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Journal: The Journal of school nursing : the official publication of the National Association of School Nurses

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The purpose of the study was to explore how fixed and modifiable family, activity, and school factors affect a student’s myopia risk and severity. We used national cross-sectional data from Taiwanese children in Grades 4-6. Bivariate and multivariate analyses, including logistic and ordinary least squares regression, examined factors related to children’s myopia status and severity. Age, parent myopia, and school district were associated with risk of myopia. One hour or more per day of near work (OR = 1.26) increased the odds of myopia. The same amount of time in outdoor activities (OR = 0.85) or moderate or vigorous physical activities (OR = 0.82) was associated with lower risk. Near work (β = 0.06), outdoor activity (β = -0.04), and outdoor recess (β = -0.03) predicted myopia severity. To promote healthy vision, nurses should advocate for and implement interventions that increase school children’s time outdoors and in physical activities and reduce their time on near work.

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A better understanding of the social influences, self-efficacy, and communication with parents, peers, and teachers associated with teenage pregnancy is required owing to the consequences of teenage pregnancy. This article aimed to determine the prevalence of teenage pregnancy and to understand the association between social influences, self-efficacy, and communication about teenage pregnancies, among high school students in KwaZulu-Natal, South Africa. Grade 11 students at 20 randomly selected schools in two districts completed an anonymous questionnaire on sociodemographics, social influences, self-efficacy communication, and teenage pregnancy. Teenage pregnancy was associated with age, being female, and exposure to communication discouraging pregnancy. Students living with both parents, or where family and peers believed that the adolescents should abstain from sex, or who experienced positive social pressure discouraging pregnancy were unlikely to have had a pregnancy. This study identified sociodemographic and sociobehavioral influences associated with teenage pregnancy that can assist school nurses in their work.

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Millions of students with mental health concerns attend school each day. It is unknown how many of those students experience psychogenic nonepileptic seizures (PNES); however, quality of life, academic, and mental health outcomes for students experiencing PNES can be bleak. Currently, no authors have addressed potential school nurse interventions for students with PNES. Because PNES is a mental health condition and is often influenced by underlying anxiety and/or depression, an integrative review of school nurse interventions and outcomes for students with general mental health concerns was conducted. An integrative review resulted in the identification of 13 quantitative and 2 qualitative studies that met inclusion criteria. The findings from this review suggest school nurses, following principles from the Framework for 21st Century School Nursing Practice, play an active role in mental health interventions and should be involved in replicating and testing known mental health interventions to investigate their effectiveness for students with PNES.

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Prevalence of eating disorders (EDs) has increased among adolescents in Arabic and Western countries. The purposes are to identify the risk of ED and psychosocial correlates of risk of ED among high school girls in Jordan. The researchers employed a cross-sectional, correlational design using 799 high school girls from governmental and private schools in the central region of Jordan. The results indicate that prevalence of the risk of ED was 12%. The risk of ED had significant and positive correlation with body shape dissatisfaction, self-esteem, psychological distress, and pressure from family, peers, and media ( p < .001). Body shape dissatisfaction, low self-esteem, negative peer pressure, and being young were significant predictors of the risk of EDs. Risk of ED is highly prevalent among high school girls, and school nurses need to adopt a model of care addressing the risk factors while caring for high school girls.

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Studies show that senior high school students living in lodgings (away from home) when attending high school are vulnerable to stress and mental health problems. Moving away from home at the age of 15-16 is a transition that might affect adolescents' well-being. The aim of this study is to explore the experience of living in lodgings during senior high school. In-depth interviews were conducted with 21 Norwegian lodgers of both genders between the ages of 16-18. Interviews were analyzed according to a phenomenological hermeneutical approach. Four main themes were identified: (a) striving between controlling time and being controlled by time, (b) striving between finding comfort in being alone and feeling left alone, © striving between being independent and being taken care of, and (d) striving between leaving and finding home. The findings illuminate many challenges experienced by lodgers. A raised awareness and preventive initiatives from school nurses are recommended.

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The aim was to describe school nurses' experiences working with students with mental health problems. In this inductive qualitative study, interviews were conducted with 14 school nurses in Sweden. The content analysis revealed three themes: (1) sense of worriedness about working with students with mental health problems, (2) taking care of students with mental health issues was an opportunity for personal and professional development, and (3) the experience of making a difference for young people with mental health problems. The school nurses working with students who have mental health problems had to cope with their own emotions, worries, and feelings of insufficiency. However, the school nurses also found the work to be meaningful and rewarding because they appreciated the opportunity for personal and professional development while taking care of students with mental health problems. They felt grateful for having a profession that had a huge impact on children’s/adolescents' lives.

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Adolescents with overweight and obesity are at risk for future health problems. The purpose of this study was to examine the feasibility and initial efficacy of a weight management intervention to help adolescents develop healthy nutrition and physical activity behaviors and improve their anthropometrics. This study used a single-group repeated measures design in a small school in Durham, North Carolina (NC). The intervention consisted of a nurse-led and teacher-assisted nutrition and physical activity education and exercise classes that met twice each week for 45-60 minutes for 7 weeks. Data were collected at Time 1 (baseline), Time 2 (after intervention completion), and Time 3 (after 3 months on their own). Interview feedback, low cost, and successful completion of all planned activities indicated that all stakeholders found the project beneficial and suitable for their school. This study suggests that a weight management intervention for adolescents was feasible in the school setting.

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School-based health centers (SBHCs) have been suggested as potential medical homes, yet minimal attention has been paid to measuring their patient-centered medical home (PCMH) implementation. The purposes of this article were to (1) develop an index to measure PCMH attributes in SBHCs, (2) use the SBHC PCMH Index to compare PCMH capacity between PCMH certified and non-PCMH SBHCs, and (3) examine differences in index scores between SBHCs based in schools with and without adolescents. A total of six PCMH dimensions in the SBHC PCMH Index were identified through factor analysis. These dimensions were collapsed into two domains: care quality and comprehensive care. SBHCs recognized as PCMHs had higher scores on the index, both domains, and four dimensions. SBHCs based in schools with just young children and those with adolescents scored similarly on the overall index, but analysis of individual index items shows their strengths and weaknesses in PCMH implementation.

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If special educators cannot identify pain in students with intellectual disability (ID), students cannot be referred to the school nurse for assessment and management. The purpose of this study was to examine how special educators identify pain in the school setting. Twenty-four special educators participated in focus groups aiming to (1) identify educators' observations and perceptions of pain in students with ID and (2) determine the decision-making processes educators use to determine the need for student presentation or referral to the health office. Overall, special educators know students well enough to differentiate pain-related behaviors from normal well-child behaviors, prioritize student safety, and draw on personal experiences with pain when addressing pain in students with ID. Special educators welcome opportunities to learn more about pain in children with ID. Teachers, nurses, and other professionals should share knowledge about and experiences of working with students in pain to improve practices.

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Despite tremendous challenges, in the early 20th century school nurses provided the first, and often only, medical care for thousands of schoolchildren and their families. However, multiple barriers impeded the developing role. Influences of historical events, financial support, lack of knowledge regarding benefits of the school nurse role, limited access to training, and issues of poor pay affected the Commonwealth of Virginia’s attempts to develop and provide school nursing throughout the diverse rural counties across the state. School nurses continue to face these challenges today. The purpose of this social historical research is to identify, describe, and analyze the origins and evolving role of the school nurse in the rural counties of Virginia, 1900-1925; investigate how this history influences school nursing today; and offer several suggestions rooted in findings for moving the profession forward as outlined by Cowell’s response to recommendations made by the Institute of Medicine.