Development of a Music Group Psychotherapy Intervention for the Primary Prevention of Adjustment Difficulties in Korean Adolescent Girls

PROBLEM

Traditionally, adolescent mental health in Korea has not been a prime focus for educators, health workers, and politicians, yet a majority of sampled adolescents report interpersonal sensitivity (Kim, 2003).

METHOD

Thirty-five adolescent girls took part in a six-session school-based music group psychotherapy pilot intervention designed to promote relationships and improve self-control skills.

FINDING

Participants identified several outcome benefits that may serve as protective factors in their continued social and emotional development.

CONCLUSIONS

Music is a medium that promotes interpersonal relatedness among Korean adolescent girls. More research is necessary to identify long-term benefits of preventive music group psychotherapy interventions among the adolescent population.

An integrative research review: effective school-based childhood overweight interventions

PURPOSE

To describe theoretical and methodological characteristics of effective school-based interventions that used healthy lifestyle education, dietary habits, and/or physical activity in children ages 4 to 14.

DESIGN

Integrative research review.

METHODS

Stetler's model of research utilization.

RESULTS

Social Cognitive Theory was the stated or implied theory in eight of the 10 studies. Healthy lifestyle education was initiated in nine studies, dietary habits in four, and physical activity in eight. Four of the 10 studies used a combination of all three interventions; three used a combination of two interventions; and three used only one intervention.

PRACTICE IMPLICATIONS

Social Cognitive Theory and the role of social learning are useful when designing interventions for preventing and treating childhood overweight.

Tobacco prevention in children and cessation in family members

PURPOSE

To examine the effects of a theory-driven tobacco prevention program in sixth-grade children with a family tobacco cessation component implemented by school nurses in conjunction with the initiation of a statewide toll-free Quit Line.

DATA SOURCES

Self-report questionnaires completed by the sixth-grade children and their parents/guardians (N= 1024) representing largely rural southern school systems from disparate areas with high prevalence rates of tobacco use and lung cancer diagnoses. Pre- and posttest measures that evaluated the impact of both student and parent/guardian interventions were obtained over a 10-week period. Paired t-tests were used to examine differences between pre- and posttest scores for all student and parent/guardian variables. Repeated-measures analysis of variance was used to examine the effect of parent/guardian smoking on student pre- and posttest scores.

CONCLUSIONS

The student program resulted in significant improvements in drug knowledge, refusal skills, attitudes, normative expectations, assertiveness, and anxiety reduction techniques. In addition, the effectiveness of several components of the tobacco prevention program for the children was impacted by the smoking status of their parents/guardians. Drug-use intentions and behaviors were lower at posttest for children from homes of nonsmokers versus children from homes of smokers. Parents/guardians consistently reported that smoking was detrimental to themselves, the public, and their children. Of those parents/guardians who identified themselves as smokers (26%) and received cessation materials, 46.4% indicated that the information motivated them to want to quit.

IMPLICATIONS FOR PRACTICE

Tobacco use continues to be the leading cause of preventable death in the United States, with greater than 2000 new youth becoming regular smokers each day. School nurses and nurse practitioners are in various pivotal positions to address tobacco and its related health concerns through delivery of effective family interventions that target children for tobacco prevention and parent/guardian smokers for cessation.

Integrating nursing care into systems of care for children with emotional and behavioral disorders

PROBLEM

Recent developments in providing care to children with emotional and behavioral disorders, especially those with serious emotional disturbance, have included the establishment of systems of care. Guided by a set of principles and values, these systems of care have organized and delivered services to children and families with complex needs. To date, nurses have not had a salient role in systems of care.

RESULTS

It is estimated that 20% of American children and adolescents have an emotional or mental disorder. As many as two thirds of these children are not receiving services. Systems of care have been funded to provide services for these children, particularly for the most severely affected. To date, nursing has not had a prominent role in these systems of care.

CONCLUSIONS

Based on their knowledge, skills, and holistic approach to care, nurses could better integrate nursing care into systems of care. Possible roles as case managers, primary therapists, in-home interventionists, and in educational programs are suggested.

The health-promoting school: what role for nursing?

AIM

To review the existing literature on health-promoting schools and put forward recommendations for continuing progress.

BACKGROUND

The World Health Organisation's Ottawa Charter for Health Promotion in 1986 sought to create a framework for health promotion action that conveyed the notion of capacity building as it related to specific settings. It provided the catalyst from which the health-promoting school movement emerged, against the backdrop of health professionals adapting to the changing needs and demands of clients and the evolving social context of the communities in which they live. Since then, the international health-promoting school movement has been one of the most successful of the settings-based projects and has expanded considerably over recent years.

METHOD

An extensive review of available health-promoting school-related literature provides the basis for critical discussion and recommendations.

FINDINGS

Traditionally, the school nursing movement has provided the backbone of nursing-related health promotion activity in the school setting. The literature, however, is generally critical of its contribution over the years - especially as its role is mainly confined to a 'conventional' health education function and has little to do with health-promoting school projects. There are more and more calls now for the school nursing service to either re-evaluate its function and processes or be devolved back into a broader primary health care practitioner role.

CONCLUSION

Nurses should view the health-promoting school movement as another opportunity to embrace evolving broad-based health promotion concepts truly, as a means to forge and own their own health agenda and also as a means to move beyond a traditional reliance on a limited health education role. Schools also need to adapt and expand their efforts to focus on health promotion activities, in collaboration with the ever-widening community networks of health and social agencies. This requires the commitment of all healthcare professional groups. Nurses who practice in all settings, and not just school nurses, should be aiming to initiate and promote radical health promotion reform as set out in the health-promoting school movement.

RELEVANCE TO CLINICAL PRACTICE

If health professionals wish to be at the forefront of current health-promoting school strategies they must embrace the radical health promotion reforms that are emerging from the current literature and put forward in this article. Building such group capacity, through developing social interaction, cohesion, participation and political action can only benefit the community at large and further emphasize the health promotion role of nursing. The health-promoting school movement is truly an international concept and, as such, deserves a concerted nursing representation and resourcing well beyond its current commitment.

Foregone mental health care and self-reported access barriers among adolescents

Adolescents forego mental health care in spite of self-perceived needs for services; this presents a significant public health problem. Using data from the 2001 Adolescent Health Care Access Survey of 16-year-olds in Saint Louis County, Minnesota, we assessed barriers to mental health care among the 878 respondents who reported ever needing psychological or emotional counseling. Demographic characteristics were compared among those who had always, had sometimes, or had never received needed mental health care. Overall, 57% of the youths reported foregoing mental health care at least once. Girls and adolescents living with both parents were significantly more likely to have foregone care. Youths identified two common barriers to accessing care: "Thought or hoped the problem would go away" (50%) and "Didn't want parents to know" (36%). School-based interventions should be sensitive to mental health needs, especially among girls and teens living in two-parent families.