A Person-Centred Approach When Encountering Students With Recurrent Pain: School Nurses' Experiences

An alternative theoretical approach to develop a new conception about pain in people with dementia

The theoretical approach presented in this paper describes a novel experimental-theoretical methodology to conceptualise pain in people with dementia. Existing procedures for assessment of pain rely on subjective self-report using pain questionnaires and rating scales that have proven to be highly problematic where a person has dementia. Consequently, pain in people with dementia can be undetected and/or undertreated. To address that, we have developed an alternative experimental approach that builds on theoretical and methodological precedents from the arts, humanities and social sciences, for instance, visual thinking strategies, creative thinking or two-step flow of communication. Based on this approach, we designed an experimental workshop setting to ingrate these methodologies to explore pain and its expression in people with dementia. This had led to a new definition of pain as an interruption of the socially mediated process of bodily meaning-making. Furthermore, our experimental methodology could equally well be applied as a training method, where professional staff can intervene into existing implicit meanings and understandings of medical issues. These results emphasise that the future of pain research needs to consider the relational aspects of pain more seriously.

School nurses and menstrual communication: Destigmatizing the stigma among adolescents

OBJECTIVE

The purpose of this study is to understand how school nurses, often the first line of defense for menstruating adolescents, use communication to assist adolescents in destigmatizing menstruation.

DESIGN

I conducted semi-structured narrative interviews with nine nurses employed in a large school district in Northeast Indiana.

METHODS

Interviews were coded, categorized, and used a phronetic iterative approach.

RESULTS

Analysis determines that nurses assist menstruating students using steps toward accepting menstruation and suggesting ways to avoid menstrual stigmatization.

CONCLUSION

This study suggests that school nurses use positive language to assist students in handling their menstruation problems, develop allyships with parents and other teachers, and stress menstrual education. This study highlights the need for more funding for menstrual products and additional school nurses.

Help overcoming pain early, a brief person-centred intervention for adolescents with chronic pain in a school setting, may improve symptoms of insomnia

Introduction and aims

Chronic pain and symptoms of insomnia affect large numbers of adolescents and early interventions are prioritized. The aim of the current study was to evaluate potential secondary effects of the intervention, Help Overcoming Pain Early (HOPE), on symptoms of insomnia and self-rated health.

Methods

The study included non-randomized aggregated data from the active and control conditions in a previously conducted randomized controlled trial evaluating the efficacy of HOPE, after the participants in the control condition also had received the intervention. Symptoms of insomnia were assessed with the Minimal Insomnia Symptom Scale and self-rated health was assessed with one item, at the start of the intervention, post intervention, and at a six-month follow-up. Baseline variables included age, gender, pain localization, pain impact, school absence and symptoms of depression (assessed with the Center for Epidemiological Studies Depression Scale for Children). Inferential analyzes were performed using Linear Mixed Models (LMM). Effect sizes were evaluated by calculating Cohen's d.

Results

There were statistically significant improvements in symptoms of insomnia at the six-month follow-up, and statistically significant improvements in self-rated health at the end of the intervention and at the six-month follow-up. Effect sizes were small across outcomes and assessments.

Discussion and conclusion

Results illustrated significant but small improvements in symptoms of insomnia and self-rated health in adolescents with chronic pain following the HOPE intervention. Although caution is needed when assessing the findings, results illustrate the potential utility of an accessible brief early intervention in a school context.

Adolescents' Experience of Pain: A Focus Group Study in Sweden

The purpose of this study was to describe experiences of pain among students at upper secondary schools (adolescents aged 16-19 years) in Sweden. Focus group (n = 9) interviews with 41 adolescents were conducted in southern Sweden in 2021. The interviews were analyzed by qualitative content analysis, which identified four categories encompassing the theme how pain expressed itself: (1) a warning bell-the body's way of saying that something is wrong; (2) school- and work-related pain; (3) interpersonal physical and emotional pain; and (4) heartache-a sign of humanity; and four categories describing the theme ways of dealing with pain: (1) turn your attention elsewhere; (2) "bite the bullet" and endure the pain; and (3) use painkillers or complementary treatments; and (4) ask for help from others. Findings are linked to the crucial role of school nurses in supporting students who experience pain.

Supporting girls with painful menstruation - A qualitative study with school nurses in Sweden

BACKGROUND

Painful menstruation is common among girls. To optimize school nurses' work more knowledge about their experiences of supporting these girls is needed. The aim of this study was to describe school nurses' experiences of supporting girls with menstrual pain.

METHODS

Interviews were conducted with 15 school nurses in Sweden and analyzed using thematic analysis.

RESULTS

Three themes emerged: Taking menstrual pain seriously, Being a disseminator of knowledge, and External conditions for conducting professional work as a school nurse.

CONCLUSION

School nurses felt competent in supporting girls with menstrual pain. However, they lacked structural, written guidelines and routines for how to treat, support, follow-up and refer girls with menstrual pain.

PRACTICE IMPLICATIONS

School education about menstruation and sexual health needs to be strengthened. Cooperation with other healthcare facilities and networks with other school nurses should be increased. Specific guidelines on how to support girls with menstrual pain should be implemented.

A Philosophical Review of School Nursing Framed by the Holistic Nursing Theory of Barbara Dossey

This article is a philosophical review of school nursing and its constructs framed by Barbara Dossey's holistic nursing theory. The author describes the application of holistic nursing theory within the school nurse's area of activity. The review suggests that holistic nursing theory can be applied in several areas of school nursing. School nurses have a multifaceted occupation that includes meetings with students, parents, and school staff. Barbara Dossey's holistic nursing theory offers the school nurse tools to deal with people's varied experiences, feelings, and needs.

Schoolchildren's experience of pain-A focus group interview study

AIM

To explore the experience of pain in 10- to 12-year-old children.

METHODS

This interview study included students (n = 42) in grade 4-6 in focus groups (n = 10) in southern Sweden (52% girls); mean age, 11.3 years (range 10-12 years). The interviews were audio-recorded and transcribed verbatim and analysed with qualitative content analysis.

RESULTS

The analysis resulted in one theme: Pain as a unique experience for each individual, which was divided into five categories: (a) Feeling bodily pain; (b) Pain related to the school environment and schoolwork; (c) Internal pain related to sorrow and grief; (d) Pain related to conflicts and remorse; and (e) Pain can be good.

CONCLUSION

The children made distinctions between physical pain and emotional pain. Bullying, noisy school environments, grief and remorse were reported to be linked with headaches, stomachache and heartache.