School nurses' engagement and care ethics in promoting adolescent health

Reading Groups as a Health-Promoting Intervention in Upper Secondary Schools: A Qualitative Study

OBJECTIVES

To explore public health nurses' (PHN) perceptions and experiences of supporting siblings of children with complex care needs (CCNs) by using reading groups as a health promotion intervention in upper secondary schools.

DESIGN

An action research approach using a qualitative design.

SAMPLE

Interviews with 10 PHNs.

MEASUREMENTS

Thematic analysis.

RESULTS

The analysis resulted in the overarching theme "A much needed health promotion intervention in upper secondary schools," presented in terms of the following three themes: (1) supporting siblings is important, but resources and established procedures are lacking. (2) Reading groups using fiction have potential as a health-promoting intervention in upper secondary schools. (3) A realistic collaborative approach is necessary for reading groups to be implemented.

CONCLUSION

PHNs have no established procedures to support siblings of children with CCNs in upper secondary schools. Reading groups can enable PHNs to reach out and support these siblings. Providing the intervention can be a way of reaching all pupils and thus creating an understanding of the plight of siblings who have a brother or sister with CCNs.

Public health nurses' experiences of ethical responsibility: A meta-ethnography

Public health nursing is grounded in public health ideologies and fundamental nursing values. Researchers have argued that ethical responsibility from the perspective of the nurse is an understudied phenomenon. This meta-ethnography provides in-depth knowledge of how public health nurses (PHNs) experience ethical responsibility when working to prevent injury and disease, and promote health and well-being in children, young people and their families. There are reciprocal findings across the 10 included studies. The findings reveal that these nurses often feel alone, have worries and uncertainties and are afraid of doing wrong. They describe unclear boundaries in their work, creating a heightened sense of responsibility. PHNs fight lonely battles. Yet they show courage and commitment and are ready to stand up and fight for children and families who do not receive adequate care. A line of argument is developed and the metaphorical phrase Chivalrous knights in moral armour is used to express the authors' overall interpretations of the findings. Reflection on the findings shows how the different dimensions of ethical responsibility are interconnected. The nurses' ethical sensitivity enables them to feel compassion for others and they show indignation when vulnerable others are not treated with dignity and respect. Indignation and compassion are interrelated, and when human life and dignity are threatened, the ethical demand to respond emerges. Indignation is a precursor to moral courage, and the nurses' moral sensitivity and respect for their clients emboldens them to stand up for vulnerable others. The findings also illustrate the paradoxical nature of freedom. Freedom of choice due to unclear boundaries heightens the nurses' sense of responsibility. This research is an important step in theory development and has implications for further research, education and practice.

The role of nurses in implementation of public policy on adolescent health in Colombia, Ecuador, and Peru

BACKGROUND

In Latin America, interventions aimed at adolescents' health suffer from a shortfall of investment and lack of sustainability. Nurses, as an integral part of health services and systems, can lead the implementation and development of public health policies to improve adolescent health.

OBJECTIVE

To identify and analyze the role of nurses in the development and implementation of public policies and in the provision of health care to adolescents in Colombia, Ecuador, and Peru.

METHODS

The research was carried out in three phases: a documentary analysis, an online survey, and semi-structured focus groups. A total of 48 documents were analyzed, 288 nurses participated in the survey, and 29 nurses participated in the focus groups.

RESULTS

State policies aim to guarantee rights, with special protection for children and adolescents. It is an incremental process, with greater involvement of civil society and governments. Participants reported a lack of synergy between law and practice, as well as differences in regulatory compliance in rural areas and in populations of different ethnicities and cultures. Their perception was that the protection of adolescents is not specifically enshrined in the legal bases and regulatory structures of the countries, meaning that there are both protective factors and tensions in the regulatory framework. While nurses are highly committed to different actions aimed at adolescents, their participation in policy development and implementation is low, with barriers related to a lack of specialized training and working conditions.

CONCLUSIONS

Given nurses' involvement in different actions aimed at adolescents, they could play a fundamental role in the development of policies for adolescents and ensure their effective implementation. Policymakers should consider revising the budget to make compliance viable, incorporating and using monitoring indicators, and increasing the involvement of educational institutions and the community.

[The role of nursing professionals in the development and care of adolescent health in HondurasPapel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras]

Objective

Identify and analyze the role of nursing professionals in the development and care of adolescent health in Honduras, by analyzing the curricular content of the training provided to nursing students with respect to adolescent health, and by studying policies on adolescent health.

Methods

Mixed methods study, with a sequential explanatory approach, carried out from May to July 2023 through surveys of nursing schools, analysis of policy documents, a survey with nursing professionals, and a focus group. Quantitative data were analyzed using descriptive statistics and qualitative data, applying the theoretical framework of Walt and Gilson.

Results

During the research, 18 documents were analyzed and seven nursing schools, 141 nurses, and 10 key actors in leadership positions participated. The results point to the need to update and disseminate the regulatory framework, ensure the necessary resources and structure to implement sustainable intersectoral programs, and train professionals. Schools are an important space for the implementation of actions; in this context, the adoption of school nursing programs could be beneficial. Nurses were identified as key figures in program implementation and should be taken into consideration when developing policies aimed at adolescents.

Conclusions

Nurses participate in various stages of the policy implementation process and can make important contributions to school health at the first level of care. To this end, it is necessary to increase the capacities of nurses and nursing educators in relation to current and relevant issues in adolescent care.

The effect of structured health promotion education given to adolescents on health literacy and health-promoting behaviors

PURPOSE

This study was conducted to determine the effect of structured health promotion education given to adolescents on health literacy and health promotion level.

DESIGN AND METHODS

The research was designed according to the pretest-posttest control group model and conducted using the quasi-experimental method. The population of the study consisted of students studying in the 6th, 7th, and 8th grades of a secondary school. A total of 191 students were assigned to the intervention group and the control group. The data were collected using the Sociodemographic Characteristics Form, the Adolescent Health Promotion Scale, and the School Age Health Literacy Scale. Structured Health Promotion Education consisting of six modules was given to the intervention group. The control group did not receive any intervention.

RESULTS

Of the students, 33.9% were in the 8th grade, 76.6% were born in Turkey, 31.6% had a father and mother who were secondary school graduates, 72.5% were from moderate-income families, and 83% had no chronic health problems. The groups' health literacy and adolescent health-promoting behaviors pretest mean scores before the intervention were homogeneous (p > 0.05). There was a significant difference between the groups' health literacy and adolescent health-promoting behaviors posttest mean scores after the intervention (p < 0.05).

CONCLUSIONS

While structured health promotion education was found to increase health literacy and health-promoting behaviors, nutrition, stress management, life satisfaction, and health responsibility behaviors in adolescents, it did not affect social support and exercise behaviors.

IMPLICATIONS FOR PRACTICE

Nurses should provide training to increase students' health literacy and health-promoting behaviors.

Health education provided by nurses to children and young people: parents' assessment

BACKGROUND

Healthy literacy is a determinant key children/teenager's health and health outcomes. The aim of this study to identify the parents' assessment about Health Education practice to children and teenagers.

METHODS

We opted for a descriptive, quantitative and cross-sectional research, with a non-probabilistic convenience sample. The inclusion criteria were: being a parent who uses attending children health appointments in primary health care; being a parent who has a child hospitalized and is accompanying him/her in the pediatric hospital inpatient ward. A questionnaire survey was built with three sections: sample characterization, Health Education practices performed by nurses (5 questions) and a scale that measured Health Education Assessment Scale (HEAS), which contained 48 items and was validated. It was applied from September to December 2018.

RESULTS

The survey was filled in by 113 parents. The results showed that 100% (n = 113) of the parents feel comfortable to talk with nurses about children/teenagers health; 79.6% (n = 90) consider that nurses have time availability for the doubts clarification; 61.9% (n = 70) point out that nurses identify child/teenager needs; Healthy eating" (60.2%; n = 68), the "National Vaccination Plan" (53.1%; n = 60) and "Harmful behaviors prevention" (46.9%; n = 53) are the most important topics; 56.6% (n = 64) of the parents, when in doubt, turn first to the pediatrician, and 66.4% (n = 75) considered that this practice was equal important, compared with other nursing interventions.

DISCUSSION

This study shows that Health Education provided by nurses is based on the need's identification, with a perspective of involvement and participation, promoting health and conscious changes which reinforces the nurses' position as health educators.

The current state of international research on the effectiveness of school nurses in promoting the health of children and adolescents: An overview of reviews

OBJECTIVE

School nurses are engaging worldwide to promote and protect children's health. Many researchers who examined the effectiveness of the school nurse criticized the inadequate methodology employed in many of the studies. We therefore carried out an evaluation on the effectiveness of school nurses based on a rigorous methodological approach.

METHODS

In this overview of reviews we performed an electronic databank search and global research results on the effectiveness of school nurses were sought. We identified 1,494 records through database search. Abstracts and full texts were screened and summarized using the dual control principle. We summarized the aspects of quality criteria as well as the significance of the effectiveness of the school nurse. In the first step, k = 16 systematic reviews were summarized and evaluated following the AMSTAR-2 guidelines. In a second step, j = 357 primary studies included in these k = 16 reviews were summarized and assessed following the GRADE guidelines.

RESULTS

Research results on the effectiveness of school nurses show that school nurses play a key role in improving the health of children with asthma (j = 6) and diabetes (j = 2), results on combating obesity are less certain (j = 6). The quality of identified reviews is mostly very low with only six studies of medium quality, of which one identified as a meta-analysis. A total of j = 289 primary studies were identified. Approximately 25% (j = 74) of identified primary studies were either randomized controlled trials (RCT) or observational studies, of which roughly 20% (j = 16) had a low risk of bias. Studies with physiological variables such as blood glucose or asthma labeling led to higher quality results.

CONCLUSION

This paper represents an initial contribution and recommends further evaluation of the effectiveness of school nurses, particularly in the areas of mental health or children from low socioeconomic backgrounds. The general lack of quality standards in school nursing research should be integrated into the scientific discourse of school nursing researchers to provide robust evidence for policy planners and researchers.

Sexuality and Religious Ethics: Analysis in a Multicultural University Context

Sexuality is still perceived by some cultures as a taboo subject. Although there is now a more open attitude towards sexuality, the maintenance of virginity is one of the most concerning issues in some religions. The aim of this research is to investigate the sexual behavior of university students and analyze how culture and religion influence the beliefs and maintenance of virginity in women and men. A mixed methodology was used, involving 355 students in the quantitative design and 18 informants for the qualitative study who took part in two focus groups. The results indicate that religion and the degree of religious practice are predictor variables for the decision to have penetrative sex, with Muslim women and men giving more importance to the maintenance of a woman's virginity. However, this hymen-centric view does not prevent other sexual practices, such as oral and/or anal sex, among young people who wish to maintain their virginity until marriage. Religious ethics continue to influence the sexual behavior of young people today. Therefore, nursing education must address these issues to improve the affective sexual health of the population.

Health literacy in childhood and adolescence. A bibliometric analysis of scientific publications and professionals' involvement

Background

Health Literacy (HL) is a powerful tool to empower children and adolescents in their own health. School nurses are the professionals who, with their expertise in health promotion and education, can facilitate this literacy throughout the educational process.

Purpose

To analyze the scientific production in HL in childhood and adolescence in the last two decades, and to determine the involvement of professionals in this field, with emphasis on nursing professionals.

Methods

A bibliometric analysis of the scientific literature (from 2000 to 2021) of articles retrieved from the Web of Science database was carried out. Original articles in all languages were considered as inclusion criteria. Bibliometrix 3.1.4 package from RStudio and VOSviewer were used to analyze publications and explain main results about citations, authors, countries, keywords trends, evolution, clusters of related terms, and professionals' involvement.

Results

A total of 2032 articles were included in the analysis. The results of the analysis showed that both publications and citations increased substantially since 2014. The most prolific authors in this field are not the most cited so far. The countries that published the most during the period evaluated were the United States, Australia and Canada. The keyword clusters identified in this scientometric study made it possible to determine hotspots in the study of HL in childhood and adolescence, with "mental health" being one of the main terms identified. There are different health-related professionals who are publishing in this field; in spite of this, nurses are not visible as authors in the publications.

Conclusion

The scientific literature on HL in childhood and adolescence is a growing field in which different professionals are involved. Despite the increase in the number of publications, and despite the role that nurses play in schools regarding HL, their presence in scientific production is practically nonexistent.

Concepts and issues related to adolescent health in nursing education

OBJECTIVE

analyze the structure of teaching programs and contents of the adolescent health and its development in nursing education.

METHOD

descriptive observational study conducted in Colombia, Ecuador and Peru. Data was collected by the Instrument for (self-)evaluation of the adolescent health and development component in undergraduate nursing programs, and investigated using descriptive statistics.

RESULTS

A total of 95 nursing schools participated in the study (84.1% of the total). Of the faculty responsible for teaching contents relating to adolescent health, 31.6% had no specific training on the topic and 18.9% had no educational/pedagogical training. Behavior, gender identity and sexual orientation, bullying and cyberbullying, use of digital technologies, partner violence, parenting, and pubertal delay were the main topics which could be incorporated into nursing education.

CONCLUSION

the faculty of the schools analyzed have limited education in pedagogical/educational topics and specific adolescent health issues. Curricula should be updated, including knowledge of laws and policies, thus expanding nurses' ability to generate, analyze and use data for decision making.

(1) 31.6% of faculty have no specific education in adolescent health. (2) 18.9% of faculty have no educational/pedagogical training. (3) Progress is needed in the use of active methodologies and interactive multimedia. (4) Knowledge of laws and policies for the adolescent population must be expanded. (5) Current and relevant adolescent health issues need to be addressed in nursing education.

School Nurses' Perspectives on Health among School-Aged Children and Adolescents During the COVID-19 Pandemic

The aim of this study was to investigate school nurses' perspectives on students' health during the COVID-19 pandemic in Sweden in 2021. A cross-sectional survey design was used with school nurses (n = 225) working in schools in Sweden from elementary to upper secondary levels. The Clausson School Nurse Perception Questionnaire was used with two additional questions about the COVID-19 pandemic. The school nurses rated students' physical health as very good or good in 78% of the cases and their mental health as very good or good in 64%. There was also a negative trend in mental health during the pandemic, especially among girls. School nurses working in vulnerable areas (i.e., areas with a high proportion of immigrants and those receiving financial assistance) rated students' physical and mental health significantly worse compared other areas.

School nurses’ experiences of health-promoting work to prevent stress in Swedish adolescents

Aim

To investigate school nurses’ experiences of health-promoting work to prevent stress in Swedish adolescents.

Materials and methods

Swedish school nurses (n = 225) responded to a web survey with open-ended questions. The results were subjected to a qualitative content analysis.

Results

Six categories were identified from the analysis: (1) Knowledge of body and soul, (2) Identifying stress and ill health, (3) Collaborative working within/outside school, (4) Make yourself (i.e., school nurses) visible to the students, (5) Support students’ learning, and (6) Tools for stress management. One of the most important themes in preventing and counteracting stress in school-aged children and adolescents was promoting healthy living habits. That school nurses were easily accessible and visible were important for them to identify stress as early as possible. The close collaboration with the school health care team and building relationships with the students were emphasized. The stress in adolescents was largely linked to schoolwork and performance anxiety. To counteract this, the dialogue with the teachers was important to increase their knowledge of mental health problems and stress and influence the scheduling of school exams.

Conclusion

The study contributes to increased knowledge in the field and provides concrete strategies for how school nurses can work to counteract stress in students.

Conceptos y temas relacionados a la salud de los adolescentes en la formación en enfermería

Resumen Objetivo: analizar la estructura de los programas de enseñanza y los contenidos del componente de salud y desarrollo del adolescente en la formación de los estudiantes de enfermería. Método: estudio observacional descriptivo, realizado en Colombia, Ecuador y Perú. Se aplicó el Instrumento para (auto)evaluar el componente de salud y desarrollo del adolescente en la formación de pregrado de los proveedores de salud. Se utilizaron estadísticas descriptivas. Resultados: participaron 95 escuelas (84,1% del total). De los docentes encargados de la enseñanza de la salud de los adolescentes, el 31,6% no tenía formación específica en la materia y el 18,9% no tenía formación en el ámbito de la educación/pedagogía. Los principales temas que podrían incorporarse a la formación son: comportamiento, identidad de género y orientación sexual, bullying y cyberbullying, uso de las tecnologías digitales, violencia en el noviazgo, paternidad y retraso puberal. Conclusión: el profesorado tiene una formación limitada en temas pedagógicos/educativos y en temas específicos de la salud del adolescente. El plan de estudios debe actualizarse con contenidos del desarrollo y salud del adolescente, incluir conocimientos sobre las leyes y políticas, y ampliar la capacidad de las enfermeras para generar, analizar y utilizar datos para la toma de decisiones.