title: An intensive social cognitive program (can do treatment) in people with relapsing remitting multiple sclerosis and low disability: a randomized controlled trial protocol.
abstract: BACKGROUND
  In people with multiple sclerosis (MS) disabilities and limitations may negatively affect self-efficacy. Lowered self-efficacy has been associated with decreases in health-related quality of life, physical activity and cognitive performance. In an explorative observational study we found that a 3-day intensive social cognitive program (Can Do Treatment [CDT]) with the participation of support partners was followed by substantial increases in self-efficacy control and health-related quality of life 6 months after treatment in those people with MS who had relapsing remitting disease and low disability.
  
  
  METHODS
  CDT is a sociologically oriented approach, its goal is to uncover and promote existing capabilities, and the notion "stressor" is the central concept. CDT's components are plenary group sessions, small group sessions, consultations, a theatre evening, and start of the day with a joint activity. The small group sessions form the actual training. Depending on their individual goals the participants join the training groups 'Body', 'Feeling' or 'Life', to work out their aims and to reduce their stressors. The multidisciplinary team includes a psychiatrist, psychiatric nurse, neurologist, specialized MS nurse, physiotherapist, dance therapist, and a person with MS. To evaluate the (cost)effectiveness of CDT in persons with relapsing remitting MS and low disability we perform a single-centre, randomized controlled trial in 140 patients, with or without support partners. The primary outcome is self-efficacy control. The secondary outcomes are self-efficacy function, health-related quality of life, autonomy and participation, anxiety, depression, cost effectiveness and cost utility. The tertiary outcome is care-related strain to support partners. Outcomes are assessed at baseline and at 1, 3 and 6 months after CDT.
  
  
  CONCLUSIONS
  This randomized controlled trial will adequately evaluate the clinical and cost effectiveness of a 3-day intensive social cognitive program in people with relapsing remitting MS and low disability, with self-efficacy control as primary outcome.
  Application number: 22444.
authors.affiliation: Department of Community & Occupational Medicine, University Medical Centre Groningen, Antonius Deusinglaan 1, 9713, AV, Groningen, The Netherlands. ms4ri@kpnmail.nl.|MS4 Research Institute, Ubbergseweg 34, 6522, KJ, Nijmegen, The Netherlands. ms4ri@kpnmail.nl.
authors.forename: Peter Joseph
authors.initials: PJ
authors.lastname: Jongen
authors.affiliation: National MS Foundation The Netherlands, Mathenesserlaan 378, 3023, HB, Rotterdam, The Netherlands.
authors.forename: Marco
authors.initials: M
authors.lastname: Heerings
authors.affiliation: Medical Psychiatric Centre PsyToBe, Metroplein 50, 3083, BB, Rotterdam, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Ruimschotel
authors.affiliation: National MS Foundation The Netherlands, Mathenesserlaan 378, 3023, HB, Rotterdam, The Netherlands.
authors.forename: Astrid
authors.initials: A
authors.lastname: Hussaarts
authors.affiliation: Department of Health Services Research, Maastricht University, Duboisdomein 30, 6229, GT, Maastricht, The Netherlands.
authors.forename: Silvia
authors.initials: S
authors.lastname: Evers
authors.affiliation: Medical Psychiatric Centre PsyToBe, Metroplein 50, 3083, BB, Rotterdam, The Netherlands.
authors.forename: Lotte
authors.initials: L
authors.lastname: Duyverman
authors.affiliation: Fysiotherapie Maaspoort, Maaspoortweg 182, 5235, KB, 's-Hertogenbosch, The Netherlands.
authors.forename: Joyce
authors.initials: J
authors.lastname: Valkenburg-Vissers
authors.affiliation: Dansjobs, Vossestaartstraat 8, 1121, BL, Landsmeer, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: Cornelissen
authors.affiliation: St. Anna Hospital, Bogardeind 2, 5664, EH, Geldrop, The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: Bos
authors.affiliation: National MS Foundation The Netherlands, Mathenesserlaan 378, 3023, HB, Rotterdam, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: van Droffelaar
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
authors.forename: Wim A
authors.initials: WA
authors.lastname: Lemmens
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
authors.forename: Rogier
authors.initials: R
authors.lastname: Donders
authors.affiliation: National MS Foundation The Netherlands, Mathenesserlaan 378, 3023, HB, Rotterdam, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: van der Zande
authors.affiliation: St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022, GC, Tilburg, The Netherlands.|University of Humanistic Studies, Kromme Nieuwegracht 29, 3512, HD, Utrecht, The Netherlands.
authors.forename: Leo H
authors.initials: LH
authors.lastname: Visser
mesh_terms: D001007:Anxiety / Q000453:epidemiology; D003071:Cognition; D003362:Cost-Benefit Analysis; D003863:Depression / Q000453:epidemiology; D006801:Humans; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000523:psychology*; D011788:Quality of Life; D020377:Self Efficacy; D012919:Social Behavior
keywords: Disability; Health-related quality of life; Multiple sclerosis; Randomized controlled trial; Relapsing remitting; Self-efficacy; Social cognitive; Wellness