Strategies of Adolescent Girls and Boys for Coping With School-Related Stress

Abstract

Stress among adolescents in Western societies is becoming an issue of increasing concern of adolescent’s health. The aim of this study was to gain greater knowledge about how girls and boys perceive and cope with school-related stress. Participants were 14- to 15-year-old adolescents from a medium-sized municipality in southern Sweden. The data were collected from focus group interviews. The data were subjected to qualitative content analysis. The findings show that adolescents “prioritizing the future or the present by making choices, finding their own private sphere to relax, and recovering with family and friends.” There were gender differences in how these strategies were used. The findings could be used for initiating and planning health promotion interventions in school with focus on supporting girls’ and boys’ equal terms to cope with school-related stress in present and for the future and to give equal condition for future studies and opportunities in life.

Keywords

adolescent school-related stress gender well-being school nursing

Adolescence can be a period of challenge with physical, emotional, cognitive, and social changes associated with the transition from childhood to adulthood (Moksnes, Moljord, Espnes, & Byrne, 2010) and can be a more or less stressful period in young people’s lives depending on individual characteristics and differences (Hollenstein & Lougheed, 2013). Stress can be seen as a state of imbalance that arises when environmental demands exceed an individual’s perceived or appraised ability to cope (Lazarus & Folkman, 1984). There are, according to these authors (1984), two different coping strategies, one that is problem focused, directed toward managing or altering the problem, and the other that is emotion focused, directed at regulating the emotional response. Girls experience more stressors than boys during adolescence and also have greater flexibility in coping (Wiklund, Malmgren-Olsson, Öhman, Bergström, & Fjellman-Wiklund, 2012) and in endorsing a variety of coping strategies in comparison to boys (Malooly, Flannery, & Ohannessian, 2015). The present study focused on the subjective perceptions of 15-year-old girls and boys in how they perceived and coped with school-related stress. Stress among adolescents (in Sweden) has increased in recent decades (Wiklund et al., 2012), and school has become a stressor that has a negative effect on young people’s health and well-being (Inchley & Currie, 2016; Ollfors & Andersson, 2007). Adolescents spend a great deal of their time in school settings, which presents them with academic challenges, and there is a negative relationship between stress and academic achievement that has been seen in poorer school performances (Gustafsson et al., 2010; Moksnes, Rannestad, Byrne, & Espnes, 2011). Moreover, concern about the future and the emerging responsibilities that come with the transition to adulthood also contributes to perceived stress (Bor, Dean, Najman, & Hayatbakhsh, 2014; Côté & Bynner, 2008; Roy, Ganesch, & Kamath, 2016; Wiklund, Bengs, Malmgren-Olsson, & Öhman, 2010). Research shows that adolescents who report good health perform better in school (Gustafsson et al., 2010; Saab & Klinger, 2010; Walburg, 2014) and that health problems have a negative impact on academic achievement (Inchley & Currie, 2016; Östberg et al., 2015). Demands generally increase for both girls and boys during adolescence, but the norms and values related to demands in different social contexts have a stronger impact on girls and their health (Gustafsson et al., 2010; Inchley & Currie, 2016; Låftman, Almquist, & Östberg, 2013; Östberg et al., 2015; Schraml, Perski, Grossi, & Simonsson-Sarnecki, 2011). This results in girls experiencing greater pressure and demands from school compared to boys (Moksnes, Johr, Lillefjell, Byrne, & Haugan, 2016; Plenty, Ostberg, Almquist, Augustine, & Modin, 2014; Wiklund et al., 2012) and that girls more often report school burnout (Walburg, 2014). A stronger perception of personal responsibility for their schoolwork and other obligations in life contributes to girls generally having higher grades than boys (Eurydice, 2010; Wiklund et al., 2010). Connell (2000) maintains that young people are actively involved in creating and constructing their gender and that girls identify themselves in a subordinated position to boys. This hierarchy between genders can be experienced as a stressor for girls (Wiklund et al., 2010), and Harding (1986) believes that internalization through this order of gender reproduces hierarchy. On the other hand, Butler (1990) maintains that gender is a social construction that is consciously or unconsciously created through performative acts that we continuously and constantly repeat in social interactions and social contexts. Earlier research shows that girls perceive and are more negatively affected by stressors from school compared to boys. There is limited research about what may affect adolescents’ perceptions of stressors from school, how they cope with such stressors, and how this differs from a gender perspective. The aim of this study is thus to gain greater knowledge about how girls and boys perceive and cope with school-related stress.

Method

Design and Settings

This study was an exploratory design using qualitative content analysis with an inductive approach (Graneheim & Lundman, 2004). A new research question was formulated from data previously collected by the first author (M.W.) in 2013–2014 and studied on the subject, how adolescent handle their everyday life (Wilhsson, Svedberg, Högdin, Carlsson, & Nygren, 2016). This research is a secondary analysis and is a way of using preexisting research data for investigating new questions that were not the aim of the original data collection (Åkerström, Jacobsson, & Wästerfors, 2004). The secondary analysis of the data in this study has a different purpose compared to that of the first data collection (Heaton, 2008) and was performed to address the new research question: How girls and boys perceive and cope with school-related stress?

Ethical Considerations

The Regional Ethical Review Board in Lund, Sweden (Dnr 2013/55), formally approved the study. The participants and their guardians were given written and oral information about the aim of the study, what participation entailed, the confidentiality of the data, and that they had right to withdraw from the study at any time. Written consent was obtained from the participants, who all were least 15 years old, in accordance with Swedish law. The names used in the quotations are fictitious in order to uphold the integrity of the participants.

Participants

The study took place in a medium-sized municipality in southern Sweden. The participants were 20 girls and 22 boys aged 14–15 years from the five largest schools in the municipality. The schools were situated in different urban and rural areas with distinctive socioeconomic and ethnic characteristics. Two of the schools were located in urban areas where families have high or average socioeconomic standards and with family members predominantly born in Sweden. Two schools were located in urban areas where families have low socioeconomic standards and are predominately foreign-born (one school) or with mixed ethnicity. The fifth school is located in a rural area where families have average socioeconomic standards and mixed ethnicity. Information about socioeconomic and ethnic characteristics for each area is taken from Statistics Sweden. The children who participated in the interviews can be assumed to represent the differences in socioeconomic standards and ethnicity among pupils in the different schools based on their location and thereby providing a broad variation of the collected data. Socioeconomic, ethnic, and other individual background data concerning the participants were thus not collected.

First, 20 girls and 22 boys were recruited from five randomly selected schools and divided into five focus groups with 4–8 participants in each group at each school. These focus groups were divided by gender. Second, eight girls and six boys were recruited from two of the randomly selected schools and divided into two gender-mixed focus groups. A representative from the school administration at each school assisted in the recruitment of adolescents by selecting children who could attend without affecting their schoolwork while ensuring that the groups were representative of the variations in the school’s students.

Data Collection

Data were collected from interviews in the focus groups and were performed at each school and during school time in an environment that was familiar to the participants (Heary & Hennessy, 2002; Krueger & Casey, 2000). The structure of the focus groups allowed participants to engage and interact with each other. The groups were initially divided by gender in order to increase the interaction between participants and to create incentives for discussion (Holloway & Wheeler, 2002; Krueger & Casey, 2000). The interviews took place at each school and started with a presentation of the interviewers and the aim of the study. The adolescents were then asked to talk about how they perceive and cope with school-related stress during their leisure time. During the discussion between the participants, some recurring themes were identified, and those themes seemed to be important for the participants to discuss further in the group. Based on this, follow-up questions were used to give the participants the opportunity to further discuss what was important for them. Questions that were used were, for example, tell me more about your own sphere and why it is important for you to have time on your own? and tell me more about how you think and felt when you are forced to prioritize. The adolescents discussed, listened, and interacted with each other in a respectful way. The interviewer made sure that everyone was able to participate in the discussion. The focus groups interviews lasted between 45 and 60 min and were performed by the first author (M.W.) and an observer took field notes. All interviews were video-recorded and audio-recorded.

Data Analysis

The text was analyzed by means of inductive qualitative content analysis and resulted in categories described by Graneheim and Lundman (2004). The interviews were transcribed verbatim and the analysis started with a rereading of all data from the focus groups in order to gain a general sense of the whole data in relation to the new research question: How do girls and boys perceive and cope with school-related stress? Similarities and differences in the data were identified both as a whole and as gender experiences. In the next step, texts were divided into meaning units, which were condensed into short sentences, while keeping close to the original text. The sentences were thereafter labeled with a code, and codes with similar content were sorted into categories in line with Graneheim and Lundman. All the interviews were first analyzed to create categories. In a second round of analysis, interviews were analyzed by separating the responses of the girls and boys. Similar categories as to those in the first analysis emerged and showed that categories could be applied to both genders but with different meanings for girls and boys. There were no meaning units that could not be labeled with a code and sorted into one of the categories. The sorting and formulation of categories was continuously reflected on and discussed among the authors, who were an interdisciplinary team with experience from medical science, nursing, and social work.

Findings

Three categories emerged from the analysis: prioritizing the future or the present by making choices, finding their own private sphere to relax, and recovering with family and friends. The result shows that girls and boys sometimes use different strategies to cope with school-related stress.

Prioritizing the Future or the Present by Making Choices

The results show that both girls and boys talk of having to prioritize in their lives in order to cope with school-related stress, but there appears to be a difference in how they choose to prioritize. Several girls express that they have to choose not to take part in activities in order to be able to cope with the demands emanating from school. This means that some girls experience having to make priorities that entail abstaining from satisfying their own needs and what they really want to do in their lives. On the other hand, the boys have a completely different experience; they describe having to make choices and prioritizing activities in order to attain perceived well-being. Their priorities are based on their own needs and choose activities that they feel are important for gaining strength in order to cope with demands and school-related stress. Most of the boys focus on the present, while most of the girls have concerns for the future and have difficulties in prioritizing in the same way as the boys do. Some of the girls feel that they have to do their homework before allowing themselves to participate in certain leisure activities, while boys often express that it is important to be with their friends before doing their homework.

In this study, it is important for many of the girls to attain good grades in order to gain entry to higher education that can give them a place and status in the labor market and in society. Several of the girls are worried about their future. Some of them talk of the importance they feel concerning being able to be financially independent and not having to be dependent on their partner. One of the girls said: “I want to have a job and be able to support myself and live independently” (Sofie).

The demands that many of the girls feel from school make them choose not to participate in leisure activities that they previously used to do with friends away from home and which they consider to be important for them. This prioritizing is something that a majority of the girls say they have to do because of not having time for both homework and these activities. One of the girls talks of how she had to forsake her interest in music and the companionship she was part of in her leisure time in order to reduce her stress:

I used to play the violin, played in an orchestra, etc. and I chose not to because…. thought it was great fun but I felt I didn’t have the time for it. I was often at church and also in their youth activities, etc. but had to prioritize…because I didn’t have time, I felt really stressed. (Charlotte)

Several of the girls are aware that physical activity is relaxing and helps them to feel less stressed, but they still feel that they have to give priority to their homework so as not feel stressed because of not having done the homework for tomorrow. One of the girls described this: “Study and then train takes the stress away…become less stressed then” (Sara).

Many of the girls found it difficult to cope with the stress created by homework and thoughts of the future. This then sometimes causes them, when they feel they are too stressed, to choose to do something completely different for a short while in order to dispel their thoughts about the future and get away from the demands they experience coming from school. The girls escape from the stress by performing activities they do alone, such as walking their dog, running or riding in the forest, which they talk of relaxing and joyful. These single activities that the girls choose are only an escape for a short while before returning to their homework. Some of the girls describe how they struggle with a bad conscience and feelings of insufficiency when they choose not to do their schoolwork and to do some activity to distract themselves from demands and stress. This can be seen in a quotation from one of the girls: “Sometimes I don’t care about it but sometimes I think that I should have studied a little more, but sometimes I know that I haven’t the time to study more, it’ll have to be as it is” (Emma).

Some of the boys talk of how they choose to live in the present and not to think so much ahead and about the homework they have the following days. It is important for several of the boys to be able to relax and dispel thoughts about school and the future, which contrasts with how some of the girls describe living daily with thoughts about the future and the demands they experience from school. One of the boys states that it is important to fill one’s leisure time with other things than homework and thoughts of the future: “Live in the present and don’t plan so far ahead…think about other things than just school, find a hobby” (Philip).

It is important for some of the boys to have plans and plan for something fun to do ahead, in order to diverge from daily routines. They do this by planning a variety of activities together with friends, which is a way of coping with the demands from school in the form of homework and tests. They choose to switch their focus from everyday life to something fun that is going to happen in the future in order to motivate themselves for the next day at school: “Yes, when you’re tired and there’s nothing fun going on, then you want something to look forward to and struggle on” (Oscar).

Several of the boys choose to prioritize their own activities before their homework, as they think it is more important to give themselves priority. They choose to prioritize themselves as a strategy to cope with stress. The boys counteract stress by focusing on things they like doing that help them relax and give them energy to cope with school and its demands. One of the boys says, “When I’m playing volleyball it feels like it’s…like this…good to play. You don’t think so much about school and you really want to go in for volleyball and then it’s often so good” (Jacob).

The majority of the boys talk about the importance for them to be in the company of their friends through doing activities together. This social companionship and activity is, for the boys, a way to shield themselves from homework and thoughts of the future that they feel are stressful. It is important for them to prioritize their friends before their homework that they think they can do later in the day and as one boy states: “With friends and so, have a bit of fun, one can study when one gets home instead” (Alex).

Finding Their Own Private Sphere to Relax

It is important for both the girls and boys in this study to feel that they have some sort of private place where they can relax and protect themselves from demands and stress. This place is, primarily for both the girls and boys, their own room at home.

The girls talk of how important it is for them to have their own private sphere where they can shield themselves from the stress they experience in the form of demands from school. They speak of this private sphere as being their own room where they can avoid physical contact and where they have the possibility to recover. Their room creates a distance from school for many of the girls and a place where they can be alone and which can be clearly marked by having the door closed. One of the girls describes this moment of solitude in the following: “Like just sitting and reading in my room. Watching a film or…reading a book or something. Taking it easy. In order to manage other things” (Oliwia). Several of the girls choose solitude and go into themselves for a while. It is important for these girls to be alone and do something creative such as painting, which can help them relax and which is important for their recovery. Some of the girls choose instead to watch a series on the Internet alone as a way of relaxing and getting time for themselves. One of the girls describes this as: “Peace and quiet, solitude and just relaxing. Not caring about anything and just entering into another world with those TV series” (Victoria).

It is important for some of the girls to be updated about what is happening on social media and thus be part of a social context among friends and outside the home. Using social media is a way of relaxing and shutting out the life they experience as being stressful and demanding. One of the girls says, “Yes, switch off everything. Lie down with the phone and just check on the internet and just take care of oneself” (Anna).

Several of the boys talk in a similar way as the girls do about the home being an important place where they can relax from demands and stress. The boys choose to consciously and mentally force away thoughts about school when at home. This differs from several of the girls who do not shut school out when at home and often think about school and the future. One of the boys speaks of how important it is for him to keep school out of the home: “I think it’s enough at school, am not going to take school home, school is actually school, home is home” (William).

Some of the boys talk of how they choose to sit at their computers and communicate with friends via Skype and play games online with others as a way of coping with demands and stress. Playing games is for several of the boys a way to relax and at the same time be a part of a social context among friends online. The boys are not as pronounced as the girls in expressing the importance of physically closing the door to their rooms in order to be in solitude and recover. Some of the boys, as well as some of the girls, talk of choosing to watch television series as a way to relax after school. But the girls differed in this in using television series not only to relax but also as a way of shielding themselves from the outer world in order to cope with demands and stress.

Recovering With Family and Friends

Both the girls and the boys describe physical meetings with family and friends as being important for coping with demands and recovering from stress. Being with family and friends helps them in different ways to relax and find energy to be able to continue to tackle the demands in school. There appears, however, to be a gender difference; most of the girls see their family environment as a resource where they can relax and be in the present while all the boys like to do some form of activity with their family inside or outside of their homes. Being active makes them feel relaxed and gives them new energy to cope with school-related stress.

The majority of the girls talk of their families as being an important part of their lives, giving them security and a place where they are allowed to just be themselves and relax. One of the girls speaks of how she allows herself to relax in the company of the family without feeling any demands on accomplishing anything or giving a show of being perfect: “You’re perhaps more relaxed at home because you can then…. your family knows all about you so that you can just completely be yourself. Relaxed” (Emma). Being with the family is an important part of everyday life for the girls, and it also plays a social role where they feel a belonging to and a security in being able to express oneself or able to just be. One of the girls talks of how she leaves her own sphere to relax with her pet and being together with her parents: “Home…there it’s just to put on your running pants and just be. You relax. And then you put the dog in your lap and just lie on the sofa. Talking a little to mum and dad” (Isabell).

Many of the girls also talk about how they can relax for the moment by being with friends away from their homes. The girls choose activities that have a social role and are able to just be for the moment, rather than activities that demand some form of physical performance. One of the girls talks of this:

Yes, I like shopping and yes…but I think that one can relax when shopping and just look at clothes and not think of anything else. It’s not only shopping, it’s also going to town, having a coffee and just having a good time. (Emma)

For some of the girls, this is a way to relax and be free from stress and to recover.

The family is also important for the boys, and several of them say that it is important to do different activities with the family both within and outside the home. On the other hand, the girls mostly use the family as a social resource and a place to be themselves and get energy. The boys talk of being active together with the family and that the activity is a way for them to relax and recover from stress. One of the boys says that “The family is like…hang around with them. I have four brothers and we are all about the same age and we go and watch big matches together and things like that” (Alexander). The boys want to have enjoyable activities that are fun to do with their families and do not see the family as a secure place where they can just be themselves as the girls do. A majority of the boys describe their contact with their families with different activities as a way of relaxing, which gives them new energy to manage schoolwork.

Being with friends is also important for the boys for coping with stress. They often choose to do different types of physical activities with friends outside the home. It can be activities that they themselves have planned together or organized activities such as football or other team sports. The physical meeting with friends is important for many of the boys and also to be active just as being active with the family. One of the boys talks of this: “And one is with friends .are outside, we do everything, one can go fishing, ride a moped, play football, play other sports” (Gabriel).

Discussion

The purpose of this study was to create greater knowledge about how adolescents perceive and cope with school-related stress. There were three strategies that emerged from the interviews with the participants: prioritizing the future or the present by making choices, finding their own private sphere to relax, and recovering with family and friends. These strategies were similar for girls and boys, but there were gender differences in how they talk about and use these strategies. The frameworks of Harding (1986), Butler (1990), and Cornell (2002) were used to understand and discuss the result from a gender perspective.

Most of the girls and boys in this study perceived an imbalance between obligations associated with schoolwork and their leisure time, and this imbalance seems to create feelings of stress. In order to cope with this, they expressed that they felt forced to prioritize and tried to find places and social contexts where they could shield themselves, relax, and recover from demands. The girls talked a great deal about the future and the pressure they expressed to perform at school to attain higher grades. Previous research shows that girls take greater responsibility for their schoolwork and other obligations in life than boys (Bor et al., 2014; Roy et al., 2016) and that they are more often suffering from school burnout (Walburg, 2014). The girls in our study generally perceived greater demands from school, and such demands have been found to have a negative impact on their health (Inchley & Currie, 2016; Låftman & Modin, 2012; Plenty et al., 2014; Wiklund et al., 2012). The boys expressed a more relaxed attitude toward demands and the future, which concurs with findings in earlier studies (Banks & Smyth, 2015; Wilhsson et al., 2016). This may be one of the several explanations for the differences between the attitudes of girls and boys toward demands and the future in our study.

Earlier research shows that boys generally are better at ignoring problems as a strategy to cope with demands (Frydenberg, 2008; Seiffge-Krenke, 2013) or to seek distraction by participating in sports or engaging in hobbies (Brown, Nobiling, Teufel, & Birch, 2011; Plenty et al., 2014). This is in line with the result from our study where most of the boys choose to prioritize their leisure activities prior to doing their homework. The boys described that they needed to prioritize their leisure activities to feel well. This is also demonstrated in earlier research that highlights the positive benefits of social physical activity on health and as a buffer to academic stress (Gerber et al., 2015). Furthermore, previous research shows that it is important for boys’ masculinity to be part of a popular social group and to be associated with masculine attributes such as physical strength or being sporty (Connell, 2002). Butler (1990) highlights that gender is something performative where actions are usually unconscious and performed automatically through linguistic beliefs, norms, and symbols that are associated with each sex such as speech; external attributes, such as clothing, jewelry, shoes, and hairstyles; and how we act. These types of performative behaviors are associated with norms and perceptions about what it is to be an ideal girl or boy in certain contexts and illustrate how adolescents are active agents in their construction of gender through social interactions (Connell, 2002). As discussed earlier, girls in this study took great responsibility for their schoolwork and for their future, and this could be linked to Connell’s theory (2002) describing how girls identify themselves with a gender ideal that takes responsibility for schoolwork. That girls experience more school-related stress than boys in our study could explain the ways that they automatically and repeatedly perform and construct their gender.

According to Connell (2000) and Harding (1986), boys generally try to strive to perform masculinity while girls tend to adapt to a subordinate position. This could be an explanation for why some girls in our study perceived that they are forced to prioritize schoolwork, as a strategy to obtain god grades, to reach a higher status, and to cope with their subordinate position relative to boys. There is an attitude among some boys to see performance in school as a feminine trait that is not consistent with their view of hegemonic masculinity (Phoenix, 2003). This attitude creates an antischool culture among some boys that has a negative impact on their school performance (Löfström, 2012). The boys in our study prioritized activities with their friends who provided them with a social capital that could have a positive impact on both their well-being and their performance in school (cf. Bourdieu, 1986; Dufur, Parcel, & Troutman, 2013; Morgan & Haglund, 2009; Rothon, Goodwin, & Stansfeld, 2012). One way for girls in our study to create social capital was through using social media to maintain and expand their social network. This is consistent with previous research where social media is described as a place where girls can rest and recover from stress (Frison & Eggermont, 2015; Jacobsen & Forste, 2011; Johnston, Tanner, Lalla, & Kawalski, 2013). In this study, girls used networking on social media as a strategy to escape from schoolwork in the short term.

The girls in our study expressed that they need to close their door to shield themselves from demands outside of their home. As they relax in their private sphere, they prefer to watch television to be in their own world for a while. Earlier research shows that boys prefer to play games and use services from real-time video links to communicate with friends (Dolatabadi, Eslami, Mostafavi, Hassanzade, & Moradi, 2013), and this was also true for the boys in our study. When the girls and boys in our study had spent time by themselves, they chose to spend their leisure time with their family, which serves as a source of strength and charges their batteries to motivate them for another day in school. The girls in our study use their family as a resource for relaxation and support, while boys prefer to do physical activities with their family as a way to relax. Girls are more willing to seek social support within their family (Brown et al., 2011; Roy et al., 2016). Social support could be an important resource to handle stress (Lazarus & Folkman, 1984) and is a common and frequently used coping strategy among adolescents (Zimmer-Gembeck & Skinner, 2011). Previous research shows that strong ties within families and parents who are involved in their children’s education promote school performance and the attainment of good grades (Rothon et al., 2012). Based on the results of the present study, it is therefore important to create conditions for adolescents to cope with school-related stress that is related to their perceptions of demands on their performance. To enable equal conditions for girls and boys, we need to highlight prevailing structures of gender in school. This knowledge is important for all professionals in school in order to balance girls and boys’ attitudes toward school performances and to promote their health in the present and for the future.

Methodological Considerations

It is important to have both variation and diversity in the data material when using qualitative content analysis (Graneheim & Lundman, 2004). In order to achieve this, both girls and boys from different schools and areas participated in this study. They received both written and oral information about the aim of the study and their ethical rights as a way of ensuring trustworthiness. The dialogues in all six focus groups were fruitful and generated a large amount of data for the purpose of the study. There was a respectful attitude in the groups and space to talk, which helped to create new perspectives to discuss among the participants. Most of them said that they enjoyed and felt comfortable talking about matters that they perceived to be important for them at this stage of life. Homogeneity in focus groups, in terms of age and gender, can contribute to constructive discussions between group members (Holloway & Wheeler, 2002; Krueger & Casey, 2000). However, the discussions in the mixed groups in this study were not different from those in the homogenous groups. This might be explained by the participants being of the same age and coming from similar school environments based on the conditions as supported by Swedish Education legislation. It may have been a coincidence in these two specific focus groups, which could thus affect the transferability of the result. One weakness in our approach is that recruitment was dependent on the involvement of a representative from the school administration at each school. These representatives selected adolescents to ensure that the groups would as far as possible be representative of the pupils at each school. This setup limited our ability to ensure representation and avoid the risk for important perspectives not missed. The interdisciplinary research team with experience from nursing, social work, and medical science discussed the content continuously during the analysis process. The methodological approach and the carefully described analysis as well as the use of quotations contribute to the credibility and trustworthiness of our results (Graneheim & Lundman, 2004). In terms of transferability, the result from this study can serve as valuable knowledge for school settings in Sweden. However, the readers from other contexts have to determine the usefulness of the results and assess whether they can be applied to their contexts.

Conclusions and Implications for School Nurses

This study reflects the differences between the strategies of girls and boys in coping with school-related stress. Although they talk about stress in similar ways, the differences in the ways they use their strategies to cope with stress need to be highlighted theoretically and clinically to promote equal health among adolescents. The most important finding in our study was that boys were more relaxed toward demands from school and the future and lived more in the present, while girls thought and worried more about the future compared to boys. This kind of pressure forced the girls to prioritize their schoolwork, while boys allowed themselves to prioritize their leisure activities. It is important to highlight attitudes among boys that succeeding in school is a feminine attribute, as it could contribute to a situation where boys fall behind in school performance. Boys need to be aware of the importance of school for their future and girls need to allow themselves to live in the present. It is important for both girls and boys to find balance between school and their leisure time to achieve health. This study contributes to the discussion of similarities and differences between boys and girls coping of school-related stress based on differences in gender perspectives, knowledge that is relevant for the development of health promotion initiatives in schools. Furthermore, it is important for professionals in school to be aware of gender-based antischool culture that prevails among boys. While working with the culture of boys and girls in school, it is important for school professionals to be aware of how these different cultures are associated with girls’ and boys’ views about femininity and masculinity. Further studies are needed for a more comprehensive understanding of girls’ and boys’ coping strategies and whether gender order affects their choices of strategies.

An overall conclusion drawn from this study is that health promotion interventions at school should primarily focus on cooperation between school nurses and other professionals in school for reducing school-related stress among girls and motivate boys to focus more on school. School nurses act as a link between the educational and health-care systems and could therefore initiate health promotion interventions in school with focus on supporting girls and boys coping with school-related stress to achieve equal conditions for future studies and opportunities in life.

Footnotes

Authors’ Note

The article has not been previously published and has not been submitted for publication elsewhere.

Acknowledgments

We would like to thank all survey participants, school staff, and the municipality of Halmstad who kindly agreed to participate in our study.

Author Contribution

The first author was responsible for all data acquisition. All authors contributed to conception and design; analysis and interpretation of data; and drafting, critically revising, and approving the final version of the manuscript.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by grants from the municipality of Halmstad, Länsförsäkringar Halland and Ljungbergska foundation.

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