[Spanish validation of the MacArthur Competence Assessment Tool for Treatment interview to assess patients competence to consent treatment].

BACKGROUND AND OBJECTIVE:To validate the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) Spanish version, which assesses the mental capacity of patients to consent treatment, by examining 4 areas (Understanding, Appreciation, Reasoning and Expressing a choice). PATIENTS AND METHOD: SAMPLE:160 subjects (80 Internal Medicine inpatients, 40 Psychiatric inpatients and 40 healthy controls). INSTRUMENTS:MacCAT-T, Mini-Mental Status Examination (MMSE). PROCEDURE:Feasibility study, reliability and validity calculations (against to gold standard of clinical expert). RESULTS:Mean duration of the MacCAT-T interview was 18min. Inter-rater reliability: Intraclass correlation coefficient for Understanding=0.98, Appreciation=0.97, Reasoning=0.98, Expressing a choice=0.91. Internal consistency (Cronbach's alpha): Understanding=0.87, for Appreciation=0.76, for Reasoning=0.86. Patients considered to be incapable (gold standard) scored lower in all the MacCAT-T areas. Poor performance on the MacCAT-T was related to cognitive impairment assessed by MMSE. CONCLUSIONS:Spanish version of the MacCAT-T is feasible, reliable, and valid for assessing the capacity of patients to consent treatment.