The Journal of School Nursing

This study investigated the effects of school violence prevention education using a chatbot (SVPE-C) on sixth-grade students. By applying a pre and posttest design, the students’ (a) degree of knowledge and (b) attitude toward school violence were examined. In addition, (c) satisfaction with the educational method and (d) awareness about SVPE-C were surveyed only in the experimental group. Of the 135 students, the experimental group (n = 67) received six sessions of SVPE-C with class lectures, whereas the control group (n = 68) received education only through class lectures. Between the two groups, there were significant differences in the degree of knowledge (t = 2.837, p = .005) and attitudes toward school violence (t = 2.98, p = .003). Furthermore, satisfaction with the educational method was significantly higher in the experimental group than in the control group (t = 2.810, p = .006). Therefore, SVPE-C may be effective for elementary school students.

The purpose of this study was to examine the relationship between rurality and challenges to school success: lack of school engagement, school absenteeism, and repeated grade. Cross-sectional data from the 2020 to 2021 National Survey of Children's Health, children ages 6 to 17 (n = 42,089), was used. Bivariate and multivariable logistic regression models were used to examine the associations between residence rurality and each outcome of interest. In bivariate analysis, rural children were more likely to have school absenteeism and repeat a school grade. In our adjusted models, there were no differences between rurality and the three measures of school success. Rural and urban children may be vulnerable to different risk factors for school failure. Findings from this study may be used by school nurses and policymakers as they design and implement programs in rural schools.

Utah implements an abstinence-based approach to sex education. However, research has found that abstinence-based sex education is associated with higher risk-taking behaviors, and youth would like more from their school-based sex education. This study examined what sex education information or programs young adults in Utah would have liked to receive during high school. Participants provided responses to a single open-ended question included in the Utah College Sexual Behavior Survey. The results of a thematic analysis show the emergence of four salient themes, including fundamental knowledge, contraception and sexually transmitted infection prevention, personal safety, consent, and abuse. Findings suggest that participants wanted sex education beyond just abstinence and stressed the importance of inclusive education. Recommendations for school nurses and the important role they play in delivering sex education include receiving education needed to teach sex education and working with school health educators to act as a resource.

After completing treatment, hematologic malignancy survivors face a critical phase of reintegrating into society. This study explored how survivors and their parents gradually returned to daily life, using grounded theory and in-depth interviews with 13 survivors and 16 parents. Data were analyzed revealed that hematologic malignancy survivors and their parents needed time to gradually return to daily life after a life-altering disruption after completing treatment. This process includes three categories: (1) adjusting to achievable learning goals, (2) incrementally expanding social relationships, and (3) strengthening daily life skills. As they return to daily life, both hematologic malignancy survivors and their parents need to adjust their mindset and pace to gradually adapt to the challenges they encounter. In the future, school nurses and oncology nurses can collaborate to design appropriate return-to-school plans to assist these children in their adaptation.

The prevalence of chronic diseases, including allergies, is increasing in schoolchildren, making school nurses essential in managing students’ health. This study aimed to determine the prevalence of chronic conditions in schoolchildren within a network of Spanish educational centers with school nurses. A descriptive cross-sectional study was conducted in May 2023, covering 25,951 students from these centers. Schoolchildren and educational center data were collected from the school health records to document health information and nursing activities. Mean age of students was 10.11 years (50.20% female). A total of 9.45% had chronic disorders, including disorders of the respiratory (4.14%), neurological (2.94%), digestive (2.28%), musculoskeletal (1.25%), and cardiovascular (1.14%) systems. A total of 12.5% had allergies (6.10% food allergies), and 2.81% had food intolerances. Identifying and recording these diseases are key responsibilities of the school nurse, supporting improved care quality and informing policies to ensure school nurse availability and enhanced health management protocols for students.

The relationship between school connectedness and bullying among a cohort of American high school students in the COVID and post-COVID eras has yet to be studied. Data from the 2021 Youth Risk Behavior Survey were analyzed to gain insight into this association. Weighted percentages were calculated, and multivariable logistic regression was conducted. More female, 9th and 10th grade and White participants reported being bullied at school (55.5%, 57.4%, 60.5%, respectively) and electronically (63.2%, 54.4%, 60.2%, respectively) compared to their counterparts. The regression model indicated that sex, grade, race/ethnicity, and school closeness were significantly associated with being bullied. Taking sex, grade, and race/ethnicity into account, the more strongly high schoolers agreed with feelings of school closeness, the less likely they were to report being bullied, both at school and electronically. Findings can be used to inform programs to improve school connectedness and address bullying, aiming to enhance the wellbeing of adolescents.

The COVID-19 pandemic exacerbated demanding workloads and poor working conditions for school nurses, both of which are strong predictors of burnout. This study explores Pennsylvania school nurses’ perspectives on burnout and the value of peer mentorship programs in mitigating burnout. Fourteen (N = 14) school nurses who served as mentors or mentees in a one-year (2023–2024) mentorship program participated in one of two focus groups. Content analysis was performed by two coders using MAXQDA software (Cohen's kappa coefficient = 0.75). Results demonstrate that school nurses feel misunderstood in their role; they additionally experience frequent worry, low availability of substitutes, high student caseloads, stress over managing multiple buildings, and challenges navigating administrative and parental relationships; these factors were identified as sources of burnout. Nurses view peer mentorship positively, valuing the opportunity to share ideas and experiences and benefiting from a supportive organizational culture. Qualitative data supports that peer mentorship may reduce school nurse burnout.

School nurses play a significant role in the coordination of school-entry immunization requirements across the United States. The COVID-19 pandemic changed the school landscape and introduced additional responsibilities to a school nurse's workload. We conducted a cross-sectional survey with n = 110 Pennsylvania school nurses to explore the impact of the COVID-19 pandemic on school-entry immunization compliance management. Qualitative and quantitative data indicated increased difficulty obtaining school-entry immunization data (n = 52) and reduced school-level enforcement of immunization compliance (n = 30). We also observed increases in the percentage of students enrolled with an immunization exemption in Kindergarten, 7th, and 12th grades between the 2019–2020 and 2020–2021 school years. However, few respondents (15%) offered school-located immunization clinics (SLIC) for school-entry-required immunizations. While the benefits of SLICs are documented, the capacity required to execute recommended actions may be limited among school nurses—particularly post-COVID-19 pandemic. School nurses may need additional support to address these gaps.

High school freshman students without documentation of physical examinations and/or vaccination are excluded from school by state-mandated health requirements. With social determinants impacting student medical compliance, school nurses lack evidence-based interventions to reduce medical exclusion. This quality improvement project aims to reduce medical exclusion at the project site by 25% from the previous year by focusing on meeting the freshman physical examination requirement. A three-pronged PDSA cycle evaluates each program intervention [resource guides, phone calls, temporary health clinic] in reducing medical exclusion. After the distribution of two resource guides, 93 personalized phone calls were made to families with missing health documentation. On the first day of school, 28 freshmen remained out of medical compliance. The temporary on-site health clinic provided physical examinations to 13 of the 28 students. Through a systematic approach operationalizing community partnerships, school nurses can reduce barriers to achieving medical compliance and support student agencies in accessing healthcare.