School nurses as health counsellors in Finnish ENHPS schools

Implementation of an ICT‐based learning environment in a nutrition health project

Purpose

The purpose of this study was to investigate the views of school staff on a nutrition health project implemented via an ICT‐based learning environment in a secondary school (7th to 9th grades).

Design/methodology/approach

The study was a part of the wider European Network for Health Promoting Schools programme (ENHPS; since 2008, Schools for Health in Europe SHE) in Finland, and particularly its sub‐project, From Puijo to the World with Health Lunch, which sought to renew secondary schools' nutrition health education by developing and utilising an ICT‐based learning environment using participatory action research. The data were collected by means of recall interviews conducted with 12 teachers, two school health nurses and two school catering managers after the nutrition health project ended. The data were analysed with qualitative content analysis using Atlas.ti software.

Findings

The findings regarding the views of the school staff – teachers, school health nurses and school catering managers – on the nutrition health project implemented via an ICT‐based learning environment at the end of the three‐year educational development project revealed five main categories: the basis of multidisciplinary education in nutrition health, motivation to lifelong nutrition health learning, school community support of nutrition health activities, operational ICT culture in the nutrition health project and ICT for the nutrition health project process.

Research limitations/implications

The sample of school staff consisted of two secondary schools in Eastern Finland, and the results cannot be generalised widely due to the small, geographically defined sample. However, the results are suggestive for other schools elsewhere in Finland.

Originality/value

Development of a nutrition health project via an ICT‐based learning environment as a project involves the entire school staff and all the pupils. It also enables renewing of the nutrition health curriculum. Pupils use ICT in their everyday activities, thus the school staffs have to manage and update their knowledge and skills in ICT and new action environments to promote pupils' nutrition health learning today and in the future.

The role of school nurses in delivering accessible health services for primary and secondary school students in Hong Kong

AIMS

To explore and describe the distinctive role of nurses in delivering school health services for primary and secondary school students in Hong Kong.

BACKGROUND

The practical responsibility of nurses in delivering school health services has not been established. There is no literature on this topic and, in particular, nothing has been written from the perspective of the practitioner in communities in Hong Kong.

DESIGN

A qualitative design using semi-structured interviews was employed.

METHODS

Thirteen school nurses were recruited and interviewed in 2006. The narratives were analysed using content analysis steps to identify categories.

RESULTS

Seven categories were formulated. School nurses described their roles as providers, counsellors, leaders, promoters, collaborators, referrers and administrators and housekeepers. The school nurses also reported that they needed to maintain a diverse range of skills and knowledge, such as effective communication skills and clinical updated knowledge, to cope with the demands and the diversity of their roles and to support the health and educational needs of the students and their local communities.

CONCLUSION

The future development of the 'one school, one nurse' policy envisaged by the current government for ordinary schools in Hong Kong will not occur unless the role of school nurses is clearly delineated and valued by society as reducing school children's and adolescents' risk-taking behaviours and promoting the health and well-being of school children and adolescents.

RELEVANCE TO CLINICAL PRACTICE

The findings provide relevant information for school nurse leaders and school nurse policy makers to understand how school nurses are practicing and promoting child and adolescent health services, which can inform regional and national policy and practice.

Determinants of the intention of elementary school nurses to adopt a redefined role in health promotion at school

Background

The quest for greater efficiency in the provision of primary healthcare services and the implementation of a "health-promoting school" approach encourage the optimal redefinition of the role of school nurses. School nurses are viewed as professionals who might be significant actors in the promotion of youth health. The aim of this study was to identify the determinants of the intention of elementary school nurses to adopt a new health-promotion role as a strategic option for the health-promoting school.

Methods

This study was based on an extended version of the theory of planned behaviour (TPB). A total of 251 respondents (response rate of 70%) from 42 school health programs across the Province of Québec completed a mail survey regarding their intention to adopt the proposed health-promotion role. Multiple hierarchical linear regression analyses were performed to assess the relationship between key independent variables and intention. A discriminant analysis of the beliefs was performed to identify the main targets of action.

Results

A total of 73% of respondents expressed a positive intention to accept to play the proposed role. The main predictors were perceived behavioural control (β = 0.36), moral norm (β = 0.27), attitude (β = 0.24), and subjective norm (β = 0.21) (ps < .0001), explaining 83% of the variance. The underlying beliefs distinguishing nurses who had a high intention from those who had a low intention referred to their feelings of being valued, their capacity to overcome the nursing shortage, the approval of the school nurses' community and parents of the students, their leadership skills, and their gaining of a better understanding of school needs.

Conclusions

Results suggest that leadership is a skill that should be addressed to increase the ability of school nurses to assume the proposed role. Findings also indicate that public health administrators need to ensure adequate nurse staffing in the schools in order to increase the proportion of nurses willing to play such a role and avoid burnout among these human resources.

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.