Trastorno Deficit De Atncion E Hiperactividad

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Attention deficit hyperactivity disorder: a model of nursing care
Sue Keoghan describes how the role of specialist nurse practitioner can be expanded to include the diagnosis and treatment of adults with this condition
Correspondence susan.keoghan2@swyt.nhs.uk Date of acceptance April 4 2011 Peer review This article has been subject to double-blind review and has been checked usingantiplagiarism software Author guidelines www.mentalhealthpractice.co.uk

Abstract
People with attention deficit hyperactivity disorder (ADHD) can suffer its consequences throughout their lives. This article considers the development of a specialist nurse practitioner role and the adoption of a nursing model of care in delivering innovative services for adults with ADHD. Keywords Attentiondeficit hyperactivity disorder, specialised care Attention Deficit Hyperactivity Disorder (ADHD) is a developmental condition that begins in childhood. Until recently it was believed that ADHD was outgrown in adolescence, but it is generally recognised that it can span people’s lifetimes and lead to considerable impairment (Barkley 2010). the symptoms of ADHD are high levels of impulsivity,hyperactivity and inattention, which often cause difficulties at home and in education, work and social settings. Although symptom frequency and severity tend to reduce with age, the overall effect of the condition can increase because of the changing demands of adult life. Procrastination, overreacting to frustration, risk-taking behaviour, poor motivation, insomnia and time-management difficulties arecommon in adults with ADHD, who often experience higher rates of relationship and marital breakdown, lower socioeconomic status, poorer educational and employment performance, and a higher incidence of criminal behaviour than people without the disorder (Stevenson et al 2002, Davidson 2008, Barkley 2010). Significant coexisting conditions for adults diagnosed with or requiring treatment for ADHDinclude substance misuse, personality disorders,

emotional problems and learning difficulties. it is estimated that ADHD affects 2 per cent of the adult population worldwide (national institute for Health and clinical excellence (nice) 2008) Adamou (2009) suggests there is a lack of services for adults with ADHD, and that many people have been diagnosed with the condition incorrectly and that othersremain undiagnosed. Meanwhile, few commissioners have set up specialist services for diagnosing and treating adults with ADHD, even though effective treatment can produce beneficial personal and economic outcomes (Adamou 2009). the nice (2008) treatment guidelines for adults with ADHD acknowledge that there is a paucity of research into the effectiveness of treatment outside the medical model ofcare. they recommend pharmacological treatments except for people who have made informed decisions not to accept them and who state a preference for psychological approaches. Similarly, in studies relating to the assessment and treatment of adult ADHD, medical and psychological approaches predominate. Although the value of nursing interventions for children with ADHD has been recognised (Brown andBruce 2004, McGuiness 2008, Ghanizadeh 2009), that of such interventions for adults with the condition has yet to be determined.

Empowerment
the defining characteristic of nursing interventions is the empowerment of people to achieve or recover and maintain their independence, taking into account individual physiological, psychological, social, cultural and spiritual needs (Royal college ofnursing 2003).
MENTAL HEALTH PRACTICE

20 November 2011 | Volume 15 | Number 3

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Feature
this characteristic has informed the development of nursing theories and models over the past 50 years (Alligood and tomey 2009). nursing models guide and enhance the assessment, planning, implementation and evaluation of care delivery. Many...