Effectiveness and cost-effectiveness of cognitive adaptation training as a nursing intervention in long-term residential patients with severe mental illness: Study protocol for a randomized controlled trial

Annemarie P. M. Stiekema, Piotr J. Quee, Marian Dethmers, Edwin R. van den Heuvel, Jeroen E. Redmeijer, Kees Rietberg, A. Dennis Stant, Marte Swart, Jaap van Weeghel, Andre Aleman, Dawn I. Velligan, Robert A. Schoevers, Richard Bruggeman, Lisette van der Meer

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Abstract

Background
Despite the well-known importance of cognitive deficits for everyday functioning in patients with severe mental illness (SMI), evidence-based interventions directed at these problems are especially scarce for SMI patients in long-term clinical facilities. Cognitive adaptation Training (CAT) is a compensatory approach that aims at creating new routines in patients’ living environments through the use of environmental supports. Previous studies on CAT showed that CAT is effective in improving everyday functioning in outpatients with schizophrenia. The aim of this study is to evaluate the effect of CAT as a nursing intervention in SMI patients who reside in long-term clinical facilities.
Methods/Design
This is a multicenter cluster randomized controlled trial comparing CAT (intervention group) as a nursing intervention to treatment as usual (control group). The primary goal is to evaluate the effectiveness of CAT on everyday functioning. Secondary outcomes are quality of life, empowerment and apathy. Further, an economic evaluation will be performed. The study has a duration of one year, with four follow-up assessments at 15, 18, 21 and 24 months for the intervention group.
Discussion
There is a need for evidence-based interventions that contribute to the improvement of the functional recovery of long-term residential patients. If our hypotheses are confirmed, it may be recommended to include CAT in the guidelines for SMI care and to implement the method in standardized care.
Keywords: Cognitive adaptation training, CAT, Functioning, Severe mental illness,, Schizophrenia, Quality of life, Nursing intervention, Cognitive remediation
Original languageEnglish
Article number49
JournalTrials
Volume16
DOIs
Publication statusPublished - 2015

Keywords

  • Cognitive adaptation training
  • CAT
  • Functioning
  • Severe mental illness
  • Schizophrenia
  • Quality of life
  • Nursing intervention
  • Cognitive remediation

Cite this

Stiekema, A. P. M., Quee, P. J., Dethmers, M., van den Heuvel, E. R., Redmeijer, J. E., Rietberg, K., Stant, A. D., Swart, M., van Weeghel, J., Aleman, A., Velligan, D. I., Schoevers, R. A., Bruggeman, R., & van der Meer, L. (2015). Effectiveness and cost-effectiveness of cognitive adaptation training as a nursing intervention in long-term residential patients with severe mental illness: Study protocol for a randomized controlled trial. Trials, 16, [49]. https://doi.org/10.1186/s13063-015-0566-8