Using an assessment tool to support capacity assessments undertaken remotely in the context of a global health crisis : A feasibility study

Fowler, Emma and Perez Algorta, Guillermo and Duxbury, Anna and Hodge, Suzanne (2020) Using an assessment tool to support capacity assessments undertaken remotely in the context of a global health crisis : A feasibility study. PhD thesis, Lancaster University.

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Abstract

This thesis comprises a systematic literature review, an empirical paper and a critical appraisal. A systematic review of quantitative studies examining the efficacy of cognitive interventions to improve decision-making in people with Mild Cognitive Impairment (MIC) was conducted. Twenty-six papers were identified. Results indicate that interventions to improve decision-making in people with MCI can be effective. Most studies tested interventions designed to improve higher-order thinking skills, or executive functions, that are thought to underpin decision-making. Of these, interventions targeting logical reasoning, cognitive control and inhibition demonstrated the best results. Risk of bias arising from poor quality research design or reporting affected most studies. Consequently, it was not possible to draw clear conclusions about the efficacy of particular interventions at this time. Implications and recommendations for research are discussed. The empirical paper explores the feasibility of using a capacity assessment tool designed to support remote working during the COVID-19 health crisis. Views were gathered from eight participants either through online focus groups or online individual interviews. Data from transcribed discussions, notes taken by a focus group assistant and notes from focus group debrief sessions between the researcher and focus group assistant were analysed using thematic analysis. Findings indicate that the tool is perceived to be feasible for use in practice and merits additional research. The assessment tool was praised for its structure and for prompts, questions and examples that enabled participants to obtain useful data in a pressurised context. Clinical implications are discussed and recommendations for research are outlined. The critical appraisal section offers reflections on the process of undertaking research into mental capacity and decision making. Ethical, philosophical and practical benefits and challenges are explored. The experience of undertaking research during a significant health crisis is examined and recommendations made for future applied research in these areas.