Sammanfattning Titel:                    Skolsköterskors erfarenheter av mötet med föräldrar till överviktiga barn - ett hälsofrämjande arbete Författare:           Karlsson, Erika; Wern, Pernilla                                              Institution:           Institutionen för hälsa och lärande, Högskolan i Skövde Program<img src="https://cdncache-a.akamaihd.net/items/it/img/arrow-10x10.png" />kurs:      Examensarbete i omvårdnad, OM854A, 15 hp Handledare:         Larsson, Margaretha Examinator:         Brovall, Maria         Sidor:                   22 Nyckelord:          Skolsköterska, övervikt, samarbete, ansvar     Bakgrund: Övervikt hos barn och ungdomar är ett växande problem.  På längre sikt leder övervikt till följdsjukdomar. Skolsköterskor har en unik möjlighet att fånga upp de barn som är på väg att utveckla övervikt eller fetma i tidig ålder. Hälsosamtalet och hälsobesöket är skolsköterskans främsta hälsofrämjande arbete. Syftet med hälsosamtalet är att enskilt tillsammans med skolsköterskan diskutera sin hälsa och eventuella ohälsa.   Syfte: Att beskriva skolsköterskors upplevelser av det hälsofrämjande mötet med förälder till barn med övervikt. Metod: En studie har genomförts med kvalitativ metod där skolsköterskor intervjuats med öppna frågor. Innehållet i intervjuerna har analyserats med kvaltitativ innehållsanalys. Resultat: Skolsköterskorna påtalar vikten av att det både är föräldrars ansvar och skol­sköterskans ansvar att främja en god hälsa hos barnet. Samarbetet mellan skolsköterskorna och föräldrarna är avgörande för hur det hälsofrämjande arbetet utvecklas. Skol­sköterskorna förbereder sig väl inför mötet med förälder till barn med övervikt för att detta möte skall bli så bra som möjligt. Konklusion: Skolsköterskorna belyser samarbetet och bemötandet av föräldrar till barn med övervikt. Det gemensamma ansvaret som föräldrar och skolsköterskor har över barnet lyfts fram i det hälsofrämjande mötet. Deras erfarenheter och förhållningssätt har visats sig vara viktiga aspekter i mötet. / Abstract Title:                       School nurses experiences of meeting with parents in health promotion Author:                  Karlsson, Erika; Wern, Pernilla Department:           School of Health and Education, University of Skövde Course:                   Master Degree Project in Nursing, 15 ECTS Supervisor:             Larsson, Margaretha Examiner:               Brovall, Maria Pages:                     22 Keywords:             School nurse, overweight, cooperation, responsibility   Background: Obesity in children and adolescents is a growing problem<img src="https://cdncache-a.akamaihd.net/items/it/img/arrow-10x10.png" /> in most countries; in the long term leading to overweight sequelae. School nurses have a unique opportunity to localize those children who run the risk of being overweight or developing obesity at an early age. The health and development meeting is the school nurse's premier health promotion tool. The purpose of the meeting is to enable individual/student to discuss their own health situation and any potential problems<img src="https://cdncache-a.akamaihd.net/items/it/img/arrow-10x10.png" /> they might have. Objective: To describe the school nurses' experiences of health promotional meetings with parents of children with overweight. Method: A study has been conducted using qualitative method in which school nurses interviewed with open questions. The content of the interviews were analyzed by quantitative content analysis. Results: The school nurses impress in the importance of both parents' responsibility, and the school nurse's responsibility to promote the good health of the child. Cooperation between school nurses and parents is crucial for the health promotion to evolve. The school nurses must prepare thoroughly for the health meeting with parents of children with overweight if there will be any kind of positive outcome. Conclusion: The school nurses highlight the good cooperation and hospitality of parents of children with overweight. The shared responsibility of parents and school nurses is raised in the health promotion meeting. Their experiences and approaches have been shown to be important aspects of the meeting.

<p>The objective of this literature study was to describe how the school nurse can adopt the salutogenic perspective in her health promoting work. The articles were examined in order to identify what was written about the school nurse’s work from the salutogenic perspective. In parallel, Eriksson’s, Orem’s, and Newman’s nursing theories were examined from the same perspective. Health promotion enables people to increase control over, and to improve, their health. Aaron Antonovsky coined the term salutogenesis to describe why certain people can stay healthy despite stressful situations, and even grow and develop. The concept “sense of coherence” (SOC) is an important factor in this context. The Salutogenic model was a new way to develop knowledge in nursing. As caregivers capable of structuring life experiences and providing health information and services, nurses can foster and strengthen SOC. Salutogenesis promoted the understanding and the identification of factors relevant to child protection. It was also found that many factors, e.g., gender, lifestyle, habits and school climate correlated with SOC. The study showed a strong support for adopting the Salutogenic model in school health work, and that nursing theories can be used as analytical tools in the application of this model in practice.</p>

Background and Purpose: School nurses have the critical task of overseeing the health and wellness of school-aged students. Utah is 1 of 17 states which allow parents to exempt their children from vaccines. The most common parental reason for exempting children from vaccines is personal choice. With the number of students without vaccinations on the rise, school nurses are tasked with responsibilities related to the spread of vaccine-preventable diseases. However, few studies have explored the role of school nurses in managing a disease outbreak. Therefore, the purpose of this study was to 1) explore the responsibilities of Utah school nurses during a disease outbreak; 2) review disease outbreak training for Utah school nurses; 3) identify groups with which the Utah school nurse would collaborate during a disease outbreak; and 4) identify Utah school nurse concerns while attempting to manage a disease outbreak. Methods: A qualitative descriptive design was used with a semi-structured interview guide for focus groups (3 focus groups, 24 total participants) of Utah school nurses. Qualitative analysis of content and themes was utilized. Results: School nurses' responses revealed their collaborative role and cited strong teamwork with the local health department; lack of standardized disease outbreak training; high student-to-nurse ratios; and concerns with communication with parents and community. Thematic descriptions with illustrative quotes are presented as well as perceived challenges and barriers Utah school nurses faced during a disease outbreak. Conclusion: Utah school nurses face barriers that prevent them from working effectively during a disease outbreak. Most barriers are due to communication difficulties and lack of training for school nurses. Findings of this study have implications for standardized training, funding to decrease the high nurse-to-student ratio and for further education in the community to raise awareness of outbreak guidelines.

Approximately one-third of children in the United States are overweight or obese with increased risks for numerous physical and psychosocial comorbidities. Schools are ideal environments to address this serious health crisis and school nurses are uniquely positioned qualified healthcare providers to actively participate in childhood obesity prevention (COP). A review of the literature provided findings to identify a gap in the knowledge regarding the association between school nurse COP perceptions and practices. A modified theoretical framework based on Bandura’s health promotion by social cognitive theory guided this study. The purpose of this study was to identify the key perceptions (self-efficacy, perceived benefits and perceived barriers) influencing school nurse participation in COP practices and determine associations between school nurse characteristics and COP perceptions and practices. Preliminary research was conducted to determine content validity for modified perception scales, clarity of instructions and questions, data collection and retrieval procedures, and refinement of recruitment strategies. Adequate reliability and validity was determined for modified scales measuring school nurse self-efficacy, perceived benefits, perceived barriers, and COP practices targeting individual children (child-level) and the entire school population (school-level). Florida RN school nurses (n = 171) completed self-administered anonymous questionnaires from an emailed weblink or a paper version offered at two Florida Association of School Nurses conferences. School nurses with characteristics reflecting more education engaged in more COP practices (p < .05) than those without education-related characteristics. School nurses with > 8 hours of COP education reported higher COP self-efficacy than those with none (p < .01). Linear regressions showed that a model comprised of self-efficacy, perceived benefits, and perceived barriers significantly explained 12.0% of the variance in child-level practices (p < iv .001) and 9.1% of school-level practices (p < .001). Self-efficacy explained the most variance of school nurse child-level and school-level practices (p < .001), and perceived barriers were inversely associated with child-level practices (p < .05). Four series of regressions showed that only perceived barriers partially mediated the influence of self-efficacy on child-level practices. Data analyses indicated self-efficacy and perceived barriers were key determinants of school nurse COP practices. Therefore, policy changes and educational interventions to increase selfefficacy and reduce perceived barriers may be effective in mobilizing school nurses to actively engage in COP practices

School nurses who transition from hospital or clinic-based settings to a school-based work environment often lack sufficient transitioning skills and orientation to cope with the roles and responsibilities of school-based nursing. The result is a high attrition rate among school-based nurses. School nurses may leave their positions due to experiences of marginalization, including isolation, role confusion, and barriers to practice. In this phenomenological study, the lived experiences of 12 school-based nurses who transitioned from hospital or clinical settings were explored. Bandura's self-efficacy and Spreitzer's psychological empowerment theories were used in interpreting the findings. Data were collected via face-to-face individual interviews with nurses residing in the State of Maryland. The study findings revealed the difficulties experienced by these nurses during the initial years of their transition to school nursing. Multitasking was very challenging at the initial stage of transition for nurses who were new to school-based-practice. For nurses who were learning to navigate the school system, adhering to educational standards and protocols while setting appropriate priorities to provide quality nursing care for students was difficult. The nurses' understanding of health and wellness shaped and influenced their decision to continue with school nursing to help students reach their maximum health and academic achievements. This study may lead to positive social change by helping readers to better understand the transition process for hospital-based nurses who enter the school environment. With an improved understanding of this population, it may be possible to lower attrition and burnout rates among school nurses.

Bakgrund: Barn med neuropsykiatriska funktionsnedsättningar (NPF) är i behov av stöd och det centrala är att känna sig sedd i hälso- och sjukvården. Skolsköterskans primära uppgift är att stödja och stärka till välbefinnande genom att vara närvarande, lyssna och inge hopp i samtalet. Syfte: Att beskriva skolsköterskans upplevelse av att stödja och stärka elever i skolan med neuropsykiatriska funktionsnedsättningar Metod: I studien användes en kvalitativ metod med induktiv ansats där åtta intervjuer analyserades med kvalitativ innehållsanalys. Resultat: Ur analysen framkom två huvudkategorier; Att inge trygghet och hopp genom tillgänglighet och samtal och Genom samverkan med andra utvecklas ett starkare stöd, med fem tillhörande underkategorier. Slutsats: Skolsköterskans stöd leder till att eleverna med NPF känner sig stärkta i sin situation vilket ger ökat hopp och tro på framtiden. Att hjälpa eleverna att främja dess sunda och friska beteenden medverkar till att elevernas skyddsfaktorer stärks. Genom samtal och lyhördhet stärks eleverna att lära sig ta egna beslut och växa som individer. Ett bra teamsamarbete bidrar till större möjlighet att främja hälsa och förebygga ohälsa för elever med NPF / Background: Children with neuropsychiatric disabilities (NPF) are in need of support and importance to be seen in the health care sector in school. The primary duty of the school nurse is to ensure that the students are in wellbeing. School nurses are supporting and strengthening the good of health by being present, listening and giving hope in the dialogue. Purpose: Describing school nurse's experience of supporting and strengthening students with neuropsychiatric disabilities Method: The study used a qualitative method with inductive approach where eight interviews were analyzed with qualitative content analysis. Result: Two major categories emerged from the analysis; Entering security and hope through accessibility and conversation and Strengthening cooperation with others, with five belonging subcategories. Conclusion: The school nurse's support in school leads the neuropsychiatric disabilities students feeling stronger in their situation, which gives greater hope and faith in the future. Helping students to promote their health and healthy behaviors helps to strengthen the students' protection factors. Through dialogue and responsiveness, students are strengthened to learn to make their own decisions and grow as individuals. Good teamwork contributes to greater opportunities for promoting health and preventing illness for students with neuropsychiatric disabilities.

Bakgrund: Unga kvinnor som skadar sig med sin sexualitet har uppmärksammats på senare år. De som tidigare i livet varit utsatta sexuellt är överrepresenterade bland dessa kvinnor som skadar sig själva med sexualitet.Syfte: Syftet med studien var att beskriva unga kvinnors upplevelser av sexualitet som självskadebeteende.Metod: En kvalitativ studie med fenomenologisk ansats av egna skrivna berättelser. Datamaterialet analyserades med hjälp av innebördsanalys.Resultat: Unga kvinnor som skadar sig genom sexualitet söker bekräftelse bland annat genom att publicera bilder på internet för att få positiv feedback om det egna utseendet. Vidare använder de sin sexualitet till att uppnå en kick och få en känsla av att duga till och på sätt dämpa den ångest de bär på. Dessa unga kvinnor behöver mycket stöd från omgivningen för att kunna förstå och bearbeta sitt självskadebeteende.Slutsats: Skolsköterskor behöver uppmärksamma att sexualitet som självskadebeteende existerar och finns i alla samhällsklasser. Skolsköterskor kan genom kontinuitet och förtroendegivande bemötande skapa en god relation som bygger på ett genuint intresse att vilja förstå dessa unga kvinnor utifrån ett livsvärldsperspektiv. För att kunna erbjuda det stöd som dessa unga kvinnor behöver är det viktigt att hen vågar finnas där, lyssna och ställa frågan. / Background: Young girls that self-harm themselves have recent years been in focus. Thosewho earlier in life have been sexually abused are overrepresented among these women thatself-harm themselves through their sexuality.Aim: The aim of this study was to illustrate young women’s experiences of sexuality as aself-harm behavior.Method: A qualitative study with a phenomenological approach of own written stories.Result: Young women that harm themselves with their sexuality seek acknowledgement forinstance by publishing pictures on the internet to receive positive feedback on theirappearance. Further they use their sexuality to achieve a rush and a sense of suffice and bythat mitigate their anxiety. These women need a lot of support from their surroundings inorder to understand and process their self-harm behavior.Conclusion: School nurses need to pay attention that sexuality as a self-harm behavior existsin all social classes. The school nurse can through continuity and a trustworthy attitude createa good relation that is based on a genuine interest of wanting to understand these youngwomen from a life-world perspective. To be able to offer these young women the supportthey are in need of it is important that the school nurse dare to be present, listen and ask the question.

Bakgrund: Digitala medier är en del av de flesta barns vardag idag. Diskussioner om huruvida detta påverkar barns fysiska och mentala hälsa framhävs emellanåt i olika medier. Samtidig som det även diskuteras om positiva effekter. Skolsköterskan träffar alla elever och har en viktig funktion i det hälsofrämjande arbetet. Skolsköterskan kan i samverka med andra professioner och föräldrar förmedla kunskap och stöd till hälsosamma levnadsvanor. Syfte: Syftet med studien var att undersöka skolsköterskors erfarenheter av barns digitala medieanvändning och skärmtid, samt hur skolsköterskan arbetar hälsofrämjande inom området. Metod: Studien har genomförts med en kvalitativ design med induktiv ansats. Nio semistrukturerade intervjuer gjordes med stöd av en intervjuguide för att samla in data. Insamlat material har analyserats genom manifest kvalitativ innehållsanalys. Resultat: Skolsköterskans erfarenheter och hälsofrämjande arbete resulterade i två domäner med fem kategorier och 16 underkategorier. Skolsköterskor samtalade med barn och föräldrar om digitala medier i hälsosamtalen och de använde sig av standardiserade hälsoverktyg. Skolsköterskor arbetade med att väcka medvetenhet och reflektion hos eleverna. Föräldrar råddes att vara delaktiga i barnens medieanvändning och ha balans och rutiner. Skolsköterskor gav information och råd om fysisk hälsa och sömn samt arbetade med utsatthet på nätet, ofta i samarbete med andra professioner. Skolsköterskor erfor att samhällets utveckling styr, att medievanor hos barn har ändrats på fritiden. Skolsköterskor tyckte att skolor har olika förutsättningar och att digitala medier har blivit en del av lärandet. De hade erfarenhet av att digitala medier ersätter personliga aktiviteter, att det ger gemenskap och vänner, men också utanförskap och konflikter. Skolsköterskor hade också erfarenhet av att barn kan fastna i spel. De hade även erfarenhet av fysiska komplikationer, som att kroppen tar stryk och att sömnen påverkas. Slutsats: Samtliga skolsköterskor lyfte frågan om barn digitala medievanor någon gång under tiden förskola till årskurs sex. Samtliga använde sig också av standardiserade hälsoformulär under hälsosamtalet med elever. Skärmtid ansågs vara ett svårt begrepp och skolsköterskor tyckte det var svårt att ge konkreta råd angående hur länge det är lämpligt för barn att sitta vid en skärm. Skolsköterskor ansåg att deras roll i samtalet var att väcka reflektion och hjälpa elever till insikt om sina vanor. Skolsköterskor arbetade hälsofrämjande på grupp- och individnivå inom området som omfattar barns medievanor, ofta i samarbete med andra professioner. Arbetet mot mobbning på nätet var framträdande i studien. / Background: Digital medias is a part of most childrens everyday life today. Discussions about weather this effects the psysical and mental health of children is emphasized from time to time in various media. At the same time there is an ongoing discussion about the benefits of using digital media. The school nurse meets all students and has an important role in health promotion. In cooperation with other professionals and parents the school nurse can supply knowledge and support students to a healthy lifestyle. Aim: The purpose of this study was to exlore the school nurses´experiences of children´s digital media use and screen time, and also to explore how the school nurse´ health promotiong in the field. Method: The study was conducted with a qualitative design/approach. To collect data, nine semi-structured interviews with school nurses were made. Interviews were conducted with the support of an interview- guide. Collected data were analysed using manifest content analysis. Results The school nurses´ experiences and health promoting work resulted in two domains, with five categories and 16 subcategories. School nurses talked to children and parents about the use of digital medias during health conversations and they also used standardized health tools in conversations. School nurses´worked with helping students reflect on, and create an understanding of their habits. Parents were advised to be involved in their childrens media use and maintain balance and routines. School nurses gave information and advice about physical health and sleep, as well as they worked with childrens vulnerability on the internet, often in collaboration with other professions. School nurses thought that society's development rule and that the media habits of children has changed in their leisure time. School nurses felt that different schools had different conditions and that digital media has become a part of learning. They had experienced that digital media replaces personal activities, it could create solidarity and friends, but also exclusion and conflict. School nurses also experienced that children can get caught in games. They also had the experience of physical complications, such as the body in affected and that sleep is affected . Conclusion All school nurses´raised the issue of childrens digital media habits sometime during the time from kindergarden to the sixth grade. All school nurses´ used standardizied health questioairies during healthconversations with children. Screen time was considered to be a difficult concept, and school nurses found it difficult to give specific advice about how long time is appropriate for children to sit by a screen. School nurses´ felt that their role in the conversation was to help students reflect on, and to create an understanding of their habits. School nurses worked both on an individual level and group level in their health promoting work on the area of digital media habits, often in collaboration with other professions. The work against bullying online was prominent in the study.

År 2015 sökte 70 384 barn asyl i Sverige. Flyktingbarn löper större risk att drabbas av ohälsa än andra. Idag träffar skolsköterskor i Sverige dessa barn allt oftare. Syftet med denna studie var att belysa skolsköterskors upplevelse av att möta nyanlända flyktingbarn. Semistrukturerade intervjuer genomfördes med 11 skolsköterskor och analyserades med hjälp av kvalitativ innehållsanalys. Resultatet redovisas i fyra kategorier: språket, ett hinder för att kommunicera; där skolsköterskorna tar upp vikten och svårigheten av att ha en fungerande dialog. Påfrestande att stödja barnen; där skolsköterskorna beskrev det som betungande att höra barnens historier och att de upplevde en känsla av otillräcklighet. Att känna tillfredsställelse i mötet; skolsköterskorna beskrev sig vara fascinerade över barnens mentala styrka och deras positivitet. Svårighet att anpassa sig till olika kulturer; där skolsköterskorna beskrev att hälsoformulären inte var anpassade till barnens olika kulturer och skolsköterskorna upplevde själva en bristfällig kunskap om de olika kulturerna. Konklusionen av studien var att skolsköterskors möten med nyanlända flyktingbarn kan effektiviseras om skolsköterskor får ökad kunskap om olika kulturer och flyktingbarns psykiska, fysiska och emotionella hälsoproblem samt genom att optimera kommunikationen.

Allt fler rapporter visar att den psykiska ohälsan ökar bland ungdomar i Sverige och då främst bland flickor. Gymnasieskolan är en stor mötesplats för ungdomar och skolsköterskan är en viktig person då hon träffar alla ungdomar minst en gång under deras gymnasietid, i det av Skolverket fastställda hälsosamtalet. Syftet med studien var att undersöka hur elever inom gymnasieskolan vill att deras  skolsköterska ska arbeta hälsofrämjande och preventivt. Gymnasieelever vid två olika skolor i nordvästra Skåne intervjuades i två olika fokusgrupper.  Intervjumaterialet transkriberades och analyserades med en kvalitativ innehållsanalys. Efter resultatanalysen framkom tre kategorier: kommunikation, skolsköterskan som aktör på gymnasieskolan och interaktion. Faktorer som att  skolsköterskan skall finnas där, vara lättillgänglig och inge trygghet var viktiga för  gymnasieeleverna. Resultatet visar att skolsköterskan behövs inom gymnasieskolan men behöver synliggöra sitt arbete. Vidare forskning, både ur elevernas och ur skolsköterskans perspektiv behövs. Ungas ökade psykiska ohälsa finns högt på agendan i Sverige idag, ändå är skolsköterskan och elevhälsan på gymnasienivå ett område som fortfarande är outforskat. / Research is accumulating which indicates that mental illness is increasing among youth in Sweden and especially among female youth. Secondary school is a significant meeting place for young people and the school nurse is an important person as he or she meets with each youth at least once in the health conversation required by the school system. The goal of this study was to investigate how secondary school students want their school nurse to work in the promotion of health and prevention of illness. Students at two different secondary schools in south Sweden were interviewed in two different focus groups. The data procured from the interviews was transcribed and qualitatively analyzed. Three categories were derived from this analysis: communication, the school nurse's role in the secondary school and interaction. The students deemed that factors such as the presence of the nurse, the availability of the nurse and the nurse's ability to communicate safety  were important. The results indicated that the nurse is needed in the secondary school, but he or she also needs to make his or her work visible. More research is needed from both the perspective of the students and the nurses. Increasing the mental health of young people is a high priority in Sweden today. But the school nurse and student health at the secondary level is still largely unresearched.