School Nurses Practices Promoting Self-Management and Healthcare Transition Skills for Adolescents with Chronic Conditions in Urban Public Schools: A Mixed Methods Study

Role of a School Nurse in the Management of Type 1 Diabetes in Schools: Teachers' Perspectives

INTRODUCTION

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder and carries the risk of causing serious complications and/or death in the patient. In the school environment, diabetic students need monitoring and support to ensure their health. Teacher perceptions can impact T1D management in schools by influencing their preparedness, support strategies, and response to emergencies. The aim of this study was to assess attitudes and perceptions of teachers regarding the role of a school nurse in the management of students with T1DM in the school environment.

METHODS

This qualitative study was conducted in two primary schools with a final sample of 10 teachers. Data were collected through semi-structured interviews using an 11-item open-ended questionnaire. Ethical considerations ensured confidentiality and voluntary participation. Thematic analysis was employed to categorize responses into conceptual units, following an inductive approach. This method, chosen for its strength in capturing the complexity of teachers' experiences and perceptions, provided an in-depth exploration of their perspectives on the role of school nurses in managing students with T1DM.

RESULTS

Three main themes emerged from the thematic analysis. The first theme was Knowledge and Understanding of Type 1 Diabetes Mellitus, the second was Knowledge and Perceptions of Teachers Regarding the Role of the School Nurse in Supporting Students With Diabetes, and the third was Collaboration and Interaction Levels Between Teachers and the School Nurse.

CONCLUSION

The study concludes that school nurses play a key role in supporting students with diabetes, contributing to their equal inclusion in the school environment. The findings suggest that enhanced collaboration between teachers and nurses, combined with targeted teacher training, can promote a holistic and supportive approach to student care, improving their school life and overall well-being.

Perceptions on the Implementation of a School Nursing Pilot Programme in the Canary Islands

Background/Objectives: School nursing is a nursing practice focused on promoting child health within the school and community environment, integrating healthcare with the educational process. The aim was to explore the experiences of nurses and teachers regarding the implementation of a school nursing pilot programme in primary education in the Canary Islands (Spain). Methods: A phenomenological study was conducted during the 2023/2024 academic year. In-depth interviews were conducted between May and June 2024 until data saturation was achieved. The interviews were transcribed and analysed using descriptive and interpretative thematic analysis. Intentional and co-occurrence coding methods were employed, followed by triangulation using Atlas-Ti software (version 24). Ethical approval was obtained (code: 2023-216-1). Results: A total of 21 informants (7 nurses and 14 teachers) were interviewed. Nurses revealed eight subthemes grouped into two main themes: Role of School Nurses (workload, school nurses' experiences, career opportunities, and the school nurse profile) and School Nursing Project (suggested improvements, identified weaknesses, time management, and improvement needs). Regarding teachers, six subthemes were identified, also grouped into two main themes: Role of School Nurses (approach to school nursing and the importance of the presence of school nurses) and School Nursing Project (expectations, improving children's health, school health, and experiences from the pilot programme). Conclusions: The pilot programme has been well received, showing a positive impact on students' health. While successfully integrating nurses into schools, improvements are needed in working conditions, resource allocation, and specialized training to enhance its effectiveness and sustainability. Strengthening inter-professional collaboration between healthcare and education sectors and involving teachers in planning health activities are essential. Expanding the coverage and ensuring a consistent presence of school nurses would further build trust, improve chronic health management, and promote healthy habits from an early age. This programme illustrates the potential of nurses to transform schools into spaces for comprehensive health promotion.

Parents' practices, feelings, and support needs surrounding the development of food allergy literacy (FAL) in children before their transition to school

Children's knowledge of food allergy and risk prevention, coined as food allergy literacy (FAL), can bolster their safety in schools. Addressing research gaps on this topic, especially, parents' role, the aim of this study was to investigate Australian parents' practices, feelings, and support needs relating to building children's FAL before their transition to school. Questionnaire data from 159 parents were analysed statistically to characterise the sample and explore the association between children's FAL, parent anxiety, and parent confidence in their child's ability to stay safe at school. Results indicated that parents supported children's knowledge of food allergy and risk prevention using age and developmentally appropriate pedagogies. However, they focused less on building children's skills to read food labels, communicate symptoms, and seek help. Furthermore, the association between children's FAL and parents' feelings about children's safety in school was weak. However, the association between the child's FAL and parents' confidence in the child's ability to stay safe at school was moderate-to-strong. The implications of these findings for educators are discussed.

School Nursing Practice in Education Settings in Spain

School nurses and pediatric nurses play vital roles in providing healthcare for children and adolescents in educational and healthcare settings. School nurses operate within educational institutions, serving as caregivers and facilitating communication between the school, families, and the healthcare system. These professionals closely collaborate with pediatric nurses. The primary objective of this study was to examine the state of school nursing in Spain. The research comprised 27 nurses, including 18 school nurses and 9 pediatric nurses, chosen through theoretical sampling. These nurses participated in in-depth interviews as part of the data collection process. Grounded theory, following Charmaz's process, was employed for data analysis. The findings underscore the nurses' call for their mandated presence and regulation in all Spanish educational institutions to address contemporary health challenges and ensure inclusive education.