Determinants of the intention of elementary school nurses to adopt a redefined role in health promotion at school

Guylaine Chabot1 , Gaston Godin2 and Marie-Pierre Gagnon3

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Abstract Background The quest for greater efficiency in the provision of primary healthcare services and the implementation of a "health-promoting school" approach encourage the optimal redefinition of the role of school nurses. School nurses are viewed as professionals who might be significant actors in the promotion of youth health. The aim of this study was to identify the determinants of the intention of elementary school nurses to adopt a new healthpromotion role as a strategic option for the health-promoting school. Methods This study was based on an extended version of the theory of planned behaviour (TPB). A total of 251 respondents (response rate of 70%) from 42 school health programs across the Province of Qubec completed a mail survey regarding their intention to adopt the proposed health-promotion role. Multiple hierarchical linear regression analyses were performed to assess the relationship between key independent variables and intention. A discriminant analysis of the beliefs was performed to identify the main targets of action. Results A total of 73% of respondents expressed a positive intention to accept to play the proposed role. The main predictors were perceived behavioural control ( = 0.36), moral norm ( = 0.27), attitude ( = 0.24), and subjective norm ( = 0.21) (ps < .0001), explaining 83% of the variance. The underlying beliefs distinguishing nurses who had a high intention from those who had a low intention referred to their feelings of being valued, their capacity to overcome the nursing shortage, the approval of the school nurses' community and parents of the students, their leadership skills, and their gaining of a better understanding of school needs. Conclusions Results suggest that leadership is a skill that should be addressed to increase the ability of school nurses to assume the proposed role. Findings also indicate that public health administrators need to ensure adequate nurse staffing in the schools in order to increase the proportion of nurses willing to play such a role and avoid burnout among these human resources. http://www.implementationscience.com/content/5/1/93/abstract

School Nurse Teaching Topics

By Karen LoBello, eHow Contributor updated May 08, 2011

Most elementary and secondary schools have a nurse on staff. The job of a school nurse consists of much more than tending to scraped knees and administering medication. Her responsibilities are diverse and include supervising state-mandated screenings, managing student health inventories and advising parents and staff members. A critical part of a school nurse's job is educating students about healthy lifestyle choices. Individual school districts set the nurse's curriculum guidelines; however, there are common threads.

Proper Hygiene

Nurses typically address hygiene early in the school year. Students learn the importance of showering, using deodorant and washing their hands. School nurses advise them to sing a song such as "Row, Row, Row Your Boat" to determine the proper length of time to wash hands. They educate students about the perils of spreading infections.

Nutrition

Nurses teach children about healthy food choices. They acquaint them with the food pyramid and discuss how each food group affects the body. They emphasize the importance of eating a healthy breakfast as fuel for the school day. Students -- especially in middle school and high school -- often have issues with eating disorders. School nurses highlight the dangers of these disorders.

Substance Abuse

Students as young as elementary school have access to alcohol, tobacco and other drugs. School nurses educate children to the medical dangers of these substances. They differentiate "good drugs" and explain that medicines are drugs used to control and remedy various illnesses.

Puberty

Nurses educate upper elementary school and middle school students about the physical changes they will experience. As a rule, boys and girls are separated for these lessons, and parental permission is required. Nurses talk to young girls about menstruation and provide them with starter sets of appropriate products.

Sex and Pregnancy

These lessons take place in middle school and high school. Depending upon the school district's mandate, the school nurse may need parent permission. Students learn about sexually transmitted diseases, methods of birth control and what to expect when pregnant. In-depth instruction usually takes place in health classes.

Stress Management

In today's hectic society, stress affects children and adolescents as well as adults. School nurses teach the students relaxation techniques. They show them correct breathing practices. They explain the role of sleep deprivation in regard to stress management.

Safety

Children, particularly in elementary school, use playground equipment and ride bikes to school. Schools nurse teaches boys and girls methods of staying safe. They explain the medical problems that can arise when students don't follow safety procedures.

Individual Issues

School nurses generally teach lessons to an entire class or group. However, they additionally provide instruction to individuals who have unique situations. They demonstrate the proper use of an inhaler or asthma spacer and the correct procedure for checking insulin levels.

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