Bakgrund: Många vuxna med ADHD avbryter sin behandling av okända orsaker. Därför är det viktigt att undersöka hur vuxna med ADHD upplever sina möjligheter att vara delaktiga i behandlingen och på vilket sätt sjuksköterskan kan vara till stöd för dem. Syfte: Att beskriva vuxna ADHD patienters upplevelse av delaktighet och behov av sjuksköterskans stöd vid behandling inom öppenvårdspsykiatrin. Metod: Kvalitativ studie som baseras på åtta semistrukturerade intervjuer. Intervjumaterialet analyserades med innehållsanalys. Resultat: Många upplevde att de saknade information om diagnos och behandling och att de därför inte kunde vara med och påverka. Sjuksköterskan upplevdes vara lättare att nå än läkaren och kunde erbjuda tätare uppföljningar. Sjuksköterskan upplevdes också ha en samordnande funktion mellan olika yrkeskategorier. Att bli sedd som person och inte bli reducerad till en patient med ADHD var viktigt. Slutligen framkom betydelsen av att även involvera närstående i behandlingen. Slutsats: En del av sjuksköterskans arbete är att föra ut kunskap och information till patienterna på ett sätt som patienterna förstår utifrån varje persons specifika behov för att öka patienternas möjlighet till delaktighet. Specialistsjuksköterskan kan också utgöra ett stöd genom möjligheten att erbjuda tätare kontakt och mer uppföljning, samordning med andra yrkesgrupper och samhällsinstanser. Stöd kan också handla om att se människan bakom diagnosen. / Background: Many adults with ADHD drop out of treatment for unknown reasons. Therefore it is important to investigate how adults with ADHD experience their possibilities to be involved in their treatment and the way in which the nurse can be supportive to them. Objective: Describe the experience by adult ADHD patients of their participation and the need of support by the nurse in outpatient psychiatry treatment. Method: Qualitative study based on eight semi-structured interviews. The interview material was analyzed with the use of content analysis. Results: Many of the participants felt that they lack information about their diagnosis and treatment, and that they therefore could not participate and influence their treatment. The nurse was perceived easier to reach than the doctor and also to offer more frequent follow-up. Their experience was also that the nurse can play a coordinating role between the different professions. To be seen as a person and not be reduced to a patient with ADHD was considered important. Finally, the interviews revealed the importance of involving relatives in treatment. Conclusion: The specialist nurse can bring knowledge and information to patients in a way that makes it possible for patients to understand on the basis of each person's specific needs in order to increase the possibilities for patients to participate. The specialist nurse can also provide support through the ability to offer more frequent contact and more follow-up and coordination with other professionals and social organization community agencies. Support may also be about seeing the person behind the diagnosis.

Bakgrund Attention deficit hyperactivity disorder (ADHD) omfattas av tre grupper; (1) en kombinerad typ med både uppmärksamhetsstörning och överaktivitet/impulsivitet, (2) huvudsakligen överaktivitet/impulsivitet samt (3) huvudsakligen uppmärksamhetsstörning. Hos barn erhåller 1 av 20 diagnosen ADHD där pojkar är överrepresenterade. Flickor diagnostiseras oftast i vuxen ålder varför det kan misstänkas att en underdiagnostik förekommer i yngre år. Sjuksköterskor är ofta delaktiga i psykopedagogiska insatser vars syfte är ökad förståelse och att ge strategier till barnet och de personer som finns runt barnet. Sjuksköterskornas erfarenhet av att det är fler pojkar än flickor som erhåller diagnosen ADHD skulle eventuellt kunna leda till att sjuksköterskorna brister i sin förmåga att anpassa omvårdnaden och de psykopedagogiska samtalen efter flickornas behov. Syfte Att undersöka om sjuksköterskor uppfattar att symtombilden och den psykopedagogiska omvårdnaden skiljer sig vid ADHD beroende på barnets/ungdomens kön ur ett genusperspektiv. Metod Fem sjuksköterskor från barn- och ungdomspsykiatriska verksamheter i Sverige intervjuades med stöd av en semistrukturerad frågeguide. Intervjuerna spelades in, transkriberades och analyserades utifrån en kvalitativ innehållsanalys. Resultat I resultatet framkom att det fanns ämnesområden som sjuksköterskorna vanligtvis fokuserade på i de psykopedagogiska samtalen. Sjuksköterskorna beskrev skillnader mellan flickor och pojkar när det handlade om skola, fritidssysselsättning, beteende, relationer och känslor samt i symtombild. Majoriteten av sjuksköterskorna ansåg att samtalen formades efter vad barnen valde att ta upp och påverkades inte av vilket kön barnet hade. Slutsats Sjuksköterskorna upplevde inte att deras förmåga att anpassa omvårdnaden och de psykopedagogiska samtalen påverkades av barnets kön. De anpassade istället omvårdnaden efter barnens och ungdomarnas behov, resurser och intressen. Däremot upplevde sjuksköterskorna att intressen och symtombild ofta skiljde sig beroende på kön. / Background   Attention deficit hyperactivity disorder (ADHD) comprises of three subtypes; (1) a combined type with both inattention and hyperactivity/impulsivity, (2) mainly hyperactivity/impulsivity and (3) mainly inattention. One out of every 20 children is diagnosed with ADHD and boys are diagnosed more frequently than girls. Girls are often diagnosed as adults which could mean that they are underdiagnosed as children. Psychoeducation, which nurses often partake in, is directed towards increasing understanding and giving the necessary strategies for the child and the people surrounding and caring for the child. Nurses´ experience of the fact that more boys than girls are diagnosed with ADHD may possibly lead to deficits in their ability to modulate care and psychoeducation to the needs of the girls. Purpose To explore if nurses perceive the symptomology and the psychoeducational care to be different depending on the sex of the child/adolescent with ADHD from a gender perspective. Method Five nurses working in child and adolescent psychiatric care in Sweden were interviewed using a semi structured interview guide. The interviews were recorded, transcribed and analysed using qualitative content analysis.  Results The results show that there are subject areas that nurses usually focus on during the psychoeducational conversations. The nurses described differences between girls and boys in terms of school, avocation, behaviour, symptomology and relationships and emotions. The majority of nurses considered the conversations to be shaped around what the child wished to discuss and not depending on the sex of the child. Conclusion The nurses did not perceive that their ability to modulate nursing care during the psychoeducational meetings was affected by the child’s gender. Instead they modulated the nursing care according to the children´s or the adolescents needs, resources and interests. However, the nurses experienced that the interests and symptoms of the child or adolescent often differed by gender.

Samverkan är en viktig del i arbetet med unga. Särskilt viktigt blir det i arbetet med unga som har ADHD, då de kräver en viss struktur i vardagen. Då många unga med ADHD har skolproblematik samt beteendemässiga problem är det viktigt med samverkan mellan skola och socialtjänst. Syftet med denna studie var att undersöka hur skolpersonal och socialsekreterare upplever deras samverkan kring ungdomar med ADHD, vilka områden det samverkas om och vilka utmaningar och möjligheter som uppstår i samverkan. Vi har använt oss av semi-strukturerade intervjuer och har intervjuat två ur skolpersonalen och två socialsekreterare. Våra huvudsakliga resultat är att samverkan upplevs vara god och viktig men att det verkar finns behov av att förbättra samverkan. De viktigaste slutsatserna är att socialsekreterarna och skolpersonalen är intresserad och engagerade i samverkan kring ungdomar med ADHD men att det antyds att viss utveckling behövs och även att viss kunskap saknas. / Collaboration is an important part of working with adolescents. It becomes especially important when working with adolescents who have ADHD, since they often demand a certain structure in their every-day life. Since many adolescents with ADHD have school problems and also behavioural problems, collaboration between schools and social services becomes important. The purpose of this study was to examine how school personnel and social workers experience their collaboration in regards to adolescents with ADHD, which areas their collaboration concerns and what challenges and possibilities that arise in collaboration. We have interviewed two people from the school personnel and two social workers. Our main results are that the respondents perceive their collaboration as functioning and consider it to be an important part of their job. However, they think that there are areas in need of improvements. The main conclusions are that the social workers as well as the school personnel are interested in and committed to collaboration when it comes to adolescents with ADHD but there seems to be a need of development and increased knowledge on the subject.

This study aims to describe the actions and processes under the subject teachers and special educators can facilitate mathematics teaching for pupils with ADHD. Qualitative interviews were conducted with three subject teachers in mathematics and two special education teachers. The interviews were recorded and transcribed in its entirety. They were analyzed based on a categorical and a relational perspective. The results show that the most important of all education is to allow the pupils to be in focus, even a varied approach with specific materials experienced successful. It also shows that pupils with ADHD may need adjustments in the form of clarification, structure and dense feedback, but that these adaptations should be individual as it can differentiate between individuals. It is also clear that external factors affect pupils with ADHD, especially classroom placement is important for these pupils. / Denna studie syftar till att beskriva vilka åtgärder och arbetsmetoder som enligt ämneslärare och specialpedagoger kan underlätta matematikundervisningen för elever med ADHD.  Kvalitativa intervjuer har genomförts med tre ämneslärare i matematik samt två specialpedagoger. Intervjuerna spelades in och transkriberades sedan i sin helhet. Intervjuerna analyserades utifrån ett kategoriskt och ett relationellt perspektiv. Resultaten visar att det viktigaste i all undervisning är att låta eleven vara i fokus.  Det går även se att ett varierat arbetssätt med mycket konkret material upplevs framgångsrikt. Det visar även att elever med ADHD kan behöva anpassningar i form av tydliggörande, struktur och tät återkoppling. Dessa anpassningar bör vara individuella då det kan skilja mellan individ och individ. Det är även tydligt att yttre faktorer påverkar eleverna med ADHD, därför är framförallt klassrumsplacering viktig för dessa elever.

The aim with this study was to see how a few teachers with experience of young students with ADHD looks upon the need of special support through ICT and from which perspective of special needs education the support is formed. I related the informants’ answers about their views on special needs support based on a relational and categorical perspective and came to the conclusion that all of the informants uses a bit of both depending on each individual students needs. Therefor I could see that the dilemma perspective is current in schools today. The most important need for the students with ADHD in general is, according to the informants, structure and routine. The result from this study also shows that general knowledge about ICT is lacking and needs to increase. This could in most cases be explained by the schools economic resources as that partly prevent purchase of new and more equipment but also forces the school to keep larger groups of students in each class. This leads to less time for the teacher to learn about how and when ICT can be used. When asked if or how ICT could work as an asset for the students with ADHD in their studies, all of the informants said that it could be used mainly as motivation for the students to keep focus but is not seen as a tool only for those in need of special support but acts as motivation for all students, with or without diagnosis. In general ICT is viewed as a complement to the ordinary education and all of the informants points out the importance of letting go of these artifacts once in a while to actually see what surrounds them and that it is important to know the purpose of its use.

ADHD is the fastest growing diagnosis of the last decade and there is an ongoing debate about how ADHD should be understood with a psychosocial perspective opposed to a medical perspective. The purpose of this study was to investigate how a Swedish daily and evening newspaper (Aftonbladet and Dagens Nyheter) portrays ADHD. Further, the study asked whether medical or social explanation is used in the discourse that appears in newspaper articles, how ADHD is described as well as which people are quoted in the articles. In this study we used Norman Fairclough´s critical discourse analysis with the 26 sampled articles which we believe highlight different perspectives on ADHD diagnosis. Our study shows that there are representatives cited in the articles from school, the judiciary and the medical field. However representatives from social work are conspicuous by their absence. We have found that there are clearly defined areas in which ADHD is written about. The largest group of stories consists of school, then crime rates, the increase in ADHD and finally a category we call life stories. Our analysis examines the discourse types used within the media discourse with regard to ADHD. We have established that medical discourse dominates when it comes to explaining ADHD. We have found some resistance against what is sometimes called psychosocial discourse and a drug sceptical discourse as evidenced by articles critical of over-medication and malpractice. Our analysis shows that ADHD diagnosis is represented as something unproblematic, with an undifferentiated view of diagnosis, whereby ADHD is reproduced as a taken-for-granted problem which is rarely questioned. / ADHD är den snabbast växande diagnosen det senaste decenniet och det finns en pågående debatt om hur ADHD ska förstås utifrån ett psykosocialt perspektiv och ett medicinskt perspektiv. Syftet med den här studien var att studera hur en svensk dags- och kvällstidning (Aftonbladet och Dagens Nyheter) framställer ADHD. Vidare studerades om det är den medicinska eller sociala förklaringsmodellen som används i diskursen, hur ADHD beskrivs i tidningarna samt vilka personer det är som kommer till tals i artiklarna. Vi har i studien använt oss av Norman Fairclough´s kritiska diskursanalys för att analysera de 26 utvalda artiklar. Vår studie visar att det finns representanter i artiklarna från skolan, rättsväsende och det medicinska fältet. Däremot lyser representanter från socialt arbete med sin frånvaro. Vi har funnit att när det gäller den bild som ges av ADHD i media är det genomgående en reproducering av den medicinska modellen och därmed ett befästande av den rådande dominansordningen och medicinens starka ställning. Vi har funnit några drag mot det som ibland kallas psykosocial diskurs och en läkemedelsskeptisk diskurs som visar sig genom kritiska artiklar till övermedicinering och felbehandling. Analysen visar även att ADHD som diagnos omskrivs som något förgivettaget, med en onyanserad bild av diagnosen, där ADHD framställs ur ett problemperspektiv som sällan ifrågasätts.

Denna uppsats handlar om personer med neuropsykiatriska funktionsnedsättningar (NPF) som det finns en pågående samhällsdebatt kring (Lundälv 2013). Syftet med studien var att förstå hur personer med gruppen hanterar eventuella svårigheter i vardagen. Där ville vi bland annat urskilja om det fanns resultat som tydde på strategier, som personer med gruppen använder sig av för att kunna dölja eller anpassa sina funktionsnedsättningar i samhället och i sådana fall vilka. Som metod använde vi en hermeneutisk utgångspunkt där vi hämtade empiri från bloggar skrivna av personer som finns i målgruppen. Som teori använde vi oss av Lazaruz & Lazarus (2006) copingstrategier. Vi tematiserade vårt resultat och analys utifrån de två olika huvudkategorierna i coping, problemfokuserad och känslofokuserad coping. Under problemfokuserad coping tematiserade vi det utifrån copingstrategierna planering, söka information, söka och finna lösningar, konfrontera, ventilera och prioritera. Under känslofokuserad coping tematiserade vi det utifrån copingstrategierna distansera, förneka, undvika, känna uppgivenhet och ventilera. Vi framställde vårt resultat och analys gemensamt efter vardera copingstrategi. Vi kom fram till att de använder sig av strategier som de i vissa fall kanske inte ens är medvetna om och att det var enkelt att koppla det till copingteorin. I slutdiskussionen kopplade vi ihop vårt resultat med den tidigare forskning där vi jämförde om tidigare forskning styrkte vårt resultat vilket den främst gjorde. Undantaget var främst att Bussing och Mehtas (2013) studie visade på existerande stigmatisering av ungdomar med ADHD vilket vi inte hittade mycket i bloggarna om. / This paper is about people with neuropsychiatric disorders, NEPRC, which we have seen is an ongoing public debate in Sweden and many other countries(Lundälv 2013). The purpose of the study is to understand how people with neuropsychiatric disabilities manage difficulties in their everyday life. We wanted to distinguish whether there were any results which suggested strategies that people with NEPRC uses to hide or adapt their disabilities in society. As method we used a hermeneutical research were we got our empirical data from blogs written by people with a NEPRC. As theory, we used Lazaruz & Lazarus(2006) coping strategies. We themed our results and analysis divided in the two main categories of coping: problem-focused and emotion-focused coping. In problem-focused coping, we themed the result and analysis in the coping strategies planning, sought information, sought and found solutions, confronted, ventilated and prioritized. During emotional focused coping, we themed the coping strategies in distance, deny, avoid, feel despair and ventilate. We produced our results and analysis together by each coping strategy. We came to the conclusion that we were able to see that the people we used in our study uses strategies, which they may not be aware of in some cases, and it was easy to bind it to the theory of coping. In the discussion we connected our results with previous researches in which we compared the results of our study if it confirmed each other or not, which it mainly did. The exception was Bussing´s and Mehta´s (2013) study which showed the existing stigmatization of adolescents with ADHD, which we did not find much from the bloggers that confirmed it.

Bakgrund: Studier visar på patienters upplevelse av kommunikation med sjuksköterskor, att sjuksköterskor behöver ha kunskap om kommunikation och kunskap om de funktionsnedsättningar patienter med ADHD kan ha. Tidigare studier belyser också olika kommunikationsteorier som är användbara i vårdrelationer, men inte så mycket om sjuksköterskors upplevelser. Syfte: Att beskriva hur sjuksköterskor vid öppenvårdsmottagningar inom psykiatrin upplever och beskriver kommunikation med vuxna patienter med ADHD. Metod: Studien hade en kvalitativ design där data samlades in genom semistrukturerade intervjuer. Analysmetoden utgjordes av en kvalitativ innehållsanalys. Resultat: Analysen resulterade i ett tema, fyra kategorier och elva subkategorier. Sjuksköterskor vid öppenvårdsmottagningar upplevde kommunikation med patienter med ADHD som tärande och närande på samma gång. Olika kommunikationstekniker användes i kombination med kunskap om funktionsnedsättningar för att skapa de bästa förutsättningarna för kommunikationen med patienter. Bra bemötande och ett bra förhållningssätt rapporterades vara viktiga i kommunikationen med patienter. Slutsats: Sjuksköterskor inom öppenvårdspsykiatrin upplevde kommunikationen med patienter med ADHD som både närande och tärande. Sjuksköterskorna anpassar kommunikationen efter patientens behov och förmåga, och bemöter alla patienters olika behov med respekt. Sjuksköterskor ansåg att ett bra förhållningssätt och en gott bemötande var viktigt för att kommunikationen med patienter med ADHD skulle fungera optimalt. / Background: Studies show patients' experience of communication with nurses, nurses need to have knowledge of communication and knowledge of disability patients with ADHD may have. Previous studies also illustrate various communication theories that are useful in healthcare relationships, but not so much regarding nurses’ experiences. Aim: To describe how nurses at outpatient psychiatric experience describe communication with adult patients with ADHD. Methods: The study had a qualitative design where data was collected through semi-structured interviews. Qualitative content analysis was used as analytical method. Results: The analyses resulted in one theme, four categories and eleven subcategories. Nurses at outpatient clinics experienced communication with patients with ADHD nourishing and debilitating at the same time. Various communication techniques were used in combination with the knowledge of disabilities to create the best conditions for communication with patients. Good attitude and a good approach were reported to be important. Conclusion: Nurses in outpatient psychiatry experienced communication with patients with ADHD as both nourishing and debilitating. The nurses adapt their communication to the patient’s needs and abilities, and they treat all needs of the patients' different with respect. Nurses felt that a good attitude and a good treatment was important for communication with patients with ADHD.

The purpose of this study is to examine collaboration between social services and secondary education in a municipality in Sweden regarding adolescents diagnosed with ADHD. Swedish legislative texts stipulate that authorities working with adolescents should collaborate in matters relating to children in risk of harm. Earlier research shows that children and adolescents diagnosed with ADHD often behave contrary to how students are expected to behave in the classroom, that they may need support from social services, and that they rarely get such support to manage their education. The method used in this study was qualitative and the empirical data were obtained through semi structured interviews. Eight respondents participated in total, four social workers and four school counsellors. The results were analysed using profession theory and collaboration theory. The results show that the two professions both have a positive attitude towards collaboration, but that it rarely happens and when it does it feels unstructured and irregular, particularly for the social workers. Almost none of the respondents had any experience of working with students in secondary education diagnosed with ADHD, and instead spoke generally about their experience of collaboration. There seems to be a gap between the tendency to direct efforts, both divided and conjoined, to adolescents in an educational setting after they move on from elementary school.

Research indicates that some college students may be strongly motivated to feign AHDD symptoms for desired external incentives, such as stimulant medication or academic accommodations. To date, literature examining feigned ADHD has been primarily focused on ADHD specific self-report measures (e.g., CAARS) and continuous performance tests (e.g., CPTs); however, little attention has been devoted to the use of multi-scale inventories in detecting feigned ADHD. For CPT measures, virtually no literature exists on the effectiveness of the TOVA to identify feigned ADHD, despite its frequent clinical use for establishing this diagnosis. The current study utilized a between-subjects simulation design to validate feigning cut scores on ADHD-specific measures using 66 feigners and 51 confirmed ADHD cases. As prior literature suggested, the results convincingly demonstrated that face-valid ADHD assessment measures were easily faked. Across both TOVA modalities (e.g., Auditory and Visual), the ADHD simulators performed significantly poorer than those diagnosed with ADHD. As an innovative approach, a Dissimulation-ADHD (Ds-ADHD) scale was developed and initially validated. The Ds-ADHD is composed of ten MMPI-2-RF items mistakenly believed to be clinical characteristics associated with ADHD. Requiring cross-validation, Ds-ADHD optimized cut scores and classification of ADHD feigners appears promising. They were clearly distinguishable from ADHD client, as well as those feigning general psychopathology. Recommendations for the utilization of the Ds-ADHD scale, and future directions for research are discussed.