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Aivey SA, Fukushima Y, Rahman MM, Nahar NS, Ahmed A, Prihanto JB, Hawlader MDH, Moriyama M. Effects of school nurse-led health education to reduce malnutrition among primary school children in Bangladesh: Cluster nonrandomized controlled trial. J Family Med Prim Care 2024; 13:1024-1036. [PMID: 38736776 PMCID: PMC11086752 DOI: 10.4103/jfmpc.jfmpc_1560_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 05/14/2024] Open
Abstract
Background Malnutrition is a major health concern among children especially in low and middle-income countries. However, there are limited studies on school health in Bangladesh. This study aimed to reduce malnutrition among primary school children in Bangladesh by increasing awareness and knowledge through school nurse-led health education. Methods and Materials A prospective, open-label, parallel-group (1:1), cluster nonrandomized controlled trial on primary school children conducted in rural Bangladesh. The study lasted 13 months between September 2021 and September 2022. Four schools were selected and assigned to the intervention and control groups (CGs). Next, school nurses provided evidence-based health education to the children in the intervention group (IG) for 9 months to improve awareness and knowledge of malnutrition. Data were collected at baseline, midline, and endline. Results Overall, 604 children were enrolled at the baseline; among them, 455 (CG, n = 220; IG, n = 235) completed the study. Changes in the malnutrition rate-the primary outcome-were not significant (P = 0.225). However, after adjusting the endline data with baseline and sociodemographic data, the children's body mass index improved significantly in the IG than in the CG (P < 0.05). Changes in eating behavior, and awareness and knowledge of malnutrition-the secondary outcomes-significantly differed between the groups (P < 0.001). Conclusion The school nurse-led health education program significantly improved primary school children's awareness and knowledge of malnutrition. This study revealed the effectiveness of school nurses in reducing malnutrition among children, which may decrease future morbidity and mortality rates in children.
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Affiliation(s)
- Sadia A. Aivey
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuko Fukushima
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Md Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Niru S. Nahar
- Department of Nursing Science, Grameen Caledonian College of Nursing, Dhaka, Bangladesh
| | - Ashir Ahmed
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Junaidi B. Prihanto
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Physical Education, Universitas Negeri Surabaya (State University of Surabaya), Surabaya, East Java, Indonesia
| | | | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Aivey SA, Rahman MM, Fukushima Y, Ahmed A, Prihanto JB, Sarker MHR, Hawlader MDH, Moriyama M. Nutritional status and prevalence of helminthic infection among primary school children in Bangladesh: A cross-sectional study. Jpn J Nurs Sci 2024; 21:e12568. [PMID: 37800657 DOI: 10.1111/jjns.12568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 10/07/2023]
Abstract
AIM Malnutrition and infectious diseases, such as helminthic infections, are widespread among primary school children, especially in low- and middle-income countries. However, there are limited studies on school health in Bangladesh, particularly in rural settings. This study aimed to explore the nutritional status and prevalence of helminthic infections in relation to associated health behavior, awareness, and knowledge regarding malnutrition and helminthic infections which were evaluated by school nurses among primary school children in Bangladesh. METHODS This was a descriptive, cross-sectional survey study with a total duration of 1 month, from September to October, 2021. This study formed part of a school nurse project as a cluster non-randomized clinical trial in Bangladesh. Selected variables from that clinical trial were analyzed and reported in the results section. The study participants were primary school children from four schools in rural Bangladesh. RESULTS In total, 604 children participated in the baseline survey and health checkups. Among them, 163 (27.0%) children were classified as malnourished according to the World Health Organization growth reference standard 2007. The prevalence of helminthic infections was 53 (8.8%). Approximately >50% of the children responded that they never/rarely practiced hygiene-related behaviors and had no awareness and knowledge regarding malnutrition and helminthic infections. However, differences between the variables were not statistically significant. CONCLUSION Children's nutritional status and prevalence of helminthic infections with related deprived health behaviors, and minimal awareness and knowledge, reinforce the importance of implementing educational interventions in the future.
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Affiliation(s)
- Sadia Alam Aivey
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Md Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuko Fukushima
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ashir Ahmed
- Faculty of Information Science and Electrical Engineering, Kyushu University, Japan
| | - Junaidi Budi Prihanto
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Physical Education, Universitas Negeri Surabaya (State University of Surabaya), Surabaya, Indonesia
| | - Mohammad Habibur Rahman Sarker
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Nutrition and Clinical Services Division, icddr, b, Dhaka, Bangladesh
| | | | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Brentari M, Franceschi R, Longhini J, Maines E, Mozzillo E, Marigliano M, Vivori C. Family and Community Nurses as a Resource for the Inclusion of Youths with Type 1 Diabetes at School. J Pers Med 2023; 13:981. [PMID: 37373970 DOI: 10.3390/jpm13060981] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
School nurses can facilitate the inclusion of students with type 1 diabetes (T1D) at school; this model has been widespread in some countries but not in Italy, which is due to the insufficient number of school nurses that are able to provide medical attention at all times. The National Recovery and Resilience Plan (PNRR) devised a series of aids and support for the reorganization of the Italian National Health System (NHS) through the creation of community houses in addition to family and community nurses (FCNs), who will operate in these structures to promote the integration of the various professional figures and community services. In this study, starting with the needs and suggestions of teachers (No. 79) and parents (No. 48) collected using a survey, we developed a new model for the inclusion of students at school where FCNs who have experience in pediatric T1D have the role of an educator, coordinator, and facilitator' they cannot be on site and available all the time during school hours, so they must make many efforts to improve the school staff's knowledge, intervene to offer training when requested, and solve new emerging problems.
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Affiliation(s)
- Maria Brentari
- Community Nurse, Azienda Provinciale per i Servizi Sanitari, APSS, 38123 Trento, Italy
| | - Roberto Franceschi
- Pediatric Diabetology Unit, Pediatric Department, S.Chiara General Hospital of Trento, APSS, 38122 Trento, Italy
| | - Jessica Longhini
- Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy
| | - Evelina Maines
- Pediatric Diabetology Unit, Pediatric Department, S.Chiara General Hospital of Trento, APSS, 38122 Trento, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, Federico II University of Naples, 80138 Naples, Italy
| | - Marco Marigliano
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
| | - Cinzia Vivori
- Hygiene and Public Prevention Department, Azienda Provinciale per i Servizi Sanitari, APSS, 38123 Trento, Italy
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Pawils S, Heumann S, Schneider SA, Metzner F, Mays D. The current state of international research on the effectiveness of school nurses in promoting the health of children and adolescents: An overview of reviews. PLoS One 2023; 18:e0275724. [PMID: 36812235 PMCID: PMC9946271 DOI: 10.1371/journal.pone.0275724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 09/22/2022] [Indexed: 02/24/2023] Open
Abstract
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.
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Affiliation(s)
- Silke Pawils
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Susanne Heumann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophie Alina Schneider
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franka Metzner
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Professorship for Educational Science with a Focus on Special Education ("Emotional and Social Development"), University of Siegen, Siegen, Germany
| | - Daniel Mays
- Professorship for Educational Science with a Focus on Special Education ("Emotional and Social Development"), University of Siegen, Siegen, Germany
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Municipal Support of Diabetes Management in Daycare, Kindergarten and School: A Qualitative Study of Differences, Challenges and Potentials. Healthcare (Basel) 2022; 10:healthcare10081557. [PMID: 36011214 PMCID: PMC9407911 DOI: 10.3390/healthcare10081557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetes care during institutional hours is a major challenge affecting the whole family. The aim of this study was to highlight challenges and potentials regarding municipal support in relation to diabetes care of children in school, kindergarten, and daycare. The dataset consists of 80 semi-structured online interviews with 121 municipal employees from 74 (of 98) municipalities in Denmark. Data were analysed using qualitative content analysis. The analysis produced four main themes: (1) Institutional staff initially feel insecure about diabetes care responsibilities, (2) There is a high degree of parental involvement and responsibilities during institutional hours, (3) The roles of health employees vary, and (4) Fluctuating allocation of special needs assistants (SNAs) creates challenges. The findings of this nationwide qualitative study show that, even though Denmark guarantees, by law, the child’s right to support in diabetes self-care in school and childcare institutions, diabetes management in Denmark still needs to be improved, with a view to ensuring equal support for all children with diabetes.
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Drakopoulou M, Begni P, Mantoudi A, Mantzorou M, Gerogianni G, Adamakidou T, Alikari V, Kalemikerakis I, Kavga A, Plakas S, Fasoi G, Apostolara P. Care and Safety of Schoolchildren with Type 1 Diabetes Mellitus: Parental Perceptions of the School Nurse Role. Healthcare (Basel) 2022; 10:healthcare10071228. [PMID: 35885755 PMCID: PMC9320713 DOI: 10.3390/healthcare10071228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 11/22/2022] Open
Abstract
Schoolchildren with type 1 diabetes mellitus (T1DM) need supervision in the management of their disorder by the school nurse, securing proper care and safety in the school environment. The aim of this study was to investigate the parents’ perceptions regarding the care and safety of their children with T1DM at school. In this cross-sectional study, 356 parents of children with T1DM attending primary and secondary school (convenience sample) completed the “Parents’ Opinions about School-based Care for Children with Diabetes” and the “Safety of children with T1DM at school”. The majority (58.8%) noted that their children received some care from a school nurse, less than half (44.6%) declared feeling very safe concerning diabetes care, and 42.5% reported high levels of diabetes management satisfaction. Younger age of the child (p < 0.001), school nurses’ advanced diabetic care skills (p < 0.001), existence of school nurse’s office (p < 0.05) and higher educational level of the father were positively correlated with higher parental feelings of safety and satisfaction. The presence of a school nurse was associated with higher academic performance (p < 0.001), significantly fewer absences due to the disorder (p < 0.001) and better diabetes management (p < 0.043). The daily presence of a school nurse in school decreases absenteeism, greatly improves school performance and enhances diabetic management of schoolchildren with T1DM.
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Affiliation(s)
- Marianna Drakopoulou
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
- Correspondence:
| | | | - Alexandra Mantoudi
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Marianna Mantzorou
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Georgia Gerogianni
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Theodoula Adamakidou
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Victoria Alikari
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Ioannis Kalemikerakis
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Anna Kavga
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Sotirios Plakas
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Georgia Fasoi
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
| | - Paraskevi Apostolara
- Department of Nursing, Faculty of Health Sciences, University of West Attica, 122 43 Athens, Greece; (A.M.); (M.M.); (G.G.); (T.A.); (V.A.); (I.K.); (A.K.); (S.P.); (G.F.); (P.A.)
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Beak EM, Kim YH. Factors Included in T1DM Continuing Education for Korean School Nurses: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041620. [PMID: 33567721 PMCID: PMC7914974 DOI: 10.3390/ijerph18041620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: The aim of this systematic review was to identify key factors for inclusion in continuing education for Korean school nurses to improve their competence in managing students with type 1 diabetes mellitus (T1DM). (2) Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. (3) Results: Twelve studies were included in this systematic literature review. The factors identified for inclusion in continuing education on Type 1 diabetes mellitus included 6 competencies. These were strengthening competence in managing students with Type 1 diabetes mellitus, facilitating networking with experts and peers, the perspective of the school nurse as a leader, use of a type 1 diabetes mellitus-specific evidence-based standardized approach of care, supporting self-management to promote healthy learners, and communication and collaboration between key stakeholders. Identified barriers to accessing continuing education on type 1 diabetes mellitus were work demands, difficulty taking time off during the school year, and limited support from administrators. (4) Conclusions: Based on the findings of this study, online or e-learning continuing education on type 1 diabetes mellitus must be developed for school nurses who manage students with this condition.
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Affiliation(s)
- Eun-Mi Beak
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, Seoul 06591, Korea;
| | - Yeon-Ha Kim
- Department of Nursing, Korea National University of Transportation, Chungbuk 27909, Korea
- Correspondence: ; Tel.: +82-43-820-5181
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