The most important aspect of an encounter between a patient and his or her provider is the patient's ability to understand and implement the treatment plan and self-care instructions conferred by the provider. However, the literature in the field of patient-provider communication reveals that there is a noticeable gap in health literacy in certain patient populations that impairs their ability to understand pre-, during, and post-encounter paperwork, terminology, treatment plan, and critical self-care instructions. This has been shown to have detrimental consequences on patient health outcomes. The teach-back method, in which providers request patients to repeat key information discussed during the encounter in their own words, has been shown to successfully improve patient satisfaction, self-efficacy, and knowledge post-encounter. This paper seeks to investigate the impact of health literacy and teach-back on patient satisfaction, self-efficacy, and knowledge, and to determine the effect of a teach-back training intervention on the usage of teach-back during a patient-provider encounter. A total of 88 patients and 11 providers participated in this study over the course of two semesters. A pre- and post-encounter questionnaire was provided to patients and a post-encounter questionnaire to providers. Data regarding teach-back instances during the encounter were obtained via transcripts of encounter audio recordings. Training was given to 17 providers between semesters, 11 of whom were participating in a larger study data collection, and pre- and post-training teach-back instances were compared. The data were coded and statistically analyzed. The results were that there was a statistically significant relationship between health literacy and patient satisfaction as well as patient self-efficacy. Additionally, there was a significant relationship between teach-back and patient self-efficacy with an upward trend observed on the knowledge measures post-teach-back. Teach-back interventional training was also seen to have a statistically significant impact on provider use of teach-back during the patient encounter. Additional research in this field observing fidelity of teach-back practice and observing impacts of teach-back on a separate non-student population could be beneficial in improving patient encounters.

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The purpose of this study has been to examine and analyze school counselors’ experience of collaboration with other professions in the student health team and the preconditions for their work. The study is based on qualitative semi-structured interviews with six elementary-, and two high school student counselors in a medium-sized town in Sweden. The theoretical approach being used is: role theory, theory of professions and theory about collaboration. The study´s result shows that the school counselors’ experience an unclarity in their job assignments and their role is often described as diffuse and vauge. Furthermore, the result also shows that personality, different perspectives, education, lack of time, resources and confidentiality is affecting their possibility to execute an independent professional social work in the student health team. This study also shows that the school counselors valuate collaboration. A opportunity that sometimes is being obstructed through the different perspectives as compared to the other professions in the student health team, and therefore affects their experience of collaboration.

Elevhälsan är enligt skollagen en del av grundskolan och ska stödja elevernas möjligheter att nå kunskapsmålen. Elevhälsoarbete ska främst vara hälsofrämjande och förebyggande på en universell nivå som når alla barn och unga. Det finns däremot skillnader mellan skolor i det praktiska arbetet vilket inte är i samklang med de folkhälsopolitiska målen för en god och jämlik hälsa. Ur ett folkhälsovetenskapligt perspektiv är skolan en viktig arena som kan ses som en viktig hälsoresurs nu och för kommande generationer. En god hälsa genererar lärande och lärande bidrar till en god hälsa. Ett välfungerande elevhälsoarbete kan därmed bidra till långsiktiga samhällsekonomiska vinster. I studien användes kvalitativ metod då syftet var att undersöka elevhälsopersonalens erfarenheter av förebyggande arbete. För studien valdes målstyrt urval med sju informanter som arbetar inom grundskolors elevhälsoteam. Genom en manifest analysprocess med citat baserat på semistrukturerade intervjuer redogör denna studie för elevhälsopersonalens subjektiva uppfattningar. Resultatet visar en ojämlikhet i hur skolor arbetar förebyggande utifrån resurser och intresse hos personal och ledning. Dock genomsyras ett strukturerat värdegrundsarbete samtliga skolor. En stor del av resultatet redogör för vikten av att alla tillsammans tar ansvar för elevhälsoarbete. Det kan uppnås genom tvärsektoriellt arbete och samverkan mellan flera professioner. En engagerad rektor och ledning skapar förutsättningar för ett lyckat elevhälsoarbete. Detta i kombination med behovet på skolan avgör hur stor del av elevhälsoarbetet som prioriteras till förebyggande och hälsofrämjande åtgärder. Elevhälsopersonalen lyfter även en önskan och ett intresse för fortsatt kompetensutveckling individuellt och för samtliga professioner på skolan. / According to law, student health is part of elementary school and must support students' opportunities to reach the knowledge goals. Student health work must primarily be health promotion and prevention on a universal level that reaches all children and young people. There are differences between schools in the practical work which contradicts with the public health policy goals for good and equal health. From a public health science perspective, the school is an important arena that can be seen as an important health resource now and for generations to come. Good health generates learning and learning generates good health. A well-functioning student health program can thus contribute to long-term socioeconomic benefits. A qualitative method was used as the purpose of the study was to investigate the student health staff's experiences of preventive work. For the study, a targeted sample was chosen with seven informants who work within elementary schools' student health teams. Through a manifest analysis process with quotes based on semi-structured interviews, this study reports on the subjective perceptions of the student health staff. The results show an inequality in how schools work preventively based on the resources and interest of staff and management at the school. However, all schools are permeated by a structured values-based work. A large part of the result explains the importance of everyone taking responsibility for student health work. It can be achieved through cross-sectoral work and cooperation between several professions. Having a committed principal and management creates the conditions for successful student health work. This in combination with the needs at the school must determine how much of the student health work is prioritized for prevention and health promotion actions. The student health staff also highlight the necessity and interest in developing more competence in prevention, both individually and for all professionals at the school.

Master of Landscape Architecture / Department of Landscape Architecture/Regional and Community Planning / Hyung Jin Kim / A significant decline of mental and physical health exists within college students today (ACHA, 2014; Gallagher, 2006). Recently, to promote mental health, restorative landscapes have emerged as a trend in healthcare environments by formalizing the healing properties of nature within a designed environment. Humans have been shown to undergo a measurable relief of stress, improved attention, and an improved overall sense of well-being when exposed to a restorative landscape setting. Opportunities exist for university campuses to more advantageously employ the mental health benefits of restorative landscapes. Furthermore, to address physical health, the university campus holds unique opportunities to increase students’ physical activity through promotion of active lifestyles using active modes of transportation. Campus streets, based on their lack of affordances to promote mental and physical health as well as their inherent connectivity to key campus buildings and spaces are investigated as a site for a designed solution. A recent trend of campus street conversions to pedestrian malls is identified and explored as a tool to facilitate creation of a restorative and active campus. The project, based in two fundamental research questions, investigates how campus street design can improve the collective mental health of college students, and how campus street design can promote physical health. Literature review analysis reveals theories and principles of restorative landscape and campus design. The project unites these findings with case study analysis to form a framework to facilitate the design of restorative environments within a university campus. Pragmatic evidence of built environment interventions has been synthesized from literature review and case study analysis into an additional framework to increase physical activity through active transportation. Kansas State University’s campus has been identified as a suitable case for a design proposal. Planning and design decisions at three nested scales are made to illustrate how the frameworks may be applied to reclaim a campus street as an active and restorative “garden street.” In the context of declining mental and physical health among college students, the synthesis of principles related to restorative landscape design and active transportation presents a valuable structure to mitigate declining mental and physical health of students.

Syfte: Syftet med denna studie var att undersöka  i vilken utsträckning rektorer medverkar i elevhälsans systematiska hälsofrämjande arbete i svenska grundskolor. Metod: En deskriptiv, kvantitativ tvärsnittsstudie användes som metod för att besvara studiens syfte. Datainsamlingen genomfördes med hjälp av egenkonstruerade webbenkäter för att samla in data från 200 slumpmässigt utvalda rektorer från grundskolor från hela Sverige. Enkäterna skickades ut till rektorernas e-postadresser tillsammans med ett missivbrev. Av de 200 valda rektorerna deltog 28 % i studien och besvarade enkäten. Resultat: 88 % av rektorerna svarade (n= 51) att elevhälsan aktivt bedriver ett systematiskt hälso-främjande utvecklingsarbete. Majoriteten av rektorerna (n=52) angav att elevhälsan, aktivt bedriver samtliga faser av det systematiska arbetet. Svarsfrekvensen om rektorernas medverkande vid faserna analys, planering, och uppföljning var relativt lika då hälften av rektorerna angav att de medverkade ofta och hälften medverkade varje gång. En skillnad uppstod då 31 % av rektorerna svarade att de sällan medverkade i genomförandefasen.  Den yrkeskategori som nämndes flest gånger som initierar majoriteten av hälsofrämjande insatser var elevhälsoteamen på skolorna som bestod av skolsjuksköteterskor, rektorer, kuratorer, lärare och elever.  51 % av rektorerna angav att det var på rektorns egna initiativ som elevhälsan bedrev ett systematiskt hälsofrämjande utvecklingsarbete på skolan. Fyra rektorer nämnde att elevhälsan var de som utförde hälsofrämjande arbete i skolorna. 80 % av rektorerna ansåg även att deras medverkan var betydelsefull för att elevhälsan ska kunna bedriva ett systematiskt hälsofrämjande arbete i grundskolor. Slutsats: Rektorer initierar, bedriver och medverkar i hälsofrämjande arbete och elevhälsans systematiska hälsofrämjande arbeten inom skolorna. Elevhälsoteam eller elevhälsogruppen som fanns lokalt placerade på skolorna var de som initierade hälsofrämjande insatser. Elevhälsan initierade mycket sällan hälsofrämjande insatser på skolorna. Detta kan ifrågasätta ifall det hälsofrämjande elevhälsoarbete som bedrivs är övergripande eller möter elevernas behov. / Purpose: The purpose of this study was to explore the extent of headmasters’ participation in the systematic health promoting work carried out by the student health service. Method: A quantitative descriptive cross-sectional survey was used to collect the data. The data collection was preformed using a self-designed web survey, through email addresses to collect data from 200 randomly selected headmasters of primary schools from all over Sweden. Of the 200 selected headmasters, 28% (n = 53) attended, and answered the questionnaire.  Result: 88 % of the headmasters reported that the student health service conducted a systematic health promoting work. The majority of the headmasters (n=52) reported that the student health service conducts all of the different stages of the systematic work. The response rate was equal regarding headmaster’s participation, often and every time in the different stages; analyze, planning and follow up. The stage implementation showed a divergence from the other stages when 31 % of the headmasters reported that they rarely participate in this stage. The main profession who initiated health promotion work according to the headmasters was student health teams in the schools, consisting school health nurses, headmasters, teachers, pupils and psychologist. 51 % of the headmasters declared that it was on their initiative that the student health service started the health promotion work. Only four headmaster’s named that the student health service conducted health promotion work in the schools. 80 % of the headmasters felt that their participation was important for the student health service to manage a systematic health promoting work in primary school’s settings. Conclusions: The headmaster’s initiates, conducts and participates in the systematic health promotion work and with the student health service in the primary schools. Student health teams are placed locally at the schools and were the ones who initiated health promotion work. The student health service was very rarely the ones who initiated health promotion work in schools. This may question if the health promoting work witch is conducted in schools are overall or meets the students' health needs.

Tidigare forskning visar att psykisk ohälsa har ökat bland ungdomar och att de mår sämre idag på grund av all stress och krav som ställs på dem i skolan. Den befintliga forskningen berör ungdomars mående men vilka kunskaper som förekommer hos ungdomarna om psykisk hälsa och ohälsa är begränsat. Skolan är en viktig plattform för lärande där elever ska kunna utvecklas och bland annat främja sin psykiska hälsa. Mår eleverna inte bra psykiskt, kan de inte ta till sig kunskapen som erbjuds i skolan och lärandet begränsas. Därför behövs det strategier i skolan där all skolpersonal gemensamt arbetar för att öka den psykiska hälsan hos eleverna. Det är av vikt att elever har kunskap om detta ämnesområde och vet vart de kan vända sig om så behövs.   Syfte: Syftet är att synliggöra lärandet kring psykisk hälsa och ohälsa på gymnasieskolor och undersöka vilka förutsättningar och villkor som finns för hälsofrämjande arbete inom psykisk hälsa ur elevhälsopersonal- och elevperspektiv.   Forskningsfrågor: 1. Vilka kunskaper visar eleverna att de har om psykisk hälsa och ohälsa? 2. Hur uppfattar gymnasieeleverna att psykisk hälsa och ohälsa behandlas utifrån ett lärandeperspektiv i skolan? 3. På vilket sätt arbetar elevhälsopersonalen med hälsofrämjande insatser kring psykisk hälsa i gymnasieskolan? 4. Hur kan arbetet kring psykisk hälsa och ohälsa utvecklas i gymnasieskolan? 5. Stämmer elevernas och elevhälsopersonalens uppfattning om hur psykisk hälsa och ohälsa behandlas i skolan utifrån ett lärandeperspektiv?   Resultat: Gymnasieelevers kunskaper om psykisk hälsa och ohälsa är begränsade. Elever och skolpersonal upplever att lärandet kring psykisk hälsa och ohälsa förekommer lite eller inte alls och är något som båda parterna anser behöver integreras mer i gymnasieskolornas undervisning. Elevhälsopersonalen har som ambition att arbeta förebyggande mot psykisk ohälsa och hälsofrämjande med psykisk hälsa men begränsningar i form av tid- och resursbrist hindrar detta arbete. Både elever och elevhälsopersonal har förslag till utvecklingsmöjligheter genom att till exempel arrangera temadagar och pausaktiviteter i skolan. / Studies show that mental illness has increased among the youth and that they are affected negatively by the stress and high demand in school. The current research touches the mental health of the youth but what knowledge the youth have about mental health and illness is limited. The school is an important place for learning where the students should be able to develop and improve their mental health. In order to be able to absorb the knowledge that is offered in school the students have to feel well. That is why strategies are needed where all school personnel together strive to raise the mental health among the students. It is of utmost importance that the students are aware of the subject and know where to seek guidance if needed.   Purpose: The purpose of this paper is to raise awareness of the learning about mental health and illness in Swedish high schools and analyze different conditions for mental health raising work from both the student's perspective as well as personnel in the student care.   Research questions: 1. What knowledge do the students show regarding mental health and illness? 2. How do the students perceive that mental health and illness is discussed from a learning perspective? 3. In what ways does the student care team try to raise mental health in the school? 4. How can the work that is being done to raise mental health be improved? 5. How well do the students' and student care team's perception of how mental health and illness is handled from a learning perspective match?   Results: High school students' knowledge regarding mental health and illness is limited. Students and school personnel feel that the subject is almost non-existent in the education and both parties agrees that the subject should be more integrated with the lectures. The student care team has as an ambition to work preventive against mental illness as well as to raise mental health but limitations with time and resources prevent this type of action. Both students and the student care team have suggestions on how to develop the work that is being done for mental health, e.g. organize theme days and break activities in school.

In Sweden, all school staffs are obligated to notify suspected of child abuse or neglect. The study's purpose is to investigate how the notification requirements in Social Services Act, chapter 14, section 1, are applied in primary schools and how to best collaborate among the team of professionals responsible for dealing with suspected child neglect or abuse. The study's research question is: How do the various professions at school (apart from the teachers) deal with suspicions of child neglect or abuse? How does this affect the school management and structural management of suspected neglect? How is the report prepared and submitted to the social services? The results are based on in-depth interviews with nine people of different professions within the school health. Collaboration within the pupil health team worked mainly very well, but in one case, it did not work well at all. Many times, however, it was a lack of communication between student health teams and the teachers. The main conclusion of the study is that the importance of a well-functioning student health team is of paramount importance for dealing correctly with suspected child neglect. Firstly, this is best achieved by ensuring the quality training for school heads in matters relating to the notification obligation. Secondly, the student health personnel have to be well known faces among the teachers. Thirdly, it is crucial that horizontal cooperation is initiated by the principal. Fourthly, it also emerged that team members, teachers and other staff within the school has to be continuously updated with the details of the notification requirement.

Bakgrund: Forskning visar att innehåll och metoder skiftar i sex- och samlevnadsundervisning på olika skolor. Elever anser att sex- och samlevnadsundervisningen behöver förbättras. Skolsköterskan arbetar hälsofrämjande med elevers sexuella hälsa. Forskning påvisar att elevhälsans kompetens inte tillvaratas i sexualundervisningen. Genom ökad förståelse för hur skolsköterskor arbetar med sex- och samlevnad kan undervisningen förbättras. Syfte: Syftet med studien var att beskriva hur skolsköterskor arbetar med sex- och samlevnadsundervisning. Metod: Nio skolsköterskor verksamma på högstadiet eller gymnasiet intervjuades via e- post. Datamaterialet analyserades med kvalitativ innebördsanalys. Resultat: I resultatet framkom fem teman; Kunskap och kompetens bidrar till trygghet i sex- och samlevnadsundervisning; Stödjande omgivning och tid för planering skapar möjligheter för skolsköterskans arbete med sex- och samlevnadsundervisning; Skolsköterskans mångfald i upplägg av undervisning anpassas efter elevernas behov av kunskap; Att undervisa nyanlända elever kräver mer förberedelse och Skolsköterskans bemötande och förhållningssätt har betydelse för frågor kring HBTQ. Konklusion: Svårigheter för skolsköterskor i deras arbete med sex- och samlevnadsundervisningen är tidsbristen, vilket medför begränsad undervisning, samtidigt anser de att sex- och samlevnadsundervisningen är av vikt för elever. Upplevelsen av samarbetet inom sex- och samlevnadsundervisning ses som positiv och önskvärd. Skolsköterskors utmaningar är att undervisa elever från andra kulturer, skolsköterskor saknar djupare kunskaper. / Background: Research has shown that it is varies in the methods and the contents in the sexual- and interpersonal relation education. Students consider the sexual education need to improve. School nurses work to promote sexual health. It’s important to understand how school nurses work with education on sexuality- and interpersonal relations. Purpose: Describe how school nurses work with sex and social education. Method: Nine e-mail interviews were conducted. School nurses working with adolescents ages 12-18. Data analyzed with a qualitative meaning. Results: Demonstrated five themes; Knowledge and competence contribute to security with the sexual- and interpersonal relation education; Supportive environment and time for the school nurse´s work on the sexual- and interpersonal relation education; The school nurse´s diversity in teaching structure is adapted to the students’ knowledge; Teaching immigrants and refugees new students requires more preparation; The school nurse´s treatment and approach is important for questions about HBTQ. Conclusion: Difficulty for school nurses in their work is the lack of time, which implies limited teaching. The cooperation of teaching is perceived as positive and desirable. The sexual- and interpersonal relation education is of importance to the students. Challenge of teaching students from other cultures, school nurses lacking in deeper knowledge.