Dissertation
Focus on Functioning: Measuring Executive Functioning among Patients Seeking ADHD Treatment in a Psychiatric Clinic
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background. Attention deficit-hyperactivity disorder (ADHD) is a lifespan disorder that is associated with poorer patient outcomes and quality of life. Functional capacity can be negatively influenced through poor executive functioning (EF), which includes difficulty with impulse control, strategic planning, goal-direction and motivation, and cognitive flexibility. EF may be a primary driver for patients to seek care but is underutilized in clinical assessment. Purpose. This evidence-based practice project was completed to incorporate EF assessment and improve knowledge on EF in outpatient psychiatric practice through utilization of EF measurement with the Barkley Deficit in Executive Functioning short form (BDEFS-SF) among outpatients with ADHD and an educational presentation for healthcare staff. Methods. The Iowa Model for Evidence-Based Practice was utilized for the project, which occurred a private psychiatric and psychology practice. The BDEFS-SF was given to every adult patient with ADHD, and demographic information was collected. BDEFS-SF results were compared to sampled norms. Acceptability and feasibility measures were collected from participating providers each month to ensure the program s success. Additionally, a pre- and post-test was distributed to currently licensed healthcare professionals to evaluate their knowledge on EF. Findings. From October 2024 to February 2025, 199 individuals completed the BDEFS-SF with no patient refusal. Their EF scores were substantially worse than a normative sample of their peers. The providers administering the surveys reported documentation ease (4/5) and positive influence to clinical decisions (3.88/5). Additionally, they reported a positive impact to their practice (3.62/5) with a 25% increase in psychotherapy referrals. Provider knowledge on EF improved by 14% after the educational presentation. Discussion. The project aims had mixed results but overall findings were positive. No patient refusal indicates acceptability to participants, and providers reported a positive change. Connecting patients to psychotherapy showed positive outcomes.
Details
- Title: Subtitle
- Focus on Functioning: Measuring Executive Functioning among Patients Seeking ADHD Treatment in a Psychiatric Clinic
- Creators
- Sarah Mitchell - University of Iowa
- Contributors
- Dan Wesemann (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Psych-Mental Health Nurse Practitioner
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Sarah Mitchell
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841037402771
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