect size were the Barthel index (d: -1.398) and Pfeiffer index (d: 3.084). CONCLUSIONS: The prevalence of incapacity to make decisions about their health in elderly patients who are cared for in their homes is high. The level of dependence in activities of daily living and the deterioration of intellectual function are factors associated with the presence of this capacity.

Evaluación de la capacidad de toma de decisiones sobre su salud en pacientes ancianos / Evaluation of the capacity of elderly patients to make decisions about their health

Objetivo. Evaluar la prevalencia de capacidad para la toma de decisiones y las variables relacionadas con ella, en pacientes ancianos de un programa de atención domiciliaria. Material y métodos. Se realiza un estudio descriptivo transversal en 130 pacientes adscritos al programa de atención domiciliaria o residentes en instituciones sociosanitarias de un centro de salud urbano. Se recogen las variables demográficas, las comorbilidades, el apoyo social, la institucionalización, el número de fármacos utilizados, el grado de dependencia (índice de Barthel), la función cognitiva (test de Pfeiffer) y la variable principal que es la capacidad para la toma de decisiones sobre su salud evaluada mediante el instrumento Aid to Capacity Evaluation (ACE). Resultados. Prevalencia de capacidad de 58,5%. Se encontró una asociación entre capacidad e independencia para las actividades de la vida diaria (odds ratio [OR]: 12.214; intervalo de confianza al 95% (IC 95%): 3,90-32,29; p < 0,0001) y función intelectual intacta (OR: 282.750; IC 95%: 34,0-2351,2; p < 0,0001). Las variables numéricas asociadas a la capacidad para la toma de decisiones que presentaron una magnitud de efecto más importante fueron el índice de Barthel (d: −1.398) y el índice de Pfeiffer (d: 3.084). Conclusiones. La prevalencia de incapacidad para la toma de decisiones sobre su salud en pacientes ancianos que son atendidos domiciliariamente es elevada. El grado de dependencia para las actividades de la vida diaria y del deterioro de la función intelectual son factores asociados a la presencia de esta capacidad (AU)

Objective. To assess the decision-making capacity and variables related to this, in elderly patients in a home care program. Material and methods. A cross-sectional study was conducted on 130 patients assigned to home care program or in social welfare residences of an urban health centre. Demographic variables, as well as comorbidities, social support, institutionalisation, number of drugs used, degree of dependence (Barthel Index), cognitive function (Pfeiffer) were collected. The primary endpoint was the capacity for decision-making about their health assessed using the Aid to Capacity Evaluation (ACE) tool. Results. There was a prevalence of 58.5% capacity. There was an association between ability and independence for activities of daily living (odds ratio (OR): 12.214; Confidence interval 95% (95% CI): 3.90 to 32.29, P <.0001) and function intellectual intact (OR: 282.750, 95% CI 34.0 to 2351.2, P <.0001). Numeric variables associated with the capacity for decision-making that had a more important effect size were the Barthel index (d: −1.398) and Pfeiffer index (d: 3.084). Conclusions. The prevalence of incapacity to make decisions about their health in elderly patients who are cared for in their homes is high. The level of dependence in activities of daily living and the deterioration of intellectual function are factors associated with the presence of this capacity (AU)