A Multi-Systemic School-Based Approach for Addressing Childhood Aggression

Experiences of a mental health promotion, prevention, and early-intervention training program targeted to school nurses in the United Arab Emirates

AIM

To report participants' and facilitators' experiences of mental health promotion, prevention, and early-intervention training program targeted at school nurses in the United Arab Emirates (UAE).

BACKGROUND

The UAE school healthcare service is staffed by full-time nurses and part-time doctors and linked to primary healthcare centers. This service supports children's physical and mental well-being. However, school nurses' capacity to realize the potential of this service, particularly regarding mental health, has not yet been explored.

METHODS

We used an exploratory qualitative approach with data triangulation. Data were drawn from school nurses that participated in a targeted mental health promotion, prevention, and early-intervention training program. Data were gathered through focus group interviews with participating school nurses, written reflections, and notes recorded by the program designers and trainers. All school nurses who participated in the training program (N = 15) were included in this study. This study adhered to the consolidated criteria for reporting qualitative research.

RESULTS

Nurses' narratives encompassed three main themes, which indicated the program was an enjoyable professional and personal journey that allowed professional discovery/development and personal growth. Program organizers/facilitators indicated the training program was important, but challenging to implement. Four themes emerged from their reflections that covered the structure of school nursing services, participants' competency and education, the UAE context, and teaching style.

CONCLUSION

A well-structured professional development program can contribute to improving mental healthcare in schools. Improved service structure and regulations to support this goal are essential.

IMPLICATIONS FOR NURSING PRACTICE, RESEARCH, AND POLICY

School nurses benefit professionally and personally from targeted mental health training, which also improves the care students receive. School healthcare service managers should consider increasing such training opportunities for nurses and focus on measuring service outcomes and evaluating effectiveness. It is also necessary to reassess the minimum qualification requirement for school nurses. Specific professional development programs for school nurses will improve their clinical practice and support the recruitment of competent and prepared staff.

Is Psychological Distress a Risk Factor or an Outcome of School Violence and Cyberbullying Perpetrated by Adolescents? A Short-Term Longitudinal Panel Study

Although the associations between adolescent psychological distress (i.e., depression, anxiety, and somatization), school violence, and cyberbullying have been examined using cross-sectional data, little evidence from longitudinal panel data exists to determine the temporal association. A two-wave longitudinal panel data with a 10-month interval were obtained from a random sample of 487 Chinese junior high school students (grades 7-9) in Tianjin in Mainland China. The cross-lagged panel analysis showed that adolescent psychological distress in the first wave of the survey was significantly associated with subsequent school violence against peers and teachers in the second wave but not in the opposite direction. Student psychological distress in the first wave of the survey was not significantly associated with cyberbullying perpetration in the second wave and vice versa. The findings suggested that adolescent psychological distress was a risk factor rather than the consequence of violence against peers and teachers in school. However, the temporal associations between adolescent psychological distress and cyberbullying perpetration were non-significant. These findings were relevant to both sex groups. The findings may imply that potential interventions and policies to prevent students from committing school violence should consider reducing students' psychological distress as one of the core elements.

Assessing sense of coherence as an element of primary-focused health services in schools for children and adolescents with complex health care needs

AIM

This study aimed to clarify if sense of coherence (SOC) could be used as an element of primary-focused health services in schools.

BACKGROUND

The United Arab Emirates (UAE) is striving to develop a high-quality, primary-focused health care system. School health care services are well established in the UAE but have not yet been fully used to play a key role in this development.

METHODS

This is a cross-sectional survey study to explore adolescents' SOC and their behavioural, psychosocial and clinical outcomes.

RESULTS

A total of 408 adolescents participated in this study. Compared with others, adolescents with higher SOC had better adherence to treatment, fewer visits to the school nurse, better self-efficacy, fewer hyperactivity problems, fewer emotional problems, more prosocial behaviours and fewer conduct problems.

CONCLUSION

Implementing interventions that improve SOC may support improved well-being among adolescents. The findings also support the use of SOC and salutogenesis as a framework to reinforce primary health care services for this population.

IMPLICATIONS FOR NURSING MANAGEMENT

Health service managers can utilize SOC as a framework to focus service on illness prevention and health promotion, they should collaborate with education authorities to include more health-related topics as part of school curricula to promote students' SOC and, finally, they should assess and build awareness of SOC and associated tools among school nurses and primary health care providers.

Protocol for the design of an instrument to measure preadolescent children's self-report of covert aggression and bullying

INTRODUCTION

Covert bullying in schools is associated with a range of academic, social, emotional and physical health problems. Much research has focused on bullying, but there remains a gap in understanding about covert aggression and how to most accurately and reliably measure children's own reports of this behaviour. This paper reviews relevant literature and outlines a research project that aims to develop a self-report instrument that effectively measures covert aggression and bullying. It is anticipated that this research will result in a standardised instrument that is suitable for exploring preadolescent children's experiences of covert aggressive behaviour. The data collected by the instrument will enhance health and education professionals understanding of covert bullying behaviours and will inform the design and evaluation of interventions.

METHODS AND ANALYSIS

Relational developmental systems theory will guide the design of an online self-report instrument. The first phase of the project will include a critical review of the research literature, focus groups with children aged 8-12 years (grades 4-6) in Perth, Western Australia, and expert review. The instrument will be explored for content and face validity prior to the assessment of convergent and discriminant validity, internal consistency and test-retest reliability.

ETHICS AND DISSEMINATION

The study has been approved by the Curtin University of Human Research Ethics Committee (RDHS-38-15) and by the Executive Principal of the participating school.

Neurological and biological foundations of children's social and emotional development: an integrated literature review

This article provides an integrated review of the expert literature on developmental processes that combine social, biological, and neurological pathways, and the mechanisms through which these pathways may influence school success and health. It begins with a historical overview of the current understanding of how attachment relationships and social environments influence brain development and plasticity and are, therefore, central to the physical and mental health of individuals and populations. It then expands on the effect of plasticity in relation to behavior and learning at school. This article concludes with a discussion of the role the school nurse may play in supporting health and learning by recognizing signs of relational stress and by advocating for prevention strategies.

Children's social/emotional characteristics at entry to school: implications for school nurses

Children entering school need to build healthy peer relationships; school, however, is the central place for bullying. School nurses have a growing focus on providing care for students with social, emotional and behavioural problems. We examined the relational development of children at school entry in regard to aggression and empathy, showing that teacher-reported aggression decreased between Pre-primary and Year One, while empathy increased between Year One and Year Two classes. No gender difference was found in teacher-reported total, or covert aggression. Understanding how development of empathy can be supported in children at school entry is important, thereby supporting development of pro-social behaviour and decreasing bullying. School nurses must understand the importance of surrounding children with safety in relationships as they begin school.