Social determinants of health (SDOH), the conditions in which children are born, grow, live, work or attend school, and age, impact child health and contribute to health disparities. School nurses must consider these factors as part of their clinical practice because they significantly and directly influence child well-being. We provide clinical guidance for addressing the SDOH when caring for children with three common health problems (obesity, insufficient sleep, and asthma). Given their unique role as school-based clinical experts, care coordinators, and student advocates, school nurses are well suited to serve as leaders in addressing SDOH.
Asthma is the most common pediatric chronic respiratory illness and has a significant influence on children's health, school attendance, and overall school success. Despite the effect of education and training, gaps remain in understanding school nurses' self-efficacy in asthma care. The purpose of this integrative literature review is to gain a greater understanding of school nurses' self-efficacy in asthma care. Themes and topics in the current school nursing literature regarding self-efficacy in asthma care include the value of continuing education, educational interventions and the use of resources in clinical practice such as the asthma action plan. This review indicates the importance of developing a greater understanding of the unique features of school nursing, the necessary resources, and the external factors that influence practice. Further research to establish a framework to evaluate how a change in practice may support school nurses' self-efficacy and promote positive student health outcomes is needed. Asthma, the school-aged child and the role of the school nurse Asthma is a chronic lung disease that affects approximately six million children in the United States and accounts for nearly 14 million missed school days (Center for Disease Control (CDC), 2017). It may negatively affect academic achievement in school-aged children and lead to poor academic performance and increased dropout rates (Basch, 2011; Fowler, Davenport, & Garg, 1992). It is strongly associated with absenteeism (Cicutto, Gleason, & Szefler, 2014; Hollenbach & Cloutier, 2014), as approximately 36,000 children miss school each day due to asthma symptoms. Low-income students comprise a majority of children with asthma who miss school (Meng, Babey, & Wolstein, 2012). Proper asthma care management of children with asthma is vital for their social (Rhee, McQuillan, Chen, &
The importance of students feeling connected in school cannot be overstated, as this perception is crucial to support their health and well-being. A lack of school connectedness can lead to adverse physical and mental health outcomes, including bully victimization. Numerous factors, including individual, social, and environmental, influence students’ perceived sense of school connectedness. School nurses are well positioned to establish and maintain school connectedness due to their knowledge, accessibility to students, and familiarity with the school environment. This article details the importance of school connectedness and describes the associations between school connectedness, bullying, and mental health. In addition, we offer recommendations geared toward school nurses regarding strengthening school connectedness and promoting a culture of care and inclusivity within school environments, especially salient in the context of the COVID-19 pandemic.
Although adolescent females with asthma are at increased risk for bullying, relationships between bullying at school and electronic bullying and demographics, mental health issues, and substance use have not specifically been studied in these young women. The purpose of this research was to examine such relationships among adolescent females with asthma. Complex sampling software was used to extrapolate frequencies and χ2 analyses to adolescent females with asthma. In this U.S. sample of adolescent females with asthma ( n = 1,634), younger age, mental health issues, and substance use were significantly related to bullying at school and electronic bullying, while race/ethnicity and grade in school were significantly related only to bullying at school. In general, findings are consistent with previous research regarding relationships between bullying and risk factors among all U.S. adolescent females. Guidance by school nurses is needed to create effective supports for victimization reduction in this vulnerable group.
This article offers tangible support for school nurses to understand, recognize, and integrate self-management promotion, anticipatory guidance, and advocacy into practice. The article utilizes the chronic condition of asthma as a case exemplar, but many of the recommendations apply to other aspects of chronic illness self-management promotion. School nurses are in an ideal position to advocate for students and families and to support evidence-based self-management promotion. In the school setting, gaps currently exist regarding best practices for the promotion of self-management and anticipatory guidance for children with chronic illnesses. Future interventions within school settings should focus on multisystem level collaboration with care coordination efforts between providers and social support systems, internal and external, to the school system. These policies and this resource development will ultimately support the promotion of self-management for children with chronic illness in the school environment and maximize health outcomes.
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