Scholarship & Research
Permanent URI for this communityhttps://scholarworks.montana.edu/handle/1/1
Browse
5 results
Search Results
Item Measurement based care for improving clinical depression and attention-deficit/hyperactivity disorders(Montana State University - Bozeman, College of Nursing, 2024) Blouin, Patrick Daniel; Chairperson, Graduate Committee: Alice RunningBackground: Measurement based care is an evidence-based approach proven to enhance diagnosis and treatment of psychiatric disorders. This patient-centered strategy involves the routine use of clinically validated, self-report rating scales to quantify clinical outcomes over time and guide decision-making. Extensive research indicates that measurement based care improves the quality of psychiatric care and patient outcomes. Local Problem: Prior to implementation of the Doctor of Nursing Practice project, measurement based care for adults diagnosed with clinical depression and/or attention-deficit/hyperactivity disorders had not been implemented at a mental health clinic located in southwest Montana. Methods: Hence, the purpose of the Doctor of Nursing Practice project was to implement the Beck Depression Inventory II and the Adult ADHD Self-Report Scale for adult patients, treated in-person at the clinic, diagnosed with clinical depression and/or attention/deficit-hyperactivity disorder. Interventions: After approval by the Montana State University Institutional Review Board, qualifying patients were administered the appropriate self-report rating scale via iPad at the beginning of each clinical encounter. Immediately after patients completed the self-report rating scale, the clinician reviewed their scores and used this data to augment decision-making. Results: The results of the 11-week project revealed improved follow-up scores, suggesting that data collected from clinically validated, self-report rating scales may have enhanced earlier detection rates of deterioration and enhanced clinician responsiveness to subtle changes in morbidity. Conclusion: In summation, the Doctor of Nursing project underscores the importance of measurement based care for improving patient outcomes related to clinical depression and/or attention/deficit-hyperactivity disorders and provides valuable insights for future quality improvement initiatives.Item Attention deficit hyperactivity disorder treatment for pediatrics(Montana State University - Bozeman, College of Nursing, 2018) Brewer, John Mikkel; Chairperson, Graduate Committee: Tracy HellemAttention deficit, hyperactivity disorder (ADHD) is commonly diagnosed in children, and the frequency of this disorder being diagnosed and treated continues to rise each year. The research regarding treatment for pediatric ADHD has shown varied results ranging from pharmacological and behavioral therapies producing positive effects when combined to standalone behavioral therapy or medication producing positive effects with no therapeutic intervention. There are two published guidelines on the management of pediatric ADHD. The American Academy of Pediatrics and the National Collaborating Centre for Mental Health each created a guideline for evaluating, diagnosing, and treating pediatric patients with ADHD. This project analyzed ADHD treatments for children ages 4 to 18 years in an acute, inpatient psychiatric setting, and in an inpatient, residential-treatment-care setting. A comparison of these treatments with the national guidelines was conducted. This scholarly project compared pediatric ADHD treatment in an inpatient, acute-care unit versus a residential-care unit of a psychiatric children's hospital. Readmission rates within 30 days of discharge from a psychiatric children's hospital have been analyzed, and care practices have been compared with the national guidelines. Data was extracted from electronic medical records from the psychiatric children's hospital's healthcare record system. The types of data that were extracted included demographics, such as age, comorbid diagnoses, and concomitant medications; in addition to types of treatment, readmission rates, and treatment setting. Type-of-treatment data included type of medication versus treatment setting. The findings suggest that medications other than methylphenidate may have similar efficacy as methylphenidate for treating pediatric ADHD. The inpatient psychiatric unit is not necessarily following the National Clinical Guidelines for treating pediatric and adolescent ADHD, but the results reveal that methylphenidate versus non-methylphenidate treatment for ADHD does not demonstrate a statistically significant difference with respect to inpatient readmission rates. The research identified that patients receiving residential care for ADHD had a higher likelihood of being readmitted to the hospital than patients receiving acute care, and patients' readmission rates were not statistically significantly different regarding methylphenidate versus non-methylphenidate medication-treatment regimens. Overall, this research identified that medications other than methylphenidate can be effective in treating patients with ADHD.Item The effect of supplemental online tutorials on chemistry comprehension in students diagnosed with ADHD(Montana State University - Bozeman, Graduate School, 2016) Burgess, Megan Annette; Chairperson, Graduate Committee: Peggy TaylorStudents who are diagnosed with Attention Deficit Hyperactive Disorder (ADHD) have difficulty concentrating for extended periods. This population is predisposed to a host of comorbidities with other academically debilitating disorders such as anxiety and daytime drowsiness. This project was designed in order to assist this population of learners in a high school chemistry course. For the first treatment, students watched daily tutorial videos in order to improve comprehension, while also increasing confidence levels and decreasing anxiety. The tutorials explained chemistry concepts and demonstrated how to solve multistep chemistry problems. A second treatment was implemented in which multiple choice quizzes were interspersed throughout the tutorial videos in order to measure whether improved focus could be obtained. Data concluded that the tutorials were extremely successful. The population of ADHD students performed better on formative assessments in addition to increasing their confidence levels and decreasing anxiety levels surrounding the study of chemistry.Item Parent perceptions of the effect of ADHD child behavior on the family : the impact and coping strategies(Montana State University - Bozeman, College of Education, Health & Human Development, 1996) Bullard, Julie AnneItem Children with ADHD in a rural community(Montana State University - Bozeman, College of Nursing, 2005) Miller, Debra Joan; Chairperson, Graduate Committee: Karen ZulkowskiChildren with ADHD experience a myriad of chronic behavioral and academic difficulties. If attributes among rural children are similar to those described by studies conducted on the urban population, educators and health care professionals may have grossly underestimated the public health impact of ADHD Research does not provide adequate descriptive data of children with ADHD in rural communities and until more is known about actual attributes of these children, there will continue to be disparities in identification, access to treatment, and reports of the manifestations of ADHD and its co-existing conditions. Levine's Conservation Model- Nursing Process in the Community provides the theoretical framework for the study. A Descriptive Correlational study is conducted to gain information on the demographic attributes; to identify the distribution of ADHD subtypes; and to explore the comorbidity associated with ADHD in rural children. The sample consists of 88 children seen at a pediatric outreach clinic located in a rural community in southern Wyoming. Secondary data analysis makes the study exempt from IRB review. Descriptive statistics are used to organize and analyze the data. Because of the small sample size, results may only indicate potential trends. Findings may not be statistically significant but clinically they assisted the community in proposing systems for establishing family-centered, community-based care. The gender ratio is similar to those of larger studies with more boys than girls diagnosed. This raises the continued concern that ADHD may be under-diagnosed in girls in rural communities. Caucasians are diagnosed more frequently, raising the concern that minorities are under-diagnosed or underrepresented in research. Findings on the distribution of subtypes is somewhat ambiguous when compared to other studies. Most of the children were diagnosed during school transition times (1st and 3rd grades). Psychological comorbidities were diagnosed in 27.3% and 55.7% were identified with learning disabilities. Sleep disturbances were frequently associated with the diagnosis of ADHD and depression was found to contribute substantially to sleep disturbances. ADHD can be characterized by heterogeneity and ambiguity, and confounded by comorbidity. Nurse Practitioner strategies should include: collaborative assessment; case planning; advocacy; management; and building systems to provide a multimodal approach to interventions.