>Background: The majority of people with schizophrenia show serious cognitive impairments that cause deficits in general and social functioning. Cognitive Adaptation Training (CAT) is a compensatory strategy that aims to bypass the cognitive deficits by creating new routines in the patients’ environment through the use of environmental supports. In this study, we investigated which factors facilitate and hamper the implementation of the intervention in a hospital setting. Furthermore, we examined the relationship between implementation success and effectiveness of the intervention on functional outcomes. >Methods: This study was part of a multicenter Randomized Controlled Trial into the effectiveness of CAT as a nursing intervention in a long-term hospital setting (Stiekema et al, 2014). The Measurement Instrument for Determinants of Innovation (MIDI; Fleuren, Paulussen, Van Dommelen and Van Buuren, 2014) was used in the process evaluation, which consists of 29 determinants divided into 4 categories: (1) determinants associated with the innovation, (2) the user of the intervention, (3) the organization, and (4) the sociopolitical context. Eight additional CAT specific questions were developed. In total, 54 nurses were interviewed for the process evaluation. Functional outcomes were measured with the Multnomah Community Ability Scale (MCAS), the Social and Occupational Functioning Scale (SOFAS), the Social Functioning Scale-other (SFS), and the life Skills Profile (LSP). Both quantitative and qualitative data were collected. >Results: Preliminary results based on the qualitative data identified 5 factors that may hamper implementation: (1) demotivation of the patients, (2) demotivation of the nurses, (3) time deficiency, (4) insufficient support and coaching, and (5) staff turnover. Knowledge and understanding of the underlying mechanisms of CAT and social support were identified as facilitating factors. However, implementation success was not significantly correlated with improvement on measures of functional outcome. >Conclusion: This study identified 5 hampering and 2 facilitating factors that influence the implementation of CAT. These results will contribute to the science of implementing complex interventions into intensive psychiatric care and may help future interventions in their implementation process. Based on these results, a follow-up implementation research will be conducted.
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