Giving voice

What do the data suggest about professionals who are not SLTs?

They make invalid assumptions about patients' communication abilities (correct)

They are always able to implement communication screening tool recommendations accurately

They always use a communication screening tool in preparation for mental capacity assessments

They make valid assumptions about patients' communication abilities

What was the purpose of using SurveyMonkey software in the data collection procedure?

To measure interrater reliability of the screening tool

To observe the screening tests conducted by professionals

To collect MCAST documentation completed by professionals

To develop an electronic questionnaire for professional participants to complete (correct)

What is the purpose of the communication screening tool developed in the study?

To diagnose communication disorders in patients

To support healthcare professionals in identifying and supporting patients with communication disabilities during mental capacity assessments (correct)

To provide decision-making support to patients with cognitive impairment

To replace speech and language therapists in mental capacity assessments

What type of design was used for the MCAST feasibility study?

Mixed-methods convergence triangulation design Signup and view all the answers

What did healthcare professionals suggest as a potential method to address the limited speech and language therapy resources available for communication disorders?

Developing a simple method for multidisciplinary staff to use in order to differentiate patients with different severities of communication difficulty and how to support them during capacity assessments. Signup and view all the answers

What is the purpose of the MCAST communication screening tool?

To support healthcare professionals in identifying and meeting the needs of patients with communication difficulties during mental capacity assessments Signup and view all the answers

What is the purpose of the subtests included in the MCAST prototype?

To assess decision-making capacity in patients Signup and view all the answers

What is the Fleiss kappa statistic for the overall screening test outcomes of participants A and B?

k = 0.432, 95% CI = [−0.053, 0.917] Signup and view all the answers

What is the focus of the paper?

Developing a new communication screening tool for mental capacity assessments Signup and view all the answers

What is the main issue highlighted in the study?

NonSLT health professionals struggle with identifying and screening for communication difficulties. Signup and view all the answers

What was the response of the majority of professionals to the screening tool?

They felt confident about its outcomes Signup and view all the answers

What is the Mental Capacity Act (MCA) in England and Wales?

A law that requires health and social care professionals to provide decision-making support and complete a mental capacity assessment for people aged 16 years or above who may have difficulty making an informed decision Signup and view all the answers

What is one of the main concerns of professionals involved in co-designing the screening tool?

The need for significant training to use the tool Signup and view all the answers

How many professional participants were recruited to the MCAST feasibility study?

20 females and one male Signup and view all the answers

What software was used to analyse the qualitative data in the study?

QSR NVivo 9 Signup and view all the answers

What is the risk associated with communication difficulties in decision-making?

Professionals may make incorrect judgements about mental capacity. Signup and view all the answers

What is the limitation of the evaluation of reliability and validity in this study?

The lack of observation of professionals using the tool Signup and view all the answers

What is criterion validity?

The level of agreement observed between outcomes obtained using the communication screening tool and those obtained using an external criterion variable Signup and view all the answers

What is the purpose of the Mental Capacity Assessment Support Toolkit (MCAST)?

To identify the specific needs of people with communication disabilities during mental capacity assessments Signup and view all the answers

Who were the healthcare professionals recruited for the study?

Liaison psychiatrists, nurses, occupational therapists, physicians, physiotherapists, psychologists, SLTs, and social workers Signup and view all the answers

How was the communication screening tool developed?

Using co-production and user-centred design principles Signup and view all the answers

Why is it important to improve practice for mental capacity assessments?

To ensure legal compliance Signup and view all the answers

What is the definition of incapacity according to the MCA?

The inability to make a time-specific decision due to an impairment or disturbance in the functioning of the mind or brain Signup and view all the answers

Who is responsible for providing individualized support to maximize decision-making capacity according to the MCA?

Health and social care professionals Signup and view all the answers

Why do professionals from other disciplines not always seek specialist support from SLTs during mental capacity assessments?

All of the above Signup and view all the answers

What is the MCAST communication screening tool designed to do?

Enable professionals to identify a patient’s communication difficulties as well as provide a range of communication strategies that could be used to support the patient in specific ways during the capacity assessment. Signup and view all the answers

What is the criteria for a patient to be referred to speech and language therapy?

Inability to provide a reliable 'yes/no' response or understand simple spoken information Signup and view all the answers

Why were the screening tests not observed by the researchers?

To avoid influencing the results of the assessment of usability Signup and view all the answers

What was used as the criterion variable in the communication assessment?

The Frenchay Aphasia Screening Test (FAST) supplemented with a ‘yes/no’ reliability subtest and a photograph recognition subtest Signup and view all the answers

How many stages were involved in the thematic analysis of the data?

Five Signup and view all the answers

Which professional group had the highest number of participants in the MCAST feasibility study?

Occupational therapists Signup and view all the answers

Why did some professionals choose not to use the screening tool?

They did not think it was necessary Signup and view all the answers

How many patients did professional participant B discontinue the screening test for?

1 Signup and view all the answers

What did most participants in the study report about the communication screening tool?

They found it useful and easy to use Signup and view all the answers

What is the challenge to promoting widespread use of a communication screening tool?

Invalid assumptions made by professionals who are not SLTs Signup and view all the answers

What is the proposed method to establish the tool's psychometric properties?

Testing the tool with established language assessment tools Signup and view all the answers

What should be included in the training for professionals to use the screening tool effectively?

Information about the types of health conditions that may cause communication difficulties Signup and view all the answers

What was the feedback from professionals who used the communication screening tool in the study?

The tool was useful, easy to use, and increased understanding of communication support methods and the role of SLTs during mental capacity assessments. Signup and view all the answers

What could be a potential solution to standardize the administration of the screening tool?

Offering a digital version of the MCAST Signup and view all the answers

What do healthcare professionals without specialist training need to understand?

The importance of communication in mental capacity assessments Signup and view all the answers

Why did some professionals elect not to use the screening tool?

They judged the patient's communication skills to be intact during conversation Signup and view all the answers

What did participants value about the screening tool?

Its ease of use and clarity of instructions Signup and view all the answers

Why did the study not investigate intrarater reliability?

Practical constraints Signup and view all the answers

What is needed to further develop the communication screening tool?

A greater understanding of health professionals' thought processes regarding communication. Signup and view all the answers

How did the researchers control for learning effects and reduce bias?

By counterbalancing the order of the two screening tests and the first author’s assessment over a 48-hour period Signup and view all the answers

How many patients did professionals A and B obtain consistent outcomes for on the spoken comprehension subtest?

5 Signup and view all the answers

Why did professionals review a patient's medical notes before completing the second screening test?

To identify and record any medical events that may cause the patient's communication or cognitive abilities to fluctuate Signup and view all the answers

How many healthcare professionals and patients participated in the study?

21 professionals and 17 patients Signup and view all the answers

What was the purpose of the analysis of completed MCAST documentation?

To examine professionals' documentation of decisions about whether to use the screening tool Signup and view all the answers

What is the role of SLTs in mental capacity assessment?

To identify the specific needs of people with communication disabilities during mental capacity assessments Signup and view all the answers

Which patients were excluded from the study?

Patients who required information to be presented in languages other than English Signup and view all the answers

What does the MCA functional test of decision-making require an assessor to establish?

Whether a person is able to understand, retain, and use or weigh relevant information in order to make a decision and then communicate a choice Signup and view all the answers

How are the subtests in the MCAST prototype scored?

They are not scored Signup and view all the answers

How many patients were recruited to the MCAST feasibility study?

17 Signup and view all the answers

Who is ideally placed to lead or support capacity assessments for people with communication disabilities?

Speech and language therapists Signup and view all the answers

Who worked collaboratively to design and review successive iterations of the MCAST communication screening tool?

Healthcare professionals, service users and their family members, and experts in UCD and communication assessment. Signup and view all the answers

What do the findings suggest about healthcare professionals' awareness of communication difficulties associated with dementia?

They lack awareness of these difficulties Signup and view all the answers

What did the first author do to help patients understand the information?

Used a range of supportive communication strategies tailored to each patient’s individual needs Signup and view all the answers

Why did the researchers decide not to measure intra-rater reliability of the screening tool?

It would overburden patients if they underwent additional screening tests within the same 48-hour period Signup and view all the answers

What challenges may people with dysarthria experience during a mental capacity assessment?

They may experience challenges expressing their understanding and preferences Signup and view all the answers

What is the potential effect of professionals not adhering to all of the tool's administration instructions?

Affecting the outcomes obtained Signup and view all the answers

Which statistic was used to evaluate the tool's interrater reliability?

Fleiss's Kappa statistic Signup and view all the answers

How many patients had a new diagnosis of stroke in the MCAST feasibility study?

6 Signup and view all the answers

How did the screening tool change the way professionals thought about communication support?

They thought it was helpful in providing communication support Signup and view all the answers

What did professionals report about the usability of the communication screening tool?

They found it easy to use and useful Signup and view all the answers

What is the level of agreement between professional participant A and the first author for the overall screening test outcome?

Poor Signup and view all the answers

Why might communication difficulties in patients with dementia or memory impairment be masked in conversation?

Because of language comprehension difficulties Signup and view all the answers

What is the question raised by the fact that some National Health Service SLT services for people living with dementia are not commissioned to provide intervention for communication disorders?

Whether it would be ethical to use a screening tool that identifies the need for communication support from an SLT in some settings Signup and view all the answers

Why did healthcare professionals emphasize that the MCAST communication screening tool should be quick and easy to use?

To ensure that patients with communication difficulties receive the appropriate support during capacity assessments. Signup and view all the answers

What are information-carrying words (ICWs)?

Words that need to be understood in order to understand the meaning of a sentence Signup and view all the answers

What sources of evidence were used to develop the communication screening tool in the MCAST?

A literature review of current mental capacity assessment practice in health and social care Signup and view all the answers

What is the Consent Support Tool?

A tool developed to enable researchers to identify how to support potential participants with communication disabilities to understand information and make decisions during the informed consent process. Signup and view all the answers

How many patient participants were tested using the communication screening tool in the MCAST feasibility study?

9 Signup and view all the answers

Why did some professionals choose not to use the communication screening tool?

They thought the patient's communication was intact Signup and view all the answers

What is the proposed method to investigate how different professionals use the tool?

Using ethnographic methods Signup and view all the answers

How were the categorical outcomes assigned based on the patient's performance on the communication screening test?

By the patient's documented performance on the 'yes/no' response reliability and spoken comprehension subtests Signup and view all the answers

What strategies are suggested in the MCAST prototype for patients with difficulty using spoken language?

All of the above Signup and view all the answers

How many patients did professional participant A and the first author obtain the same overall screening test outcome for?

2 Signup and view all the answers

How can assessors improve the quality of mental capacity assessments?

By collecting dependable information about patients’ sensory and communicative abilities and needs Signup and view all the answers

What do the findings complement about other healthcare disciplines?

They do not understand or recognize the role that SLTs can play in mental capacity assessments Signup and view all the answers

How many patients in the study were judged by the first author to likely benefit from communication support during their capacity assessment?

Four Signup and view all the answers

What was the purpose of asking another professional to complete a second, independent screening test within 48 hours of the first test?

To measure interrater reliability of the screening tool Signup and view all the answers

What is the reason for not investigating intrarater reliability in this study?

To reduce participant burden Signup and view all the answers

What does the study suggest about the interrater reliability and criterion validity of the screening tool?

The interrater reliability is moderate and the criterion validity is poor Signup and view all the answers

What was the outcome of the screening test for nine patients?

The tool's interrater reliability is currently moderate Signup and view all the answers

How many patients were found to lack the capacity to make a decision relating to their place of residence in the MCAST feasibility study?

5 Signup and view all the answers

What does research evidence suggest about communication training for mental capacity assessors?

It can improve the accuracy of capacity assessment outcomes Signup and view all the answers

Which subtest did professionals A and B record the same outcomes for each of the nine patients?

Yes/no response reliability subtest Signup and view all the answers

What did the investigation of the MCAST prototype's feasibility involve?

An exploration of how professionals from different disciplines used the communication screening tool Signup and view all the answers

What does the study suggest about healthcare professionals' ability to identify and screen for communication difficulties?

They have difficulty identifying and screening for communication difficulties Signup and view all the answers

How many professionals did not follow all instructions accurately in the MCAST feasibility study?

8 Signup and view all the answers

Which subtest of the screening tool has superior criterion validity and interrater reliability compared with the spoken comprehension subtest?

Section 2 Signup and view all the answers

What is needed to further develop the communication screening tool?

Greater understanding of healthcare professionals' thought processes regarding communication Signup and view all the answers

Giving voice

Questions and Answers

What do the data suggest about professionals who are not SLTs?

What was the purpose of using SurveyMonkey software in the data collection procedure?

What is the purpose of the communication screening tool developed in the study?

What type of design was used for the MCAST feasibility study?

What did healthcare professionals suggest as a potential method to address the limited speech and language therapy resources available for communication disorders?

What is the purpose of the MCAST communication screening tool?

What is the purpose of the subtests included in the MCAST prototype?

What is the Fleiss kappa statistic for the overall screening test outcomes of participants A and B?

What is the focus of the paper?

What is the main issue highlighted in the study?

What was the response of the majority of professionals to the screening tool?

What is the Mental Capacity Act (MCA) in England and Wales?

What is one of the main concerns of professionals involved in co-designing the screening tool?

How many professional participants were recruited to the MCAST feasibility study?

What software was used to analyse the qualitative data in the study?

What is the risk associated with communication difficulties in decision-making?

What is the limitation of the evaluation of reliability and validity in this study?

What is criterion validity?

What is the purpose of the Mental Capacity Assessment Support Toolkit (MCAST)?

Who were the healthcare professionals recruited for the study?

How was the communication screening tool developed?

Why is it important to improve practice for mental capacity assessments?

What is the definition of incapacity according to the MCA?

Who is responsible for providing individualized support to maximize decision-making capacity according to the MCA?

Why do professionals from other disciplines not always seek specialist support from SLTs during mental capacity assessments?

What is the MCAST communication screening tool designed to do?

What is the criteria for a patient to be referred to speech and language therapy?

Why were the screening tests not observed by the researchers?

What was used as the criterion variable in the communication assessment?

How many stages were involved in the thematic analysis of the data?

Which professional group had the highest number of participants in the MCAST feasibility study?

Why did some professionals choose not to use the screening tool?

How many patients did professional participant B discontinue the screening test for?

What did most participants in the study report about the communication screening tool?

What is the challenge to promoting widespread use of a communication screening tool?

What is the proposed method to establish the tool's psychometric properties?

What should be included in the training for professionals to use the screening tool effectively?

What was the feedback from professionals who used the communication screening tool in the study?

What could be a potential solution to standardize the administration of the screening tool?

What do healthcare professionals without specialist training need to understand?

Why did some professionals elect not to use the screening tool?

What did participants value about the screening tool?

Why did the study not investigate intrarater reliability?

What is needed to further develop the communication screening tool?

How did the researchers control for learning effects and reduce bias?

How many patients did professionals A and B obtain consistent outcomes for on the spoken comprehension subtest?

Why did professionals review a patient's medical notes before completing the second screening test?

How many healthcare professionals and patients participated in the study?

What was the purpose of the analysis of completed MCAST documentation?

What is the role of SLTs in mental capacity assessment?

Which patients were excluded from the study?

What does the MCA functional test of decision-making require an assessor to establish?

How are the subtests in the MCAST prototype scored?

How many patients were recruited to the MCAST feasibility study?

Who is ideally placed to lead or support capacity assessments for people with communication disabilities?

Who worked collaboratively to design and review successive iterations of the MCAST communication screening tool?

What do the findings suggest about healthcare professionals' awareness of communication difficulties associated with dementia?

What did the first author do to help patients understand the information?

Why did the researchers decide not to measure intra-rater reliability of the screening tool?

What challenges may people with dysarthria experience during a mental capacity assessment?

What is the potential effect of professionals not adhering to all of the tool's administration instructions?

Which statistic was used to evaluate the tool's interrater reliability?

How many patients had a new diagnosis of stroke in the MCAST feasibility study?

How did the screening tool change the way professionals thought about communication support?

What did professionals report about the usability of the communication screening tool?

What is the level of agreement between professional participant A and the first author for the overall screening test outcome?

Why might communication difficulties in patients with dementia or memory impairment be masked in conversation?

What is the question raised by the fact that some National Health Service SLT services for people living with dementia are not commissioned to provide intervention for communication disorders?

Why did healthcare professionals emphasize that the MCAST communication screening tool should be quick and easy to use?

What are information-carrying words (ICWs)?

What sources of evidence were used to develop the communication screening tool in the MCAST?

What is the Consent Support Tool?

How many patient participants were tested using the communication screening tool in the MCAST feasibility study?

Why did some professionals choose not to use the communication screening tool?

What is the proposed method to investigate how different professionals use the tool?

How were the categorical outcomes assigned based on the patient's performance on the communication screening test?

What strategies are suggested in the MCAST prototype for patients with difficulty using spoken language?

How many patients did professional participant A and the first author obtain the same overall screening test outcome for?