The Journal of School Nursing

The complexity and demands of the school nurse role have changed greatly over time. Our aims included determining tasks and knowledge relevant to modern school nursing in the United States, identifying continuing education needs of school nurses, and describing anticipated changes to the professional role. A secondary analysis of a cross-sectional web-based survey of 750 school nurses was performed. The study team evaluated calculations of mean importance and frequency for school nursing task and knowledge statements. Conventional content analysis was used to analyze open-ended responses. School nurses rated most tasks and knowledge as relevant to practice, underscoring the great depth and breadth of education and training school nurses need to meet the demands of students today. The results of this secondary analysis may be leveraged to accurately describe the school nurse role, advocate for nursing services, and support school nurses as they strive to better the health of school communities.

This study aimed to compare related factors of depressive symptoms among multicultural adolescents in South Korea. Cross-sectional data were collected from 1,325 students studying in ninth grade (mean age: 14.97 ± 0.36 years) who had one Korean parent and one foreign-born parent. The score of depressive symptoms among girls (1.777 ± 0.550) was higher than boys (1.647 ± 0.512). The regression model—including demographic, psychological, and social factors—explained 38.3% of depressive symptoms among boys and 27.9% among girls. Body image satisfaction was the most powerful factor related to depressive symptoms in both boys and girls. Gender-differentiated factors identified in this study such as demographic, psychological, and social factors need to be studied while planning gender-tailored intervention programs to help relieve depressive symptoms among multicultural adolescents.

Adolescents in rural Uganda face unique opportunities and challenges to their health. The primary goal of this exploratory cross-sectional survey study was to describe the health behaviors of adolescents of age 13–19 living in four Ugandan fishing communities as a foundation for developing programs to reduce risky health behaviors and HIV/AIDS transmission. The majority of boys (59.6%) and one third of girls reported lifetime sexual intercourse; girls reported earlier sexual debut than boys, as well as higher rates of sexual assault, rape, and/or coerced intercourse. Sexually active youth were more likely to have viewed pornography, be tested for other sexually transmitted infections, and attend boarding schools. Alcohol use was prevalent among both sexes; however, the use of other substances was infrequently reported. Since the majority of adolescents in Uganda attend boarding school, there is an opportunity to expand the school nurse scope of care to include health promotion education and counseling.

Adolescents with type 1 diabetes (TID) and their parents depend on school nurses to keep students safe in school. Parent satisfaction with T1D care is impacted by school factors including school nurse presence. The purpose of this study was to determine the relationships among parental satisfaction with diabetes care in school, parental report of diabetes-related safety, adolescent report of school nurse helpfulness, and school nurse presence represented by school nurse to student ratios. The sample consisted of 89 parent–adolescent dyads. Adolescents 10–16 years old with T1D completed a questionnaire that included perceptions of school nurse helpfulness. Parents completed a questionnaire that included perceptions of T1D safety and satisfaction. Diabetes-related safety was positively correlated with parental satisfaction and school nurse helpfulness and inversely correlated with age and school nurse to student ratios. Findings validate the importance of school nurse presence to adolescents with T1D and their parents with implications for school nursing policy, practice, and research.

The purpose of the study is to identify the relationships between allergic disease, suicidal ideation, and plans among Korean adolescents. Additionally, we examined the mediating role of short sleep duration. We analyzed nationally representative cross-sectional data from the 12th to 14th Korea Youth Risk Behavior Web-Based Survey; the final sample included 164,725 middle school–aged and high school–aged adolescents (mean age = 15.17 years, standard deviation = .13; 51.1% male). Allergic disease was a statistically significant risk factor for suicidal ideation (crude odds ratio [COR] = 1.284, 95% confidence interval [CI] = [1.246, 1.323]) and suicide plans (COR = 1.165, 95% CI = [1.108, 1.224]). Short sleep duration was a statistically significant mediator (p < .001). We advised school nurses to assess warning signs of poor sleep—including irritability, depression, sleep problems, poor concentration, and poor academic achievement—and that programs be created to improve sleep and mental health in adolescents with allergic disease.

In Norway, new national guidelines for school service emphasize the importance of establishing structured collaboration with schools. Nevertheless, few studies have explored the characteristics of such collaboration. The purpose of the present study is to explore how principals, teachers, and school nurses collaborate and to identify barriers and facilitators of structured collaboration. The study is based on 46 qualitative interviews conducted in five Norwegian municipalities in 2018 and 2019. The results reveal that school nurses are highly valued among the school staff but collaborations between teachers and school nurses varied both within and between schools, often for arbitrary reasons such as personal relations and office locations at schools. Personal relationships built over time as well as regular meetings, seemed to foster stronger collaboration, while discontinuity in personnel, recruitment difficulties, and sick and maternity leaves were frequently reported factors that seemed to have negative impacts on collaboration.

Asthma is the most common chronic condition in children under 18. In Alabama, 11% of children report a diagnosis of asthma compared to the United States with 9.5%. Childhood asthma is the leading cause of school absenteeism due to a chronic disease, and Alabama children with asthma miss approximately 10 days of school each year for uncontrolled asthma. Managing children in the school system with asthma can often be challenging for school nurses. In this cross-sectional study, perceptions of Alabama school nurses on managing asthma in the school were explored. School nurses feel prepared to manage asthma but identify lack of certain resources and supportive policies, especially access to medications as barriers to optimum care. Implications for statewide advocacy at the policy level and broadening educational activities are supported by the survey results.

For this study, we explored the association between high school students’ reported history of sport- or physical activity–related concussions and persistent feelings of sadness or hopelessness. Data from the 2017 national Youth Risk Behavior Survey (YRBS; N = 14,765) was used for this analysis. YRBS is administered to high school students throughout the country every 2 years. Findings from this study demonstrate that the prevalence of persistent feelings of sadness or hopelessness was 36.4% among students who reported sustaining one or more concussions. Compared to students who did not report having sustained a concussion, the odds of persistent feelings of sadness or hopelessness were significantly higher among students who had sustained one or more concussions (AOR = 1.41). These findings support the need for continued efforts by school nurses and other health care providers to identify students with a history of concussion and assess their mental health needs.

Chronic school absenteeism directly affects educational outcomes while reducing school funding and reimbursement. Asthma is a prevalent disease associated with chronic absenteeism. This quality improvement project demonstrated classroom seat time preserved through use of school-based health centers (SBHC). The project also highlights the educational benefits, reduced emergency department utilization, potential cost savings to hospitals, and lower overall health care costs. Visit summary data were collected and analyzed to show quality asthma care and cost savings. Of 44 acute asthma visits that returned to class, an average classroom time of 3:42 hours were saved per student during the 2017–2018 academic year, resulting in a combined total of 166:07 hours saved. A minimum potential cost savings was estimated to be $67,770 for all 44 visits. Data analysis of structural, process, and outcome measures through quality improvement tools can demonstrate cost savings of SBHC care, which advocates funding for this pediatric care model.