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Tyndall DE, Pestaner M, Lewis T. School-Based Suicide Prevention Efforts: The Impact of School Nurse Exclusivity on Moral Distress. J Sch Nurs 2024:10598405241267210. [PMID: 39106343 DOI: 10.1177/10598405241267210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024] Open
Abstract
School nurses are well-positioned to assess, identify, and refer children and adolescents who are at risk of suicide. This multiple-case study examined the personal, behavioral, and environmental factors that influence the role of the school nurse in youth suicide prevention and intervention. Purposive sampling was used to recruit two school nurses who were identified as unique cases. Data from interviews, surveys, and documents generated a cross-case analysis. Findings indicate that school-level exclusive practices, such as a lack of communication and collaboration, greatly influence the role and reach of school nurses. Further, dilemmas arising from environmental barriers hinder school nurse capacity to promote student safety and affect moral distress levels. Leveraging data to demonstrate the pivotal role of school nurses to support mental health equity and reduce disparities in youth suicide is crucial to developing inclusive and responsive suicide prevention programs.
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Affiliation(s)
- Deborah E Tyndall
- School of Nursing / College of Health and Human Services, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Mitzi Pestaner
- College of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Travis Lewis
- College of Education, East Carolina University, Greenville, North Carolina, USA
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2
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Grano C. A Qualitative Study of School Nurses' Experience of Secondary Trauma. Creat Nurs 2024:10784535241268094. [PMID: 39099538 DOI: 10.1177/10784535241268094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
This qualitative descriptive study explored school nurses' experiences of exposure to reports of trauma from those in their care. Online interviews of school nurses practicing in NJ, USA, were recorded and transcribed verbatim. The study found that school nurses were exposed to reports of others' trauma to varying degrees, with those serving in urban settings reporting more stories of exposure than those in suburban settings. Reports included numerous, layered traumas at the community and individual levels, including students' poverty-related adversity and psychological distress. Qualitative content analysis revealed four categories: Health Office as Safe Haven, Challenges Working Within the School Model, Things That We Hear: Reports of Trauma, and The Ripple Effect of Trauma. School-based challenges included a lack of collaboration, misunderstanding of the school nurse's role, and workload issues such as competing demands and limited time and resources. School nurses reported focusing on the individual's immediate needs and processing the experience afterward. They acknowledged they can only do so much, and shared stories of coping and resilience. Additional education, resources, and support in addressing student trauma can enhance the provision of school nursing services and support the well-being of school nurses, students, and staff. Further research is warranted with a larger and more diverse sample of school nurses, including attention to school nurse wellness and resilience strategies.
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3
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Tuncay S, Sarman A. Determination of the relationship between depression and suicide in young adolescents. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12473. [PMID: 38923673 DOI: 10.1111/jcap.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE This study was designed to explore the relationships between depression, and the likelihood of suicide among young adolescents by considering various factors. DESIGN AND SAMPLES It was conducted in a descriptive-cross-sectional format, with fieldwork spanning from November 16, 2022, to June 30, 2023. The study assessed the likelihood of depression, and suicide in young adolescents attending a university in Eastern Turkey. MEASUREMENTS Sociodemographic features survey form, Beck's Depression Inventory and Suicide Probability Scale were used to collect data. RESULTS The results from this investigation indicated that women, individuals with chronic illnesses, those with a history of psychiatric conditions, those expressing a constant desire to die, those with suicidal thoughts or plans, and those with a family member who had attempted suicide exhibited significantly higher mean scores for depression and suicide. There was a positive correlation between high depression scores and suicidal tendencies. However, no conclusive evidence of a link between depression, and suicide was established. CONCLUSIONS In this study, certain demographic and psychological factors were identified as correlating with elevated levels of depression and suicidal tendencies among young adolescents. It is imperative that individuals identified as being at risk be promptly referred to appropriate units for comprehensive interventions and support.
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Affiliation(s)
- Suat Tuncay
- Department of Pediatric Nursing, Faculty of Health Science, Bingöl University, Bingöl, Turkey
| | - Abdullah Sarman
- Department of Pediatric Nursing, Faculty of Health Science, Bingöl University, Bingöl, Turkey
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4
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Price OA, Saunders B, Gibbons J, Sadlon R, Garibay L, Doe K, Nelson F, Wise T, Isaac E. School Nurses' Perceived Role and Capacity to Support School Behavioral Health Programs in DC Public and Public Charter Schools. J Sch Nurs 2024:10598405241266237. [PMID: 39051599 DOI: 10.1177/10598405241266237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
School nurses (SNs) practicing in DC public and public charter schools were surveyed to assess their perceived role and self-reported preparation to provide behavioral health prevention, early identification, and treatment services in schools. A total of 154 SNs completed a questionnaire about their role in the delivery of behavioral health services and supports. SNs reported they are primarily involved in the identification and referral of students to other school behavioral health professionals. Respondents also reported a lack of training in behavioral health and a desire for more information on related programs and services. This study offers recommendations for educating future SNs and highlights how the DC School Health Services Program utilized study findings to build capacity for SNs employed in practice. This study can help tailor educational opportunities for SNs to maximize their role in school behavioral healthcare process flows and ultimately improve outcomes for students and families.
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Affiliation(s)
- Olga Acosta Price
- Center for Health and Health Care in Schools, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA
| | - Breahnna Saunders
- Center for Health and Health Care in Schools, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA
| | - Julie Gibbons
- School of Nursing, the George Washington University, Washington, DC, USA
| | - Rachel Sadlon
- Center for Health and Health Care in Schools, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA
| | - Lori Garibay
- District of Columbia Department of Health, Washington, DC, USA
| | - Kafui Doe
- District of Columbia Department of Health, Washington, DC, USA
| | - Felicity Nelson
- District of Columbia Department of Health, Washington, DC, USA
| | - Tiffany Wise
- District of Columbia Department of Health, Washington, DC, USA
| | - Eartha Isaac
- District of Columbia Department of Health, Washington, DC, USA
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5
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Shattuck D, Ramos MM, Richard BO, Hall JL, Sparks R, Willging CE. School Nurse Leadership and the Implementation of School-Based Support for LGBTQ+ Students. J Sch Nurs 2024:10598405241265706. [PMID: 39042884 DOI: 10.1177/10598405241265706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024] Open
Abstract
In 2021, the National Association of School Nurses published an updated position statement affirming the unique position of school nurses to support the health and well-being of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) students who are faced with a variety of health disparities rooted in experiences of stigma, discrimination, and bias. The 5-year cluster randomized controlled trial "Reducing LGBTQ+ Adolescent Suicide" leveraged school nurses as leaders to facilitate the uptake of six evidence-informed, LGBTQ-supportive practices in New Mexico high schools. We analyzed 5 years of interview data from 24 school nurses in 13 intervention schools to examine what factors impacted their ability to serve as an effective leader for this initiative. Several factors including job characteristics, leadership and organizational skills, relationships and reputation, and personal commitments emerged from analysis. Contextual factors, such as working in urban or rural school, and the size of the school also influenced nurses' leadership.
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Affiliation(s)
- Daniel Shattuck
- Southwest Center, Pacific Institute for Research and Evaluation, Albuquerque, NM, USA
| | - Mary M Ramos
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | - Bonnie O Richard
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - Janie Lee Hall
- Southwest Center, Pacific Institute for Research and Evaluation, Albuquerque, NM, USA
| | - Rhonda Sparks
- New Mexico School Nurse Association, Clovis, NM, USA
| | - Cathleen E Willging
- Southwest Center, Pacific Institute for Research and Evaluation, Albuquerque, NM, USA
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6
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Liu XQ, Wang X. Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs. World J Psychiatry 2024; 14:494-506. [PMID: 38659598 PMCID: PMC11036461 DOI: 10.5498/wjp.v14.i4.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/24/2024] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
Adolescents are considered one of the most vulnerable groups affected by suicide. Rapid changes in adolescents' physical and mental states, as well as in their lives, significantly and undeniably increase the risk of suicide. Psychological, social, family, individual, and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct, indirect, or combined pathways. Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide. When deliberately cultivated, fostered, and enhanced, self-awareness, self-management, social awareness, interpersonal skills, and responsible decision-making, as the five core competencies of social-emotional learning, can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support. Among numerous suicide intervention methods, school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents. The characteristics of school-based interventions based on social-emotional competence, including their appropriateness, necessity, cost-effectiveness, comprehensiveness, and effectiveness, make these interventions an important means of addressing the crisis of adolescent suicide. To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide, additional financial support should be provided, the combination of social-emotional learning and other suicide prevention programs within schools should be fully leveraged, and cooperation between schools and families, society, and other environments should be maximized. These efforts should be considered future research directions.
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Affiliation(s)
- Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
| | - Xin Wang
- School of Education, Tianjin University, Tianjin 300350, China
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7
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Moyes A, McGough S, Wynaden D. Hidden and unacknowledged: The mental health and psychosocial interventions delivered by school nurses in Western Australia. Int J Ment Health Nurs 2024; 33:463-472. [PMID: 37994283 DOI: 10.1111/inm.13261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023]
Abstract
Schools are an important setting for the early identification, assessment and intervention of mental health problems in children and young people. Internationally, many nurses work in schools, but the role of this group with young people experiencing mental health problems has had only limited investigation. This study explored the activities school nurses undertook with young people experiencing mental health problems in Australia. Reporting was guided by the COREQ checklist. Thirty-one nurses participated in a semi-structured interview. Data were analysed using the constant comparative method of analysis as developed by Glaser and Strauss (1967). The findings identified that nurses working in schools undertake a complex and sophisticated workload to support this cohort. In addition to assessment and referral for treatment, interventions assisted young people to manage challenging life circumstances, cope with intensely difficult emotions and improve their social and occupational functioning. The work of school nurses with young people experiencing mental health problems is hidden and unacknowledged. A better understanding of the mental health work school nurses undertake can inform enhanced service provision for children, young people and their families. The research findings will be of interest to mental health nurses, education professionals, parents, policy makers and governments.
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Affiliation(s)
- Anita Moyes
- Edith Cowan University, Perth, Western Australia, Australia
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8
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Gómez-Romero MR, Montoro-Pérez N, Martín-Baena D, Talavera-Ortega M, Montejano-Lozoya R. A descriptive cross-sectional study on eating disorders, suicidal thoughts, and behaviors among adolescents in the Valencian community (Spain). The pivotal role of school nurses. J Pediatr Nurs 2024; 75:1-7. [PMID: 38091926 DOI: 10.1016/j.pedn.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE The aims of this study were: 1) to describe the rates of risk of having an Eating Disorder (ED) and the rates of suicidal thoughts and behaviors, and 2) to examine the relationship between the risk of having an ED with suicidal thoughts and behaviors in adolescents enrolled in educational centers in the Community of Valencia (Spain). DESIGN AND METHODS A cross-sectional study was conducted with 718 adolescents between September 2019 and July 2020 in five schools in the Community of Valencia (Spain). RESULTS The adolescents studied, mostly females, are at risk of having an ED (18.6% to 30.8%) and experiencing suicidal thoughts (23% to 30.7%) and behaviors (2.2% to 6.2%). A strong association was found between EDs and suicidal thoughts and behaviors in both sexes. This association was higher in females with positive EAT-26 scores (OR: 2.09; 95% CI: 1.35-3.24) and in males with positive SCOFF scores (OR: 4.66; 95% CI: 2.40-9.02). Suicidal behaviors were positively associated with both EAT-26 (OR: 2.58; 95% CI: 1.17-5.67) and SCOFF (OR: 1.89; 95% CI: 1.21-2.26) scores in females. CONCLUSIONS A considerable number of adolescents, females in particular, are at risk of having an ED and of experiencing suicidal thoughts and behaviors, establishing a strong link between EDs and suicidal tendencies. PRACTICAL IMPLICATIONS The study highlights the importance of establishing national and regional regulations to ensure the availability of school nurses in the Community of Valencia (Spain). Collaboration between school nurses, educators, and policy makers is critical to the early detection of problems and the provision of support to both adolescents and families.
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Affiliation(s)
| | - Néstor Montoro-Pérez
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, Spain.
| | - David Martín-Baena
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Marta Talavera-Ortega
- Department of Didactics of Experimental and Social Sciences, Faculty of Teaching, University of Valencia, Valencia, Spain
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9
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Blakeslee T, Snethen J, Schiffman RF, Gwon SH, Sapp M, Kelber S. Adolescent Characteristics, Suicide, and Bullying in High School. J Sch Nurs 2023; 39:463-474. [PMID: 34397299 DOI: 10.1177/10598405211038235] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Youth Risk Behavior Survey 2011-2017 data were examined for associations among high school population subsets who self-reported suicide risk behaviors and experiences with bullying. High-school students who reported suicidal risk behaviors were 4.64 times more likely to have experienced bullying electronically. Ninth grade and female students were more likely than others to experience suicide risk behaviors and bullying. At the interpersonal level, school nurses are able to identify students who are experiencing bullying and who exhibit suicide risk behaviors. At the systems level, bullying prevention efforts should target all students. School nurses, administrators, policy makers, and health providers should consider data-driven recommendations in bullying prevention programs.
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Affiliation(s)
| | - Julia Snethen
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | | | | | - Marty Sapp
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Sheryl Kelber
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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10
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Hoskote AR, Croce E, Johnson KE. The Evolution of the Role of U.S. School Nurses in Adolescent Mental Health at the Individual, Community, and Systems Level: An Integrative Review. J Sch Nurs 2023; 39:51-71. [PMID: 35019803 DOI: 10.1177/10598405211068120] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
School nurses are crucial to addressing adolescent mental health, yet evidence concerning their evolving role has not been synthesized to understand interventions across levels of practice (i.e., individual, community, systems). We conducted an integrative review of school nurse roles in mental health in the U.S. related to depressive symptoms, anxiety, and stress. Only 18 articles were identified, published from 1970 to 2019, and primarily described school nurses practicing interventions at the individual level, yet it was unclear whether they were always evidence-based. Although mental health concerns have increased over the years, the dearth of rigorous studies made it difficult to determine the impact of school nurse interventions on student mental health outcomes and school nurses continue to feel unprepared and under supported in this area. More research is needed to establish best practices and systems to support school nursing practice in addressing mental health at all levels of practice.
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Affiliation(s)
- Ashwini R Hoskote
- Robert Wood Johnson Foundation Future of Nursing Scholar, 12330University of Texas at Austin School of Nursing
| | - Emily Croce
- 12330The University of Texas at Austin School of Nursing; Dell Children's Medical Group, Austin, TX
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11
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Baur A, Carpenter DM, Driscoll K, Fromewick JC, Belden CM, Thomas KC. Implementing facilitative leadership to develop a school nurse research agenda in western North Carolina. THE JOURNAL OF SCHOOL HEALTH 2023; 93:158-161. [PMID: 36271593 DOI: 10.1111/josh.13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/02/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Affiliation(s)
- April Baur
- Mountain Area Health Education Center, 121 Hendersonville Road, Asheville, NC, 28803
| | - Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, 1 University Heights, CPO 2125, Asheville, NC, 28804
| | - Katie Driscoll
- Mountain Area Health Education Center, 121 Hendersonville Road, Asheville, NC, 28803
| | - Jill C Fromewick
- Mountain Area Health Education Center, 121 Hendersonville Road, Asheville, NC, 28803
| | - Charles M Belden
- Department of Research, Mountain Area Health Education Center, 121 Hendersonville Road, Asheville, NC, 28803
| | - Kathleen C Thomas
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Kerr Hall 2212 CB #7573, Chapel Hill, NC, 27599
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12
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Shattuck D, Sebastian R, Zamarin K, Acosta S, Ramos MM. School Nurse Management of Behavioral Health, Violence, and Trauma-Related Emergencies: Findings from a Statewide Survey. J Sch Nurs 2022:10598405221120437. [PMID: 35979606 DOI: 10.1177/10598405221120437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
School nurses are critical components of school-based interdisciplinary teams supporting student behavioral health. The purpose of the present study is to understand the extent to which school nurses in New Mexico across grade levels manage emergencies related to behavioral health, violence, and trauma. The study also seeks to identify which topics the school nurses received continuing education (CE) for, and which topics they consider to be important to their practice. Analyses of 2019 statewide survey data show a considerable number of school nurses in New Mexico provide management for behavioral health, violence, and trauma-related emergencies, and nurses in secondary schools are significantly more likely than nurses in primary schools to report managing these emergencies and to have received CE on behavioral health topics. Our findings reaffirm the essential role of school nurses in addressing emergent student health issues and underscore the need for practice- and competency-based behavioral health CE opportunities.
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Affiliation(s)
- Daniel Shattuck
- 11209Pacific Institute for Research and Evaluation-Southwest, 851 University Boulevard, Albuquerque, NM, USA
| | - Rachel Sebastian
- 11209Pacific Institute for Research and Evaluation-Southwest, 851 University Boulevard, Albuquerque, NM, USA
| | - Kim Zamarin
- 11209Pacific Institute for Research and Evaluation-Southwest, 851 University Boulevard, Albuquerque, NM, USA
| | - Susan Acosta
- 1107New Mexico Department of Health, Office of School and Adolescent Health, Albuquerque, NM, USA
| | - Mary M Ramos
- Department of Pediatrics, University of New Mexico, MSC11-6145, 1 University of New Mexico, Albuquerque, NM, USA
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13
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O'Shea ER, Phillips KE, O'Shea KN, Roney LN. Preparing for the Impact of COVID-19 on the Mental Health of Youth. NASN Sch Nurse 2021; 37:64-69. [PMID: 34889126 PMCID: PMC8668437 DOI: 10.1177/1942602x211052626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The COVID-19 pandemic is continuing to have long-term and global effects
that the vaccine may not ease. Children and adolescents endured
unprecedented periods of loneliness, social isolation, financial
stressors, in-home conflicts, changes in living circumstances, and
variable access to healthcare, resulting in increased mental health
sequelae. Timely recognition of students’ anxiety, depression, and
disruptive behaviors will allow appropriate interventions to
de-escalate these feelings and prevent suicidal ideations and
attempts. As youth return to school, their mental health needs will
not subside. School nurses and the multidisciplinary team have a vital
role in impacting this population’s already surging increase of mental
and behavioral health disorders.
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Affiliation(s)
- Eileen R O'Shea
- Professor of Pediatric Nursing, Marion Peckham Egan School of Nursing & Health Studies, Fairfield University, Fairfield, CT
| | - Kathryn E Phillips
- Associate Professor, Marion Peckham Egan School of Nursing and Health Studies, Fairfield, CT
| | - Kathleen N O'Shea
- Medical Intensive Care Unit Nurse, Boston Children's Hospital, Boston, MA
| | - Linda N Roney
- Associate Professor, Marion Peckham Egan School of Nursing and Health Studies, Fairfield, CT
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