title: Improving functional outcomes for schizophrenia patients in the Netherlands using Cognitive Adaptation Training as a nursing intervention - A pilot study.
abstract: Cognitive Adaptation Training (CAT) improves functional outcomes in schizophrenia outpatients living in the United States. The effectiveness of CAT for patients living outside the US as well as for long-term hospitalized patients remains to be determined. In addition, it has not yet been studied whether CAT can be successful if patients receive the treatment from psychiatric nurses. This pilot study investigated the effectiveness and feasibility of CAT as a nursing intervention in the Netherlands. Thirty schizophrenia patients (long-term hospitalized patients: 63%) participated in this study. Sixteen patients received treatment as usual (TAU)+CAT, and fourteen patients received TAU. Patients in CAT participated in the treatment for eight months, consisting of weekly home-visits by a psychiatric nurse, supervised by a psychologist. After eight months, CAT interventions were integrated in the usual treatment. Outcome measures were the Multnomah Community Ability Scale (MCAS), the Social and Occupational Functioning Scale (SOFAS), and the Negative Symptom Assessment-Motivation subscale (NSA-M). For inpatients, work-related activities were also tracked for 16 months after baseline. Patients receiving TAU+CAT had better scores on the MCAS (trend), compared to TAU patients. Moreover, inpatients' work-related activities increased in TAU+CAT, relative to TAU inpatients, reaching significance after ten months. Improvements on the SOFAS and NSA-M were not significant. These results indicate that CAT as a nursing intervention may improve outcomes in patients with schizophrenia living in the Netherlands, including long-term hospitalized patients. However, since the current study was designed for exploratory purposes, larger randomized controlled studies are needed to confirm our results and to investigate the long-term effects of CAT as a nursing intervention systematically.
authors.affiliation: Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, The Netherlands. Electronic address: p.j.quee@umcg.nl.
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Quee
authors.affiliation: Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, The Netherlands.
authors.forename: Annemarie P M
authors.initials: AP
authors.lastname: Stiekema
authors.affiliation: Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Johanna T W
authors.initials: JT
authors.lastname: Wigman
authors.affiliation: Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, The Netherlands.
authors.forename: Harald
authors.initials: H
authors.lastname: Schneider
authors.affiliation: Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, The Netherlands; Department of Neuroscience, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Lisette
authors.initials: L
authors.lastname: van der Meer
authors.affiliation: Division of Schizophrenia and Related Disorders, Department of Psychiatry, University of TX at San Antonio, USA.
authors.forename: Natalie J
authors.initials: NJ
authors.lastname: Maples
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Edwin R
authors.initials: ER
authors.lastname: van den Heuvel
authors.affiliation: Division of Schizophrenia and Related Disorders, Department of Psychiatry, University of TX at San Antonio, USA.
authors.forename: Dawn I
authors.initials: DI
authors.lastname: Velligan
authors.affiliation: Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: Bruggeman
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009732:Nursing Care / Q000379:methods*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents
keywords: CAT; Cognition; Compensation; Rehabilitation; Schizophrenia; Treatment