Annemarie P M Stiekema1,2, Michelle T van Dam1,3, Richard Bruggeman3,4,5, Jeroen E Redmeijer1, Marte Swart6, Marian Dethmers1, Kees Rietberg1, Ellie M Wekking7, Dawn I Velligan8, Marieke E Timmerman9, André Aleman5,10, Stynke Castelein11,12, Jaap van Weeghel7,13, Gerdina M H Pijnenborg5,12,14, Lisette van der Meer1,3,5. 1. Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, the Netherlands. 2. School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands. 3. Rob Giel Research Center University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. 4. University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, the Netherlands. 5. Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands. 6. Functional Assertive Community Treatment, Lentis Psychiatric Institute, Groningen, the Netherlands. 7. Parnassia Group, Parnassia Noord Holland, Castricum, the Netherlands. 8. Division of Community Recovery, Research and Training, Department of Psychiatry, University of Texas, San Antonio, TX. 9. Heymans Institute for Psychological Research, Psychometrics and Statistics, University of Groningen, Groningen, the Netherlands. 10. Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 11. Research Department, Lentis Psychiatric Institute, Groningen, the Netherlands. 12. Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands. 13. Department of TRANZO, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands. 14. Department of Psychotic Disorders, GGZ Drenthe, Assen, the Netherlands.
Abstract
BACKGROUND: Feasible and effective interventions to improve daily functioning in people with a severe mental illness (SMI), such as schizophrenia, in need of longer-term rehabilitation are scarce. AIMS: We assessed the effectiveness of Cognitive Adaptation Training (CAT), a compensatory intervention to improve daily functioning, modified into a nursing intervention. METHOD: In this cluster randomized controlled trial, 12 nursing teams were randomized to CAT in addition to treatment as usual (CAT; n = 42) or TAU (n = 47). Daily functioning (primary outcome) was assessed every 3 months for 1 year. Additional follow-up assessments were performed for the CAT group in the second year. Secondary outcomes were assessed every 6 months. Data were analyzed using multilevel modeling. RESULTS:CAT participants improved significantly on daily functioning, executive functioning, and visual attention after 12 months compared to TAU. Improvements were maintained after 24 months. Improved executive functioning was related to improved daily functioning. Other secondary outcomes (quality of life, empowerment, negative symptoms) showed no significant effects. CONCLUSIONS: As a nursing intervention, CAT leads to maintained improvements in daily functioning, and may improve executive functioning and visual attention in people with SMI in need of longer-term intensive psychiatric care. Given the paucity of evidence-based interventions in this population, CAT can become a valuable addition to recovery-oriented care.
RCT Entities:
BACKGROUND: Feasible and effective interventions to improve daily functioning in people with a severe mental illness (SMI), such as schizophrenia, in need of longer-term rehabilitation are scarce. AIMS: We assessed the effectiveness of Cognitive Adaptation Training (CAT), a compensatory intervention to improve daily functioning, modified into a nursing intervention. METHOD: In this cluster randomized controlled trial, 12 nursing teams were randomized to CAT in addition to treatment as usual (CAT; n = 42) or TAU (n = 47). Daily functioning (primary outcome) was assessed every 3 months for 1 year. Additional follow-up assessments were performed for the CAT group in the second year. Secondary outcomes were assessed every 6 months. Data were analyzed using multilevel modeling. RESULTS: CAT participants improved significantly on daily functioning, executive functioning, and visual attention after 12 months compared to TAU. Improvements were maintained after 24 months. Improved executive functioning was related to improved daily functioning. Other secondary outcomes (quality of life, empowerment, negative symptoms) showed no significant effects. CONCLUSIONS: As a nursing intervention, CAT leads to maintained improvements in daily functioning, and may improve executive functioning and visual attention in people with SMI in need of longer-term intensive psychiatric care. Given the paucity of evidence-based interventions in this population, CAT can become a valuable addition to recovery-oriented care.
Authors: Michelle van Dam; Jaap van Weeghel; Annemarie Stiekema; Stynke Castelein; Marieke Pijnenborg; Lisette van der Meer Journal: J Psychiatr Ment Health Nurs Date: 2022-02-18 Impact factor: 2.720
Authors: Renato de Filippis; Raffaele Gaetano; Georgios Schoretsanitis; Giuseppe Verde; Cesare Anthony Oliveti; John M Kane; Cristina Segura-Garcia; Pasquale De Fazio Journal: Neuropsychiatr Dis Treat Date: 2021-07-01 Impact factor: 2.570