Stress is the main contributing risk factor in the development of chronic diseases such as cardiovascular diseases and diabetes as well as mental illnesses such as depression, anxiety, and somatic symptoms. In particular, job stress may undermine the productivity, morale, relationships, and well-being of employees. Mounting research demonstrate that leisure can contribute to one’s health and well-being by enhancing a stress coping mechanism. The primary purpose of this study is to investigate stress coping and health-promoting behaviors in conjunction with leisure by comparing three types of leisure (active, passive, and social). In addition, the associations between types of leisure motivation and types of leisure, personal attributes influencing types of leisure, and personal attributes moderating the impact of types of leisure motivation on active leisure, were examined. A cross-sectional study was conducted by distributing electronic surveys containing five instruments (Types of Leisure, Leisure Motivation, Coping Self-Efficacy, Perceived Stress, and Health-Promoting Behaviors) along with a demographic questionnaire to 3739 Southern Illinois University (SIU) full-time employees. Self-Determination Theory (SDT) was used to provide the theoretical framework for this study. Perceived stress, coping self-efficacy, and health-promoting behaviors in conjunction with types of leisure were examined. SDT, which mainly posits human psychological well-being induced by fostering intrinsic motivation as opposed to extrinsic motivation, derived research questions with respect to the relationships between types of leisure, types of leisure motivation, and health-promoting behaviors. In addition, the influences of types of leisure motivation on alleviation of perceived stress were examined by comparing the types of leisure (active, passive, and social). For the demographic variables, the influences of personal attributes such as age and BMI on types of leisure were examined. Lastly, whether perceived health status moderates the effect of the type of leisure motivation on active leisure was investigated. Demographic data showed that out of 605 (N = 605) who participated in the survey, 448 participants completed all the survey questions. Statistical analyses which employ descriptive, Pearson correlation, simple/simultaneous regression, and multivariate analysis of variance (MANOVA) were performed to investigate the research questions. The analyses revealed that all three types of leisure (active, passive, and social) were positively correlated with each other, coping self-efficacy, health-promoting behaviors and negatively correlated with perceived stress. Also, coping self-efficacy significantly predicted health-promoting behaviors as well as perceived stress. With respect to the associations between types of leisure motivation and types of leisure, intrinsic leisure motivation toward stimulation had the strongest significant association with active leisure. Intrinsic leisure motivation toward knowledge had the strongest significant association with passive leisure. Extrinsic leisure motivation identified had the strongest significant association with social leisure. With regard to types of leisure motivation influencing perceived stress, intrinsic leisure motivation toward external regulation was the strongest significant predictor for elevated levels of perceived stress even after taking into account intrinsic leisure motivation toward stimulation and extrinsic leisure motivation identified. In addition, extrinsic leisure motivation identified significantly predicted lowered levels of perceived stress. With regard to the association between types of leisure motivation and health-promoting behaviors, extrinsic leisure motivation identified had the strongest significant association with health-promoting behaviors. For the demographic variables in conjunction with types of leisure, females exhibited a significantly higher score on social leisure than males and education levels influenced active leisure, indicating that employees with a master's degree had a significantly higher score on active leisure than those with bachelor's degree or some college/high school diploma. Perceived health status significantly predicted active leisure, indicating that university employees with higher levels of perceived health status were more likely to participate in active leisure than those with lower levels of perceived health status. Lastly, the interaction between perceived health status and intrinsic leisure motivation toward stimulation was significant, indicating that the impact of intrinsic leisure motivation toward stimulation on active leisure differed depending on perceived health status. In other words, the impact of intrinsic leisure motivation toward stimulation was significantly greater in university employees with low perceived health status as compared to those with high perceived health status. This study seems to be meaningful in suggesting that leisure can be a contributing factor for health possibly through reducing perceived stress and enhancing health behaviors. Also, meaningful engagement in leisure may play a role as an effective stress coping strategy, which may lead to long term health-promoting behaviors by fostering intrinsic motivation. Personal attributes such as age, BMI, education level, and perceived health status may impact participating in active leisure. Furthermore, perceived health status may moderate the impact of intrinsic leisure motivation toward stimulation on active leisure. Further research comparing types of leisure impacting stress and health behaviors with more well-refined types of leisure scale is warranted.

Sjuksköterskors erfarenheter av att genomföra hälsosamtal för barn och ungdomar med övervikt/fetma   Abstrakt  Bakgrund: Sjuksköterskor i barnhälsovården (BHV) och elevhälsan har ett viktigt uppdrag med att främja barns hälsa och motverka ohälsa. I Sverige går nästan alla föräldrar på hälsobesöken på BHV, trots detta ökar antalet överviktiga barn varje år. Under de sista 20 åren har antalet barn med övervikt i Sverige procentuellt fördubblats och antalet barn med fetma femdubblats.  Motiv: Idag finns få studier som berör sjuksköterskors erfarenheter av att ta upp övervikt/fetma med vårdnadshavare och deras eventuella motstånd till ämnet. Studien beskriver hur sjuksköterskor går tillväga för att lyfta ämnet kring övervikt även om motstånd finns hos vårdnadshavaren.   Syfte: Syftet med studien var att beskriva sjuksköterskors erfarenheter av att genomföra hälsofrämjande samtal för barn och ungdomar med övervikt/fetma.   Metod: En kvalitativ design med induktiv ansats användes. Enkät med fritextsvar skickades ut till sjuksköterskor inom barnhälsovården/elevhälsan på olika geografiska platser i Sverige. Studien genomfördes våren 2022.   Resultat: Resultatet visar att sjuksköterskor upplever svårigheter att lyfta ämnet i ett hälsofrämjande samtal. Orsakerna är flera, rädsla för att kränka, brist på tid, skapa komplex, samt oförstående eller defensiva föräldrar är några exempel. Det framkom att det saknas nationella riktlinjer för hur sjuksköterskor ska gå tillväga i de fall när vårdnadshavare/elever tackar nej till behandling vid övervikt/fetma. Resultatet visar även på möjligheter i samtalen. Till exempel kan motiverande samtal, bilder, skapa relationer samt att ge tid och att lyssna underlätta och öka chansen till förändring i samtalen. Konklusion: Slutsatsen av resultatet i studien visar att ny forskning och kunskap behöver nå ut i samhället. Om kunskapen ökar i samhället, kan stigmatiseringen minska och ämnet bli lättare att lyfta. Nationella riktlinjer behövs för att bidra till att barn och ungdomar får jämlik vård. Ytterligare slutsats är att sjuksköterskor behöver mer tid för att skapa bra relation med familjerna och stötta dem i det långsiktiga arbetet. / Nurses' experiences of conducting health interviews aimed at overweight / obese children and adolescents   Abstract  Background: Nurses in child health care (BHV) and student health have an important task in promoting children's health and counteracting ill health. In Sweden, almost all parents go on health visits to BHV, despite this, the number of overweight children increases every year. During the last 20 years, the number of overweight children in Sweden has doubled in percentage terms and the number of children with obesity has increased fivefold.  Motive: Today there are few studies that concern nurses' experiences of addressing overweight / obesity with guardians and their possible resistance to the subject. The study describes how nurses go about daring to raise the issue of obesity even if there is resistance among guardians.  Aim: The aim of the study was to describe nurses' experiences of conducting health-promoting conversations for children and adolescents with overweight / obesity.  Method: A qualitative design with an inductive approach was used. A questionnaire with free text answers was sent out to nurses in child health care / student health in different geographical locations in Sweden. The study was conducted in the spring of 2022.  Results: The results show that nurses experience difficulties in raising the issue in a health-promoting conversation. The reasons are several, fear of offending, lack of time, creating complexes, as well as incomprehensible or defensive parents are some examples. It emerged that there are no national guidelines for how nurses should proceed in cases where guardians / students refuse treatment for overweight / obesity. The results also show opportunities in the conversations to facilitate change, such as motivational conversations, pictures, creating relationships and giving time and listening.  Conclusion: The conclusion of the result of the study shows that new research and knowledge need to reach out to society. If knowledge increases in society, the stigma can decrease and the subject can become easier to lift. National guidelines are needed to help children and young people receive equal care. A further conclusion is that nurses need more time to create a good relationship with the families and support them in their long-term work.

Syftet med denna studie är att undersöka hur ideella ridskolor arbetar i Sverige mot en hälsofrämjande arbetsplats då få studier inom hälsofrämjande arbete genomförs i ideella organisationer. Studien fokuserar på ideella ridskolor i Dalarna. Sjukfrånvaron i Sverige 2017 uppgick till 62 miljarder kronor, där psykisk ohälsa var grunden för nästan hälften av beloppet. Tidigare forskning har visats att arbetsmiljön påverkar anställdas psykiska hälsa. Därför är trivsel på arbetsplatsen av stor betydelse på grund av dess roll för att skapa en hälsofrämjande arbetsplats. En hälsofrämjande organisation har positiva effekter på både individen och organisationen och förebygger sjukfrånvaro. Den teoretiska referensramen för studien bygger på tidigare forskning inom ämnet hälsofrämjande arbetsplatser. Studiens empiri är baserad på fem semistrukturerade intervjuer som gjorts via Zoom samt telefon på grund av Covid-19-pandemin. Resultatet visar faktorer som är förutsättningar för ett hälsofrämjande arbete. En av faktorerna är utbildning, dels i hälsofrämjande arbete då resultatet har visats att några respondenter inte är bekanta med begreppet hälsofrämjande arbete och att arbetet tar olika stor plats i de ideella ridskolorna. Även utbildning i ledarskap är av betydelse. En annan faktor är resurser där tid, stöd och ekonomi ingår. Resultatet visar att tiden många gånger inte räcker till för att arbeta hälsofrämjande samt att stödet från styrelsen är bristande många gånger. Dock är även ekonomi ett hinder och därav kan det vara svårt att ta in extra resurser. Resultatet pekar även på delaktighet och samanhållning samt kommunikation som betydelsefulla faktorer i det hälsofrämjande arbetet. En bristande kommunikation har visats vara orsaken till konflikter, kommunikation har även visats vara lösningen på konflikter. För utveckling av det hälsofrämjande arbetet i ideella ridskolor pekar resultatet på ett behov av kunskap inom hälsofrämjande arbete samt även inom ledarskap. Även ett behov av tydliggörande i vad styrelsen har för ansvar i rollen som arbetsgivare visas i resultatet. / The purpose of this study is to investigate how non-profit organizations work in Sweden towards a health-promoting workplace as few studies in health-promoting work are carried out in non-profit organizations. The study focuses on non-profit riding schools in Dalarna. Sick leave in Sweden in 2017 amounted to SEK 62 billion, where mental illness was the basis for almost half of the amount. Previous research has shown that the work environment affects employees' mental health. Therefore, well-being in the workplace is of great importance due to its role in creating a health-promoting workplace. A health-promoting organization has positive effects on both the individual and the organization and prevents sick leave. The theoretical frame of reference for the study is based on previous research in the subject of health-promoting workplaces. The empirical study is based on five semi-structured interviews conducted via Zoom and telephone due to the Covid-19 pandemic. The results show factors that are prerequisites for health promotion work. One of the factors is education, partly in health-promoting work as the results have shown that some respondents are not familiar with the concept of health-promoting work and that work takes different places in the non-profit riding schools. Leadership training is also important. Another factor is resources where time, support and finances are included. The results show that the time is often not enough to work to promote health and that the support from the board is often lacking. However, finances are also an obstacle and therefore it can be difficult to bring in extra resources. The results also point to participation and cohesion as well as communication as important factors in the health promotion work. Lack of communication has been shown to be the cause of conflicts, communication has also been shown to be the solution to conflicts. For the development of health-promoting work in non-profit riding schools, the results point to a need for knowledge in health-promoting work and also in leadership. The need also clarifies the Board's responsibility for its role as an employer.

Bakgrund Fatigue, eller kronisk trötthet, är ett vanligt förekommande fenomen bland cancersjuka, och såväl prevalensen som svårighetsgraden av fenomenet tenderar att tillta i samband med cytostatikabehandling. Fatigue har beskrivits i litteraturen som en av de allvarligaste biverkningarna av cancersjukdomar och dess behandlingsmetoder, i den mening att fatigue orsakar svårt lidande och kraftigt reducerar livskvaliteten. Fatigue är också ett svårbehandlat fenomen med en komplex bakgrundsbild, och det saknas god evidens för farmakologiska behandlingsmetoder. Syfte Syftet var att beskriva cancerpatienters erfarenheter av hälsofrämjande interventioner som syftade till att lindra fatigue-relaterat lidande under och efter cytostatikabehandling. Metod Detta var en icke-systematisk litteraturöversikt som totalt granskade 15 vetenskapliga publikationer inom området. Publikationerna hämtades in från databaserna PubMed och CINAHL, efter noggrant planerade sökningar. De sökträffar som erhölls genomgick en relevans- och kvalitetsbedömning, varpå de 15 artiklarna som slutligen inkluderades i resultatet genomgick en integrerad dataanalys. Datan samlades in från cytostatikabehandlade cancerpatienter och all data gällande fatigue var självskattad och utgick på så sätt från patientperspektivet. Resultat Denna litteraturöversikt sammanställde evidens om de hälsofrämjande effekterna av ett antal olika interventioner för att lindra fatigue. Interventionerna kategoriserades in i två huvudkategorier och fyra underkategorier, och de påvisade effekterna för varje typ av intervention diskuterades och sammanställdes i samband med dataanalysen. Exempel på typer av interventioner som togs upp i denna litteraturöversikt är instruerande interventioner och bevakade interventioner. Slutsats Fysisk aktivitet i kombination med avslappningstekniker visade sig ha störst effekt mot cancerrelaterad fatigue. En patientutbildande intervention påvisade en icke-signifikant förbättring av fatigue, medan resterande interventioner påvisade åtminstone en signifikant förbättring av fatigue i något avseende. Detta tyder på att interventioner som kräver ett mer aktivt deltagande har en större effekt på fatigue, jämfört med rent instruerande interventioner. Sjuksköterskan spelar en stödjande och vägledande roll vid omvårdnaden av fatigue, och kunskap om hälsofrämjande interventioner är en grundläggande förutsättning för att lindra det lidande som uppstår ur denna trötthetsproblematik. Otillräcklig eller utebliven vård kan leda till vårdlidande och ökat sjukdomslidande hos patienten, vilket kan beskrivas som en kränkning av patientens värdighet. / Background Chronic fatigue is a commonly occurring phenomena among cancer patients, and cancer-related fatigue has a tendency to increase in both prevalence and severity during chemotherapy. Fatigue has been described in the scientific literature as one of the most serious side effect occurring as a result of cancer or the treatment of cancer, in the sense that it is a source of great suffering and a gravely reduced quality of life. In addition, fatigue is a poorly understood phenomena and is considered difficult to treat. There exists no good evidence for effective pharmacological treatment options. Aim The aim of this study was to describe cancer patients’ experiences of different health-promoting interventions during chemotherapy, which were intended to reduce fatigue-related suffering in both the short-term as well as the long-term. Method This was a non-systematic literature review which analyzed 15 different scientific articles in order to achieve the stated aim. The articles were retrieved after entering meticulously planned search terms into the CINAHL and PubMed databases. The search results that were found went through an assessment of relevance and quality, and 15 of the search results were included for analysis. The data in these studies were collected from patients undergoing chemotherapy for a diagnosis of cancer, and all data pertaining to fatigue was self-evaluated and was thusly based entirely on the perspective and experiences of the patients. Results This literature review compiled evidence about the health-promoting effects of a variety of different interventions in regard to the treatment of fatigue. The interventions were categorized into two main categories and four subcategories, and the evidence for every type of intervention were discussed and summarized in conjunction with the data analysis. For example, this literature review distinguished between informative and supervised interventions and discussed the evidence for those types of interventions separately.  Conclusions Physical activity in combination with relaxation techniques was shown to have the largest health-promoting effect against fatigue. One study, that exclusively studied the effects of patient education sessions, showed a non-significant reduction of fatigue, which stands in contrast to all the other interventions analyzed in this study, which showed a significant reduction of fatigue in at least one regard. This implies that more active interventions have a greater effect on fatigue, as opposed to purely informative interventions. The role of the nurse in the treatment of fatigue is one of guidance and support, and knowledge of these evidence-based and health-promoting interventions is an absolute necessity in order for the nurse to be able to provide good nursing care and relieve suffering in these patients. Inadequate care or lack of care can contribute to an increase of suffering in these patients, which should be seen as a violation of the patients’ dignity.

Philosophiae Doctor - PhD / Substance abuse among adolescents is a Public Health concern globally with approximately 25 million adolescents (aged 13-15 years) who smoke tobacco, one in every ten girls and one in every five boys. In low- and middle-income countries, 14 % of girls and 18% of boys (13-15years old) are engaged in alcohol use. The Global Status Report on Alcohol and Health of 2018, reports that among the 15- to 19-year-olds, greater than a quarter were current alcohol drinkers. Cannabis (marijuana/dagga) is highly used globally with approximately 3.8% between 15 and 64 years, about 188 million people used it once or more times in 2017. The most commonly abused substances are alcohol, tobacco, and cannabis (marijuana/dagga). In South Africa, most adolescents are found in schools and the average age of drug experimentation is 12 years with early onset of use at about ten years of age.

Hypertension is a global public health issue affecting many people in the United States. African American women remain the highest in percentage by race and ethnicity for developing hypertension with poor risk awareness. Hypertension has costly implications for the health care system. Through lifestyle modifications in the form of a nutrition plan called Dietary Approach to Stop Hypertension and increased physical activity, hypertension could be prevented. Among African Americans, the incidence of hypertension increases in their late thirties. The purpose of the project was to develop a toolkit of resources for African American women between the ages of 20 to 45 years as a reference guide to reduce the risk of developing hypertension through lifestyle modifications. The clinical question for the project examined the effectiveness of a lifestyle modification toolkit as an evidence-based strategy to prevent and manage hypertension among African America women. Pender's health promotion model guided the planning and development of the project. The readability of the toolkit was at a 5th grade level for easy comprehension. A 5-item survey was given to 2 content experts and 3 members from the target population to evaluate the toolkit. Data were analyzed using descriptive statistics to obtain a content validity index score of 1.00. Findings suggested universal agreement on the content of the toolkit which was developed as a resource tool to provide culturally-based educational materials from scholarly literature. This toolkit will promote positive social change by improving the outcomes of African American women with hypertension.

Bakgrund: Förekomsten av övervikt och fetma hos barn och unga är hög och fortsätter att öka. Övervikt eller fetma kan ge negativa konsekvenser på både fysisk och psykisk hälsa. Tidig upptäckt är viktig för att förebygga sjukdom och främja hälsa. Skolsköterskan kan i sitt hälsofrämjande arbete stötta och motivera barn och unga till hälsosamma levnadsvanor. Syfte: Att belysa skolsköterskans arbete med elever i grundskolan som har övervikt eller fetma. Metod: Kvalitativ metod med induktiv ansats valdes. Semistrukturerade intervjuer genomfördes med skolsköterskor och data analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i fyra kategorier: Möjlighet att påverka till förändring, Skolsköterskans stöd i arbetet, Hindrande påverkan och Samverkan som underlättar. Till sist framträdde ett övergripande tema: Ett komplext arbete att utföra. Konklusion: Skolsköterskor upplever arbetet med övervikt och fetma som komplext och utmanande på flera sätt. Möjligheten att arbeta hälsofrämjande påverkas av vilka förutsättningar skolsköterskan har på arbetsplatsen, skolsköterskans egen kompetens, samverkan med vårdnadshavare och av stigmatisering i samhället. Arbetet syftar till att främja elevers hälsa och vara ett stöd mot en hälsosam livsstil. Utmaningar i arbetet kan handla om att ges utrymme i tjänsteutövningen för att kunna fokusera på arbetet med övervikt och fetma. / Background: The presence of overweight and obesity in children and young people is high and continues to increase. Overweight or obesity can have negative consequences on both physical and mental health. Early finding is important to prevent disease and promote health. In her health promotion work, the school nurse can support and motivate children and young people to adopt healthy lifestyles.  Aim: The purpose of the study was to the shed light on the school nurse's work with students in elementary school who have overweight or obesity. Method: Qualitative method with inductive approach was chosen. Semi-structured interviews were conducted with school nurses and data were analyzed with qualitative content analysis. Results: The analysis resulted in four categories: Opportunity to influence change, The school nurse's support in the work, Obstructive influence, Collaboration that facilitates. In the end, an overarching theme emerged: A complex work to do.  Conclusion: School nurses experience the work with overweight and obesity as complex and challenging in several ways. The possibility to work with health promotion is affected by the conditions the school nurse has in the workplace, the school nurse's own competence, cooperation with caregiver and stigmatization in society. The work aims to promote students' health and be a support towards a healthy lifestyle. Challenges at work can be about being given space in the performance of the duties in order to be able to focus on overweight and obesity.

Introduktion: Forskning visar på att regelbunden fysisk aktivitet bland barn och unga har flera positiva effekter på hälsan, både fysiskt och psykiskt. Dock är det allt för få som når upp till rekommendationen om minst en timmes fysisk aktivitet per dag. Barn och unga tillbringar en betydande del av sin tid i skolan och skolan kan därmed vara en bra plats för att främja fysisk aktivitet.  Syfte: Syftet med studien var att belysa skolsköterskors erfarenhet av att arbeta med att främja fysisk aktivitet hos elever.  Metod: Studien genomfördes som en systematisk litteraturöversikt med en kvalitativ design. Som arbetsprocess användes Polit och Becks niostegsmodell.  Resultat: I studiens resultat framkom tre teman, använder olika metoder för att främja fysisk aktivitet, olika hinder i arbetet för att främja fysisk aktivitet och samarbete krävs för att främja fysisk aktivitet. Det framkom nio undertema. Slutsats: Skolsköterskor använde sig av olika metoder för att främja fysisk aktivitet såsom hälsosamtal, frågeformulär och aktiviteter efter skolan. Skolsköterskor kunde uppleva svårigheter och hinder såsom tidsbrist, avsaknad av kunskap och att deras arbete inte prioriterades av övrig skolpersonal. Resultatet visade också på att samarbete med övrig skolpersonal och föräldrar behövs. / Introduction: Research shows that regular physical activity among children and adolescents has several positive effects on health, both physical and mental. However, too few meet the recommendation of at least one hour of physical activity per day. Children and adolescents spend a significant part of their time in school and the school can therefore be a good place to promote physical activity.  Purpose: The purpose of the study was to highlight school nurses' experience of working to promote physical activity among students.  Method: The study was conducted as a systematic literature review with a qualitative design. Polit and Beck's nine-step model was used as a working process.  Results: In the results, three themes emerged, using different methods to promote physical activity, different difficulties in the work to promote physical activity and cooperation is required to promote physical activity. Nine sub-themes emerged.  Conclusion: School nurses used different methods to promote physical activity such as health conversations, questionnaires and after school activities. School nurses could experience difficulties and barriers such as lack of time, lack of knowledge and that their work was not prioritized by school staff. The results also showed that collaboration with school staff and parents was needed.

Introduktion: Forskning visar på att regelbunden fysisk aktivitet bland barn och unga har flera positiva effekter på hälsan, både fysiskt och psykiskt. Dock är det allt för få som når upp till rekommendationen om minst en timmes fysisk aktivitet per dag. Barn och unga tillbringar en betydande del av sin tid i skolan och skolan kan därmed vara en bra plats för att främja fysisk aktivitet. Syfte: Syftet med studien var att belysa skolsköterskors erfarenhet av att arbeta med att främja fysisk aktivitet hos elever. Metod: Studien genomfördes som en systematisk litteraturöversikt med en kvalitativ design. Som arbetsprocess användes Polit och Becks niostegsmodell. Resultat: I studiens resultat framkom tre teman, använder olika metoder för att främja fysisk aktivitet, olika hinder i arbetet för att främja fysisk aktivitet och samarbete krävs för att främja fysisk aktivitet. Det framkom nio undertema. Slutsats: Skolsköterskor använde sig av olika metoder för att främja fysisk aktivitet såsom hälsosamtal, frågeformulär och aktiviteter efter skolan. Skolsköterskor kunde uppleva svårigheter och hinder såsom tidsbrist, avsaknad av kunskap och att deras arbete inte prioriterades av övrig skolpersonal. Resultatet visade också på att samarbete med övrig skolpersonal och föräldrar behövs. / Introduction: Research shows that regular physical activity among children and adolescents has several positive effects on health, both physical and mental. However, too few meet the recommendation of at least one hour of physical activity per day. Children and adolescents spend a significant part of their time in school and the school can therefore be a good place to promote physical activity. Purpose: The purpose of the study was to highlight school nurses' experience of working to promote physical activity among students. Method: The study was conducted as a systematic literature review with a qualitative design. Polit and Beck's nine-step model was used as a working process. Results: In the results, three themes emerged, using different methods to promote physical activity, different difficulties in the work to promote physical activity and cooperation is required to promote physical activity. Nine sub-themes emerged. Conclusion: School nurses used different methods to promote physical activity such as health conversations, questionnaires and after school activities. School nurses could experience difficulties and barriers such as lack of time, lack of knowledge and that their work was not prioritized by school staff. The results also showed that collaboration with school staff and parents was needed.

Bakgrund: Alla barn och ungdomar har rätt till en god sexuell hälsa och utveckling. Med pornografins ökade tillgänglighet finns risker för deras fysiska och psykiska hälsa. Genom en insyn och förståelse för elevernas livsvärld har skolsköterskan i sitt hälsofrämjande uppdrag stora möjligheter att påverka elevers kunskaper kring pornografi. I och med införandet av den nya läroplanen kan skolsköterskans insatser inom ämnet stärkas ytterligare.  Syfte: Att beskriva skolsköterskors uppfattningar om det hälsofrämjande arbetet kring elevers bruk av pornografi. Metod: En fenomenografisk metod med induktiv ansats valdes. Tolv semistrukturerade intervjuer med skolsköterskor genomfördes och analyserades enligt fenomenografi.  Resultat: Analysen mynnade ut i fem beskrivningskategorier som rangordnades i ett utfallsrum vilka beskriver skolsköterskornas uppfattningar: Organisatoriska möjligheter och hinder; Internt samarbete utifrån nya läroplanen; Externt samarbete utifrån nya läroplanen; Hälsobesökets möjligheter och hinder samt Pornografins ökade tillgänglighet och påverkan.  Konklusion: Pornografins ökade tillgänglighet påverkar eleverna på många plan, såsom språkbruk, sociala interaktioner och bilden av sex och relationer. Skolans övergripande hälsofrämjande insatser är inte anpassade efter den snabba utvecklingen. Hälsobesöket behöver dimensioneras utifrån nuvarande behov. Faktorer som påverkar arbetet är tid, kompetens och samarbete. Intresset finns hos elever att samtala om ämnet, men vuxna behöver verktyg för att kunna bemöta detta. / Background: Children have the right to a good sexual health. With the increased availability of pornography their physical and mental health are at risk. Through an understanding of the students' life-world the school nurse has opportunities to influence students' knowledge about pornography. The subject can be further strengthened through the new curriculum. Aim: To describe school nurses' perceptions of the health promoting work regardingstudents' use of pornography. Method: A phenomenographic method with an inductive approach. Twelve semi-structured interviews with school nurses were conducted and analyzed. Result: The analysis resulted in five description categories: Organizational opportunities and obstacles; Internal collaboration based on the new curriculum; External collaboration based on the new curriculum; The possibilities and obstacles of the health visit and The increased accessibility and impact of pornography. Conclusion: The increased availability of pornography affects students on many levels, such as language use, social interactions and the image of sex. The school's overall health promoting efforts are not adapted to the rapid development. The health visit needs to be dimensioned based on current needs. Factors that affect the work are time, competence and cooperation. Students show interest in the subject, but adults need tools to be able to respond to them.