Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2016-04-20T16:56:21Z No. of bitstreams: 1 Ligia Cordeiro Matos Faial.pdf: 1377894 bytes, checksum: a7b706d3be3ae1c2b3cd633d53dfb44c (MD5) / Made available in DSpace on 2016-04-20T16:56:21Z (GMT). No. of bitstreams: 1 Ligia Cordeiro Matos Faial.pdf: 1377894 bytes, checksum: a7b706d3be3ae1c2b3cd633d53dfb44c (MD5) Previous issue date: 2015 / Mestrado Profissional Ensino na Saúde / Este estudo faz parte de nossas inquietações vivenciadas ao longo de nosso percurso profissional em saúde no Instituto Federal Fluminense (IFF) que nos levaram a problematizar a saúde na educação escolar e sua contribuição na formação do adolescente. A adolescência é marcada por transformações biopsicossociais, que impulsionam mudanças no desenvolvimento do indivíduo, e sua forma de se relacionar consigo e com o meio. O adolescente tende ao isolamento no seu próprio mundo, guardando para si as dúvidas e os receios pertinentes a essa fase. Assumem comportamentos e hábitos que prejudicam sua saúde, tais como: o consumo de álcool e drogas, a violência, as práticas sexuais precoces e desprotegidas, a gravidez indesejada, os riscos das infecções sexualmente transmissíveis, dentre outros. Porém, a saúde para o adolescente não é tarefa das mais simples, pois não se reduz às ações assistencialistas com foco na doença. Trata-se de um estudo que objetivou compreender a percepção do aluno sobre o serviço de saúde desenvolvido na escola, e construir, tomando como base a fala do aluno, uma proposta de intervenção com foco na proteção, prevenção e promoção à saúde do adolescente. Na metodologia, desenvolveu-se uma pesquisa qualitativa com abordagem fenomenológica à luz do referencial teórico-filosófico de Maurice Merleau-Ponty, em que a busca das vivências concorre para ampliar o campo de percepção sobre as sensações, desejos e necessidades dos seres humanos, o que contribui para a prática da saúde mais completa. A entrada em campo ocorreu nos meses de março e abril de 2015, após a aprovação do Protocolo do Projeto de Dissertação pelo Comitê de Ética em Pesquisa da instituição, sob o n° 895.040. Mediante a disposição de urnas de sugestões em três locais de uso coletivo pelos alunos, procurou-se compreender o entendimento do discente sobre a saúde na escola. E através da entrevista fenomenológica com os discentes matriculados há cerca de um ano nos cursos técnicos integrados ao ensino médio, na faixa etária de 14 a 20 anos, cujo encerramento ocorreu ao final do 34° encontro, buscou-se responder à questão: Conte para mim qual a sua percepção em relação à saúde na escola? Como resultado da apreensão dos significados e interpretação dos discursos emergiram três temas: a percepção da saúde no “mundo-da-vida” escolar, a percepção fenomenológica da saúde na formação escolar, a saúde em si e a saúde para a escola: a construção da proposta do adolescente para o seu “mundo-da-vida”. Desvelaram-se o desejo e a pretensão de uma assistência humanizada, o atendimento estendido aos três turnos escolares, ampliação da equipe de profissionais, ações interdisciplinares, com atenção à saúde mental, adoção de práticas pedagógicas em saúde, provimento de insumos e infraestrutura adequada à prática da saúde na escola. Conclui-se que a educação em saúde, o cuidado humanizado e a participação da comunidade escolar e da sociedade são os pilares para a dinamização da saúde escolar. A contribuição da saúde reside na possibilidade de ação integrada e articulada, de cunho crítico reflexivo, capacitando os adolescentes para o enfrentamento dos riscos e vulnerabilidades próprios dessa fase / This study is part of our apprehensions experienced throughout our professional career in health care, in particular at the Fluminense Federal Institute (IFF) which led us to discuss the health in school education as well as its contribution in shaping the adolescent. Adolescence is marked by biopsychosocial changes that promote changes in the individual development and their way to relate with themselves and with the environment. The adolescents tend to isolate themselves in their own world, keeping for themselves the questions and concerns pertaining to this phase. They assume behaviors and habits that undermine their health, such as: the consumption of alcohol and drugs, violence, early and unprotected sexual practices, unwanted pregnancy, the risks of sexually transmitted diseases, among others. However, adolescent health is not the simplest task, to the extent that it cannot be reduced merely to welfare actions with a focus on disease. This is a study that aimed at understanding the student's perception about the health service developed at school, and to build, on the basis of the students’ talks, an intervention proposal focusing on protection, prevention and promotion of the adolescent health. In the methodology, therefore, a phenomenological approach qualitative research has been developed in the light of Maurice Merleau-Ponty’s theoretical-philosophical approach, where the search for students’ experiences competes to enlarge the perception field about the feelings, desires and needs of human beings, which contributes to a more complete health and practice complex. The entry in the field occurred in the months of March and April 2015 after the approval of the Dissertation Protocol Project by the Institution’s Research Ethics Committee, under the n° 895,040. Through the provision of ballot boxes suggestions in three locations of students’ collective use, we sought to understand the student's understanding on school health. Also, through the phenomenological interview with students enrolled in the high school integrated technical courses, among the 14 to 20 years old, closing at the 34th meeting we sought to answer the following question: Tell me what your perception in relation to health at school is? As a result of the appropriation of the meanings and interpretation of speeches three themes emerged: the perception of health in the world-of-school life, the phenomenological perception of health, health education and health for the school: the construction of the adolescent proposal for their “world of life”. It has been unveiled the desire and intention of a humanized assistance, extended to three school shifts, professional team expansion, interdisciplinary actions, with attention to mental health, adoption of pedagogical practices in health, provision of inputs and adequate infrastructure to health practice at school. It is concluded that health education, the humanization of care and collaborative participation of the school community and society are the pillars for the health promotion. The great contribution of school health lies within the possibility of integrated and articulated actions as well as reflective and critical measures empowering teenagers to face the risks and vulnerabilities which are common to this phase

Philosophiae Doctor - PhD / This study focused on developing an intervention programme for school health nurses on guiding adolescents in their decision-making on reproductive health. A review of literature shows that this role is necessary, as there is a great need to reduce adolescents' morbidity and mortality rates due to poor decision-making about their reproductive health. School health nurses are strategically positioned to perform this role in ensuring that adolescents are well guided in making responsible decisions about their reproductive health. However, available evidence shows that school health nurses have not been performing this role in the school health service, especially in Nigeria. The provision of guidance for adolescents, on making decisions about their reproductive health is an adaptive role of school health nurses. The literature further shows that school health nurses require adequate preparation before they can perform this role. The study was conducted in the secondary school environment of Ijebu Ode local government area of Nigeria. Work role performance theory, adult learning principles, and experiential learning constituted the theoretical point of departure for this study. The paradigmatic assumptions revolved around intrepretivism/constructionism using the qualitative methodological approach. Semi-structured interviews and focus groups were the means of obtaining information from study participants for the study. The Intervention Design and Development model of Rothman and Thomas (2013) was used to design the study. The participants for the study were eight school health nurses, five school teachers, thirty-six adolescents, and one school health coordinator. They were all purposively selected. The data collected was analysed manually using inductive content analysis. The main findings from the interviews show that school health nurses have a poor awareness of their role and responsibilities, a lack of knowledge on how adolescents make their decisions, a lack of adequate knowledge on how to guide adolescents in their decision-making. The findings also show that there is poor interpersonal communication between school health nurses, and adolescents, and between school health nurses and members of the teaching staff. The findings further show that there are insufficient continuous professional development programmes. Results from integrative reviews regarding the types of intervention programmes that had been developed for school health nurses at different times in the past focused on role orientation, knowledge and skills acquisition, and mutual interaction between school health nurses and adolescents, and members of the teaching staff. The findings reflect a gap in how school health nurses provide guidance to school adolescents in decision-making on their reproductive health, hence the need for a training programme that will assist them in discharging this function effectively. A training programme was designed and developed for school health nurses to assist them on guiding adolescents in their decision making about their reproductive health. The training programme was pilot tested with observational methods, an interview being used as a means of assessing the quality and outcomes of the training programme. The results of the pilot test show the participants' satisfaction with the organisation and the quality of the training workshop. Participants indicated that they had gained more knowledge and understanding of adolescent reproductive issues, and their decision-making processes. They also said that they had gained more interpersonal skills, and greater communication skills. Some expressed the conviction that they had gained more confidence in their ability to communicate with the teaching staff. Some also expressed their readiness to apply the skills obtained during the training to their practice area. It is recommended that the training programme be fully evaluated in phase five of the Intervention Design and Development model of Rothman and Thomas, which will enable full dissemination and implementation of the programme (Rothman and Thomas, 2013). It is further recommended that the training programme be disseminated to end users (school health nurses) by sensitizing the necessary stake-holders on the need to use the training programme for school health nurses in their respective school contexts.

The purposes of this study are: (1) to provide a history of school health programs; (2) to secure from authorities in the field an idea of what constitutes a good school health program; (3) to examine present programs in Texas Public High Schools of 50 to 500 enrollment in order to determine the nature of activities being carried on; (4) to show how programs are organized, administered, and financed; and (5) to point out existing deficiencies and to offer recommendations for improving present programs based upon the most successful and outstanding patterns.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-31T14:31:08Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertação Versão para biblioteca.pdf: 2196055 bytes, checksum: ad13360cc3c1feb03883d61ebdda7fb1 (MD5) / Made available in DSpace on 2017-07-31T14:31:08Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertação Versão para biblioteca.pdf: 2196055 bytes, checksum: ad13360cc3c1feb03883d61ebdda7fb1 (MD5) Previous issue date: 2016-02-22 / Esta dissertação objetivou apreender o significado dos Círculos de Cultura para os atores sociais envolvidos na prática educativa com adolescentes escolares multiplicadores em saúdee constitui-se de cinco artigos científicos. A fim de analisar práticas educativas em saúde desenvolvidas com adolescentes escolares, a partir de evidências disponíveis na literatura atual, realizou-se uma revisão integrativa nas bases de dados PubMed, LILACS e ADOLEC, com inclusão de 6 estudos. Observou-se predomínio de intervenções educativas centradas no educador. Para apreensão do significado dos Círculos de Cultura, foram desenvolvidos quatro artigos originais do tipo descritivo-exploratório, ancorados na abordagem qualitativa, que tiveram como cenário duas escolas estaduais de Pernambuco. Os participantes foram adolescentes escolares que vivenciaram Círculos de Culturadesenvolvidos por um Projeto de Extensão do Departamento de Enfermagem da Universidade Federal de Pernambuco, além de professores das escolas e graduandos de enfermagem da referida instituição que atuaram como facilitadores desses Círculos de Cultura em 2013 e 2014. Para a obtenção de dados foi utilizada a entrevista semiestruturada e o registro em diário de campo. Os dados foram produzidos pelo método do discurso do sujeito coletivo, técnica auxiliada pela utilização do software Qualiquantisoft. Observou-se que os Círculos de Cultura proporcionaram aos graduandos de enfermagem uma experiência inovadora de educação em saúde numa relação horizontal, compromissada com as potencialidades do educando e que faz a diferença na formação profissional. A experiência despertou criticidade, revelando a necessidade de repensar a formação do enfermeiro nas ações de educação em saúde. Para os professores, os Círculos de Cultura constituem uma tecnologia educativa que coloca o adolescente como protagonista na construção do conhecimento, proporcionando autoestima e contribuindo no rendimento escolar. Pelas suas impressões em relação aos Círculos, os professoresrevisitaram suas práticas educacionais, refletindo sobre as dificuldades que enfrentam cotidianamente. Para os adolescentes escolares, os Círculos de Cultura colocaram-nos na condição de protagonistas, o que estimulou o interesse em aprender e o desenvolvimento de criticidadefrente a abordagem de ensino bancário em sala de aula. A vivência provocou mudanças de postura nas disciplinas curriculares e vida pessoal, em família e na comunidade, fazendo com que eles quisessem multiplicar os saberes apreendidos.Conclui-se que os Círculos de Cultura tiveram significado fundamental para os atores sociais por proporcionarem uma experiência que valoriza conhecimentos prévios e envolvimento de todos nas discussões coletivas, baseadas em reflexões críticas pela problematização da realidade, configurando-se numa importante ferramenta na prática de uma educação em saúde humanizada, política e libertadora. Para a Enfermagem, os Círculos de Cultura surgem como estratégia de promoção da saúde por permitirem o desenvolvimento de espaços emancipatórios de cuidado, o que contribui para uma formação e atuação profissional comprometidas com as ideias de horizontalidade das relações e possibilidades de transformação do contexto de vida das pessoas. Sugere-se o desenvolvimento de novas pesquisas com metodologias participativas e emancipatórias onde o educador incite a curiosidade e inquietude dos adolescentes, para que esses se percebam como seres pensantese críticos, aptos a intervirem na realidade, alicerçados no compromisso com seu papel político e social. / The objective of this research was to learn the meaning of Cultural Circles for the social actors that are part of the educational practice of health disseminators school teenagers. This work consists of five scientific articles. In order to analyze the health educational practices carried out with school teenagers based on available scientific evidence, an integrative review was done in the PubMed, LILACS and ADOLEC databases, which included 32 studies. Educator-centered interventions were predominant. The other publications were descriptive exploratory original articles, based on qualitative approach, whose scenarios were two public schools of Pernambuco state. The participants were school teenagers who experienced the Cultural Circles carried out by teachers from those schools and students from an Extension Program of the Nursing Department, Federal University of Pernambuco, who acted as facilitators for those Circles in 2013 and 2014. It was verified that the Cultural Circles provided the nursery undergraduates with an innovative health education experience, committed to the teenagers’ potentialities and capable of making a difference to the undergraduates’ formation. This experience stimulated the undergraduates’ sense of judgment, revealing the need for rethinking the Nursing’s formation for working with healthcare education. As for the professors, the Cultural Circles are seen as an education technology that puts the adolescent as the protagonist in the development of knowledge, increasing self-esteem and school productivity. In addition, the professors were able to review their educational practices, reflecting about the difficulties they face daily. For the school teenagers, the Cultural Circles put them on a leadership condition, what encouraged them to learn and assume a critical position when facing the reality of the classroom, which is still based on an imposing model of education. This experience caused changes in curricular disciplines and in the teenagers’ family and community living, making them eager to multiply what they have learned. In conclusion, the Cultural Circles were significant for the social actors involved, as it provided an experience that valued previous knowledge and involvement in all of the collective discussions, based on critical reflection about their reality, serving as an important tool for the practice of a human, political and liberating healthcare education. For the Nursing degree, the Cultural Circles emerge as a strategy of health promotion, as they allow the development of caring spaces with freedom, which contribute to a professional formation committed to ideas of relationships based on equality and to transforming people’s lives. It is therefore suggested that new research with participative and liberating methodologies are carried out, in which the educator could bring about the teenagers’ curiosity and eagerness, for them to understand themselves as thinking and critical beings, able to intervene in reality, with social and political commitment.

O comportamento agressivo e uma de suas apresentações, o bullying, têm-se mostrado um problema crescente nas escolas brasileiras, com cerca de um terço dos alunos envolvidos como agressor ou como vítima. A violência em geral, assim como no ambiente escolar, é multicausal e, exatamente por esse motivo, difícil de ser controlada. Intervenções que visem prevenir e diminuir a ocorrência de bullying no ambiente escolar ainda são escassas na realidade brasileira. Os objetivos do presente estudo foram os de avaliar os resultados de uma intervenção breve antibullying para adolescentes de escolas públicas e de verificar a associação entre os tipos de bullying com as características demográficas, de temperamento e de problemas de saúde mental dos alunos. Trata-se de um quase-experimento, realizado com alunos do 5º ao 9º ano de quatro escolas (duas intervenção e duas controles) da rede pública, de ambos os sexos e com idade entre 12 e 17 anos. A intervenção breve e aplicada em toda a escola (denominada na língua inglesa whole-school intervention) refere-se a uma abordagem educativa sobre bullying e de sensibilização para alunos e para professores. O desfecho bullying foi avaliado por meio do Questionário de Bullying (QB) versão vítima e versão agressor. Os instrumentos utilizados para verificar as características de temperamento e os problemas de saúde mental foram o Affective Reactivity Index – versão criança (ARI-C) e o Questionário de Capacidades de Dificuldades – versão criança (SDQ-C), respectivamente Os instrumentos foram aplicados no horário de aula e com a autorização dos pais, no período anterior e posterior à intervenção. Nas escolas do grupo controle, os instrumentos também foram aplicados no mesmo intervalo de tempo do grupo intervenção. A pesquisa foi aprovada pelo Comitê de Ética da Universidade Federal do Rio Grande do Sul (UFRGS) e da Secretaria Municipal da Saúde (CAEE 19651113.5.3001.5347). Um total de 1.043 alunos foi incluído, sendo 526 (50,4%) meninas, com média de idade (desvio padrão) de 12,5 (DP=1,62) anos. Verificou-se que 146 (14%) estavam envolvidos com bullying como agressores, 163 (15,6%) como vítimas e 339 (32,5%) como vítimas-agressores. Observou-se associação significativa entre ser vítima (B=0,26) e agressor (B=0,28) com temperamento mais irritável. Também foi significativa a relação entre ser agressor com problemas de conduta (B=0,30) e ser vítima com problemas de relacionamento (B=0,52), conforme o SDQ-C. As escolas foram sorteadas, sendo alocados 613 (58,8%) alunos para o grupo intervenção e 430 (41,2%) para o controle. Não foi observada diferença significativa nos escores de bullying, considerando-se a interação tempo*intervenção. Tanto no grupo intervenção quanto no grupo controle, manteve-se a associação significativa verificada entre vítimas e agressores com maior temperamento irritável, problemas de conduta e de relacionamento após a intervenção. Os resultados do presente estudo indicam que intervenções breves, com inclusão somente de alunos, podem ser úteis como estratégia educativa sobre o tema, porém não são efetivas para modificar o envolvimento com bullying na escola. Novas pesquisas com intervenções de longo prazo, que sejam focadas na população de envolvidos e que incluam pais e professores, ainda precisam ser testadas para modificar o comportamento relacionado ao bullying escolar. / Aggressive behavior manifested in the form of bullying has become a pressing problem in Brazilian schools, with approximately one third of students involved as bullies or victims. Violence in general, including in the school environment, has multiple causes and, precisely because of that, is difficult to control. Interventions aimed at preventing and reducing school bullying are still scarce in Brazil. The present study aimed to assess the results of a brief antibullying intervention for public school adolescents and to investigate the association between types of bullying and demographic, temperamental, and mental health characteristics of students. This quasi-experiment included fifth - to ninth - grade students from four public schools (two intervention schools and two control schools), of both sexes, aged 12 to 17 years. The brief intervention applied throughout the school (called whole-school intervention) refers to an educational approach to raising awareness of bullying among students and teachers. Bullying was assessed using the Bully / Victim Questionnaire. The instruments used to assess temperamental and mental health characteristics were the Affective Reactivity Index – Brazilian child version (ARI-C) and the Strengths and Difficulties Questionnaire – Brazilian child version (SDQ-C), respectively. They were administered during classes and with parents' consent, before and after the intervention. At control schools, tests were administered using the same time interval The study was approved by the Ethics Committees of Universidade Federal do Rio Grande do Sul (UFRGS) and Porto Alegre Health Department (certificate no. 19651113.5.3001.5347). A total of 1,043 students were included, of whom 526 (50.4%) were females, and mean age was 12.5 (SD = 1.62) years. We found that 146 (14%) students played the role of bullies, 163 (15.6%) of victims, and 339 (32.5%) of bullies/victims. There was a significant association between being a victim (B = 0.26) and being a bully (B = 0.28) with a more irritable temperament. Being a bully with behavior problems (B = 0.30) was significantly associated with being a victim with relationship problems (B = 0.52), according to the SDQ-C. Schools were randomized, and 613 (58.8%) students were assigned to the intervention group and 430 (41.2%) to the control group. There was no significant difference in bullying scores considering time*intervention interaction. Significant associations between being a victim and being a bully with a more irritable temperament, behavior problems, and relationship problems were maintained in both groups after the intervention. The results of the present study show that brief, student-only interventions may be useful as an educational strategy, but they do not effectively change involvement in bullying at school. Further studies with long-term interventions focused on all people involved, including parents and teachers, are still needed to assess changes in behavior related to school bullying. / El comportamiento agresivo y una de sus manifestaciones, el acoso escolar o bullying, constituye un problema que va en aumento en las escuelas/institutos brasileños y que involucra a cerca de un tercio de los alumnos, ya sea como agresores o víctimas. En general, la violencia —como también en el ambiente escolar— se debe a múltiples causas y, justamente por ese motivo, resulta difícil controlarla. En la realidad brasileña, aún son escasas las intervenciones tendientes a prevenir y disminuir la ocurrencia de bullying en el ambiente escolar. Los objetivos del presente estudio fueron evaluar los resultados de una intervención breve antibullying para adolescentes de escuelas/institutos públicos y verificar la asociación entre los tipos de acoso escolar con las características demográficas, de temperamento y de problemas de salud mental de los alumnos. Se trata de un cuasi-experimento, realizado con alumnos del 5º al 9º año de cuatro escuelas/institutos (dos intervención y dos control) de la red pública, de ambos sexos y en la franja etaria de 12 a 17 años. La intervención breve aplicada en toda la escuela (denominada, en inglés, whole-school intervention) es un abordaje educativo y de sensibilización sobre acoso escolar dirigido a alumnos y docentes. El desenlace bullying se evaluó por medio del Cuestionario de Bullying (CB) versión víctima y versión agresor. Los instrumentos utilizados para verificar las características de temperamento y los problemas de salud mental fueron el Affective Reactivity Index – versión niño (ARI-C, por la sigla en inglés) y el Cuestionario de Capacidades de Dificultades – versión niño (SDQC, por la sigla en inglés), respectivamente. Los instrumentos se aplicaron en el horario de clase, con autorización de los padres, en el período anterior y posterior a la intervención En las escuelas/institutos del grupo control, los instrumentos también se aplicaron en el mismo intervalo de tiempo que en el grupo intervención. La investigación fue aprobada por el Comité de Ética de la Universidad Federal do Rio Grande do Sul (UFRGS) y de la Secretaría Municipal de Salud de Porto Alegre (CAEE 19651113.5.3001.5347). En el estudio se incluyeron 1.043 alumnos, de los cuales 526 (50,4%) eran niñas, con media de edad (desviación estándar) de 12,5 (DE=1,62) años. Se verificó que 146 (14%) estaban involucrados en bullying como agresores, 163 (15,6%) como víctimas y 339 (32,5%) como víctimas-agresores. Se observó asociación significativa entre ser víctima (B=0,26) y agresor (B=0,28) con temperamento más irritable. También fue significativa la relación entre ser agresor con problemas de conducta (B=0,30) y ser víctima con problemas para relacionarse (B=0,52), según el SDQ-C. Las escuelas/institutos se aleatorizaron y se asignaron 613 (58,8%) alumnos al grupo intervención y 430 (41,2%) al grupo control. No se observó diferencia significativa en los puntajes de bullying al considerarse la interacción tiempo*intervención. Tanto en el grupo intervención como en el grupo control, se mantuvo la asociación significativa verificada entre víctimas y agresores con mayor temperamento irritable, problemas de conducta y para relacionarse, tras la intervención. Los resultados del presente estudio indican que las intervenciones breves con inclusión solo de alumnos pueden ser útiles como estrategia educativa sobre el tema, pero no son efectivas para modificar la involucración en bullying en la escuela/instituto. Aún se necesita poner a prueba nuevas intervenciones de largo plazo, centradas en la población de involucrados e incluyendo a padres y docentes, para modificar el comportamiento relacionado al acoso escolar.

Sammanfattning   Bakgrund: Inom skolsköterskans arbetsfält ingår hälsofrämjande arbete med sexuell hälsa. I utbildningen till skolsköterska saknas antingen ämnet helt eller ges bristfälligt. Kunskap kring sexuell hälsa samt utformningen av det hälsofrämjande arbetet inhämtas istället via vidareutbildning som arbetsplatsen erbjuder. Tidigare studier har visat att utbildningsinterventioner inom arbetsområdet sexuell hälsa kan ge skolsköterskor ökad kompetens, liknande studier saknas i Sverige.   Syfte: Syftet var att beskriva om en utbildningsintervention om sexuell hälsa påverkat skolsköterskornas arbetssätt med det hälsofrämjande arbetet inom sexuell hälsa.   Metod: Studien var en enkätstudie bestående av slutna och öppna frågor och utgjordes av en jämförelse av svaren från två identiska enkäter som skickades ut före respektive efter en utbildningsintervention. De slutna frågorna i enkäten analyserades med hjälp av deskriptiv statistik och de öppna frågorna med hjälp av konventionell innehållsanalys.   Resultat: Utbildningsinterventionen bidrog dels till att skolsköterskorna fick ökad kunskap i olika områden inom sexuell hälsa samt dels en känsla av ökad trygghet i samtalet kring sexuell hälsa. Skolsköterskorna ansåg även att samverkan med andra professioner var betydelsefullt för ett framgångsrikt hälsofrämjande arbete med sexuell hälsa.   Slutsatser: Utbildningsinterventioner av liknande slag kan öka kompetensen och därmed öka tryggheten i arbetet kring sexuell hälsa.   Nyckelord: distriktsköterska, elevhälsa, kompetenshöjning, sexuell hälsa / Summary   The school nurse’s health promoting work with sexual health. A survey study.   Background: The school nurse's field of work includes health promotion work concerning sexual health. In school nurse education, either the subject is completely missing or given deficiently. Previous studies have shown that educational interventions in the area of sexual health can increase competence, similar studies are lacking in Sweden.   Objective: The aim was to describe how an educational intervention on sexual health effect school nurses´ work procedure in the health enhancing work in sexual health.   Method: The study was a questionnaire consisting of closed and open questions and consisted of a comparison of the answers from two identical questionnaires that were sent out before and after an educational intervention. The closed questions in the questionnaire were analyzed by using descriptive statistics while the open questions were analyzed using a qualitative, conventional content analysis.   Results: The educational intervention has helped the school nurses to gain increased knowledge in various areas of sexual health, as well as having created a sense of increased security in talking about sexual health. The school nurses also considered that a collaboration with other professions was important for successful health promoting work within sexual health.   Conclusions: Education interventions can increase competence and thus increase security in work on sexual health.   Keywords: district nurse, increase competency, school health service, sexual health

Sammanfattning Bakgrund: Skolsköterskan ska arbeta hälsofrämjande och sjukdomsförebyggande. Detta görs till stor del genom att samtala med elever om mående och hur hälsa kan förbättras och sjukdom förebyggas. Studier visar att skolsköterskan ofta styr hälsosamtalet vilket försvårar elevens interaktion och skolsköterskans personcentrerade förhållningssätt utmanas.  Syfte: Syftet med studien var att beskriva skolsköterskans erfarenheter av att genomföra hälsosamtal med grundskoleelever utifrån ett personcentrerat perspektiv.  Metod: En kvalitativ intervjustudie med deduktiv ansats tillämpades, utgångspunkt var den personcentrerade modellen. Genom ändamålsenligt urval intervjuades 13 kvinnliga skolsköterskor via digital plattform. Data analyserades med kvalitativ innehållsanalys på manifest nivå.  Resultat: Resultatet presenterades i tre kategorier: Partnerskap vid hälsosamtal i skolan, elevens berättelse om sin hälsa och skolsköterskans dokumentation. Skolsköterskan behövde skapa förutsättningar för att elevens berättelse skulle framträda och vara en aktiv lyssnare som bjöd in eleven till delaktighet i partnerskapet. Det var viktigt med ett bra bemötande där samtalet skedde på elevens villkor. Dokumentationen skulle genomsyras av elevens berättelse som dokumenterades med hänsyn och med elevens delaktighet.  Slutsats: Studien ökade förståelsen för vilka förhållningsätt, egenskaper och förutsättningar som främjade skolsköterskans personcentrerade arbete vid hälsosamtal. Om ett personcentrerat förhållningssätt eftersträvades kunde elevens förtroende vinnas. Skolsköterskan kunde då lättare hjälpa eleven att förbättra sin hälsostatus och guida eleven till en hälsosam livsstil. / Summary Background:  The school nurse shall work on health promotion and disease prevention. This is  mainly done by talking to pupils about well-being and how health can be improved and disease prevented. Studies show that the school nurse often controls the health dialouges, which makes it difficult for the pupils to interact and the person-centered perspective challenged. Aim: The aim of the study was to describe school nurses’ experiences of conducting health dialogues with primary school pupils from a person-centered perspective.  Method: A qualitative interview study with a deductive reasoning was applied, based on the person-centered model. Through purposive sampling, 13 female school nurses’ were interviewed by video conferencing. Data was analyzed with qualitative content analysis at a manifest level. Results: The results were presented in three categories: Partnership in school health dialouges, pupil narratives about thier health and school nurses’ documentation. The school nurse needed to establish conditions for the pupil's story to emerge and be an active listener who invited the pupil to participate in the partnership. It was important to have a good reception, where the conversation took place on the pupil's terms. The documentation would be permeated with the pupil's narrative, which was documented with consideration and participation. Conclusion: The study increased the understanding of which approach, characteristics and conditions that promoted the school nurse's person-centered work when she implemented health dialogues. If a person-centered approach is sought, the pupil's trust can be gained. The school nurse could then more easily help the pupil improve their health status and guide the pupil to a healthy lifestyle.

Bakgrund  Fysisk aktivitet under skoltid är av stor vikt då barn och ungdomar rör sig allt mindre. Skolans elevhälsa, däribland skolsköterskor, arbetar med främjandet av fysisk aktivitet i skolan. Studier kring hur en fysioterapeut kan verka inom elevhälsan är idag begränsade. Hur skolsköterskor uppfattar att en fysioterapeut kan bidra i skolhälsoarbetet var därför av intresse att undersöka. Syfte  Att undersöka skolsköterskors uppfattning om behovet av en fysioterapeut inom skolverksamheten, samt undersöka vad de anser har betydelse för att främja fysisk aktivitet i skolan.  Metod Studien var av kvalitativ design. Fem skolsköterskor intervjuades genom enskilda semistrukturerade intervjuer. Kvalitativ innehållsanalys användes för bearbetning av data.   Resultat  Utifrån insamlade data identifierades nio kategorier med sammanlagt trettiotvå underkategorier. Kategorier om behovet av en fysioterapeut inom skolverksamheten var ”Efterfrågad kompetens”, ”Hänvisar till extern kompetens” och ”Osäkerhet kring fysioterapeutens roll”. Kategorier om främjandet av fysisk aktivitet var ”Individanpassat”, ”Hemsituationen påverkar”, ”Gemensamma organiserade aktiviteter”, ”Aktivitetsfrämjande miljöer”, ”Gemensamt förhållningssätt” och ”Utmaningar att förhålla sig till”.  Konklusion  Samtliga skolsköterskor ger uttryck för att det finns ett behov av en fysioterapeut, samtidigt framkommer det att de är osäkra kring hur rollen skulle se ut inom skolverksamheten. Främjandet av fysisk aktivitet i skolan ansågs påverkas av skolans organisation, personal, föräldrar och elever. Utmaningar i arbetet med fysisk aktivitet beskrivs bero på tidsbrist och bristande kunskaper inom området. / Background  Physical activity during school hours is of great importance since children and adolescents move less and less. The school health services, including school nurses, is working to promote physical activity in school. Studies who aim to examine how a physiotherapist can contribute to the school health services are limited. To examine how school nurses perceive the need for a physiotherapist in the school health services was therefore of interest to investigate.  Purpose To examine how school nurses perceive the need for a physiotherapist in the school health services, as well as examining what they consider to play a significant role in promoting physical activity in school. Method  The study was of qualitative design. Five school nurses were interviewed through individual semi-structured interviews. Qualitative content analysis was used to analyzing the data.   Result A total of nine categories and thirty-two subcategories was identified from the collected data. Categories about the need for a physiotherapist were “Requested expertise”, “Refers to external competence”, “Uncertainty about the role of the physiotherapist”. Categories about the promotion of physical activity were “Individualized”, “Home situation affects”, “Organized activities”, “The environment affects physical activity”, “Common approach” and “Challenges to relate to”.  Conclusion  The school nurses perceive that there is a need for a physiotherapist within the school health services. At the same time, it appears that they are a bit unsure about the physiotherapists’ role. The promotion of physical activity in school is considered to be affected by the schools’ organization, school staff, pupils and parents. The work with physical activity in school has certain challenges which is described to depend on shortage of time and lack of knowledge in the area.

This thesis on the topic of health promotion programs in primary schools in the South Bohemian Region deals with projects that focus on the health of pupils attending primary school. The aim of the study was to find out what is the attitude of directors selected primary schools in the South Region to programs promoting health. Another objective was to evaluate the attitudes and assessment of Directors to use the effectiveness of these programs. The research is divided into theoretical and practical part, the theoretical focuses on the basic concepts, such as e.g. health, healthy lifestyles, health promotion programs, prevention, health determinants like. In other parts of the work are described individual health promotion programs, which schools are offered in the South Bohemian region, which surveyed schools also utilize. In the practical part is based on research, which is divided into two blocks. The first block is focused on the director of elementary schools and one block refers to providers of health promotion programs. In connection with the set goals, it was found that the level of implementation varies widely because headmasters somewhere implementation have been very sophisticated and large number of programs elsewhere is only a few programs and implementation lags. Following the partial...

Tato diplomová práce se věnuje tématu podpory zdraví na základních školách Jihočeském kraji. Pozornost je věnována současné situaci v dále jsou zkoumány jednotlivé programy. Text dále sleduje, jak ředitelé základních škol a pracovníci Státního zdravotního ústavu hodnotí účinnost programů podpory zdraví. Na základě kvalitativního šetření mezi zmíněnými aktéry jsou identifikována se do značné míry liší úrovní propracovanosti. Přínosem práce by mělo být zjištění aktuální situace při implementaci vybraných programů podpory zdraví, zhodnocení efektivnosti a návrhy opatření na zlepšení zjištěné situace.