Adjusting and doing the same: school nurses’ descriptions of promoting participation in health visits with children of foreign origin

Abstract

Background School nurses in the school health services are assigned to promote health and participation among children when conducting health visits. Still, for children of foreign origin this promotion of participation might be hampered by challenges related to cultural diversity and language barriers. Therefore, knowledge needs to be developed regarding how these children’s participation can be promoted, to support them in sharing and describing matters important for their health. The aim was to investigate school nurses’ descriptions of promoting participation for children of foreign origin in health visits. Methods A content analysis of 673 Swedish school nurses’ answers to eight open-ended questions regarding promotion of participation for children of foreign origin was conducted. The open-ended questions were part of a larger web-based cross-sectional survey distributed to school nurses in Sweden. Results The results show that school nurses use three main approaches during the health visit: adjusting according to the child’s proficiency in Swedish and/or cultural or national background, adjusting according to the child’s individual needs, and doing the same for all children regardless of their origin. Yet, adjustments according to the child’s proficiency in Swedish and/or cultural or national background were the most common. Conclusions By combining the approaches of adjusting, a child-centered care that contributes to children’s participation in health visits and equity in health could be provided.

In search of factors related to migration affecting children’s health – an analysis of documents guiding health visits within the Swedish school health services

“…School nurses might thereby use their previous knowledge and experience, which is considered important in guiding and assuring good quality in clinical practice [ 48 , 49 ]. In addition, using approaches that adjust to the child’s needs, language proficiency and cultural or national background when encountering children who have migrated or whose parents have migrated is described as common among school nurses [ 50 ]. The possibility of adjustment is especially important for children who have migrated or whose parents have migrated as experiences, living conditions and health differ greatly within this group of children [ 1 ].…”

Reading the signs in health visits—Perspectives of adolescents with migration experiences on encounters with school nurses

“…Similarly, Wahlström et al (2021) have shown that school nurses describe using a combination of approaches when promoting the participation of children of foreign origin in health visits. This combination included adjustments made based on both the children's language proficiency and cultural or national background and the needs and wishes of the individual child as well as doing the same for all children.…”

“…School nurses encountering unaccompanied refugee children describe the encounters as being hampered by their lack of knowledge about trauma‐informed care and intercultural nursing and highlight a need of school nurses having self‐awareness (Musliu et al., 2019 ). In addition, research shows how school nurses adjust their approach in encounters with children with migration experiences (Wahlström et al., 2021 ), but research from the children's perspective is lacking. Overall, research on healthcare encounters from the perspective of children with migration experiences is scarce (Curtis et al., 2018 ; Spencer et al., 2019 ).…”

School health professionals’ understanding of culture: a scoping review protocol

“…Previous studies have been conducted studying preschool teachers', teachers', school nurses', school social workers' and school psychologists' encounters with children, and have highlighted culture as relevant, especially in encounters with children who have migrated [15][16][17][18][19][20] and in relation to race or ethnicity. 21 Yet there is a lack of reviews collating research regarding school health professionals' (ie, school nurses, school social workers, school doctors and school psychologists) understanding of culture.…”