Audhild Løhre

School wellbeing among children in grades 1-10

BackgroundDeterminants of childrens school wellbeing have not been extensively studied. In this cross-sectional study of school children we assessed how factors assumed to promote wellbeing and factors assumed to adversely influence wellbeing were associated with self-reported wellbeing in school.MethodsChildren from five schools, 230 boys and 189 girls in grades 1-10, responded to the same set of questions. We used proportional odds logistic regression to assess the associations of promoting and restraining factors with school wellbeing.ResultsIn a multivariable analysis, degree of school wellbeing in boys was strongly and positively related to enjoying school work (odds ratio, 3.84, 95% CI 2.38 to 6.22) and receiving necessary help (odds ratio, 3.55, 95% CI 2.17 to 5.80) from teachers. In girls, being bothered during lessons was strongly and negatively associated with school wellbeing (odds ratio, 0.43, 95% CI 0.22 to 0.85).ConclusionsDifferent factors may determine school wellbeing in boys and girls, but for both genders, factors relevant for lessons may be more important than factors related to recess. Especially in boys, the student-teacher relationship may be of particular importance.

The impact of loneliness on self-rated health symptoms among victimized school children

BackgroundLoneliness is associated with peer victimization, and the two adverse experiences are both related to ill health in childhood and adolescence. There is, however, a lack of knowledge on the importance of loneliness among victimized children. Therefore, possible modifying effects of loneliness on victimized school children’s self-rated health were assessed.MethodsA population based cross-section study included 419 children in grades 1–10 from five schools. The prevalence of loneliness and victimization across grades was analyzed by linear test for trend, and associations of the adverse experiences with four health symptoms (sadness, anxiety, stomach ache, and headache) were estimated by logistic regression.ResultsIn crude regression analysis, both victimization and loneliness showed positive associations with all the four health symptoms. However, in multivariable analysis, the associations of victimization with health symptoms were fully attenuated except for headache. In contrast, loneliness retained about the same strength of associations in the multivariable analysis as in the crude analysis. More detailed analyses demonstrated that children who reported both victimization and loneliness had three to seven times higher prevalence of health symptoms compared to children who reported neither victimization nor loneliness (the reference group). Rather surprisingly, victimized children who reported no loneliness did not have any higher prevalence of health symptoms than the reference group, whereas lonely children without experiences of victimization had almost the same prevalence of health symptoms (except for stomach ache) as children who were both victimized and lonely.ConclusionsAdverse effects of loneliness need to be highlighted, and for victimized children, experiences of loneliness may be an especially harsh risk factor related to ill health.

Factors associated with internalizing or somatic symptoms in a cross-sectional study of school children in grades 1-10

BackgroundSchool related factors that may contribute to childrens subjective health have not been extensively studied. We assessed whether factors assumed to promote health and factors assumed to have adverse effects were associated with self-reported internalizing or somatic symptoms.MethodsIn a cross-sectional study, 230 boys and 189 girls in grades 1-10 from five schools responded to the same set of questions. Proportional odds logistic regression was used to assess associations of school related factors with the prevalence of sadness, anxiety, stomach ache, and headache.ResultsIn multivariable analyses, perceived loneliness showed strong and positive associations with sadness (odds ratio, 1.94, 95% CI 1.42 to 2.64), anxiety (odds ratio, 1.78, 95% CI 1.31 to 2.42), and headache (odds ratio, 1.47, 95% CI 1.10 to 1.96), with consistently stronger associations for girls than boys. Among assumed health promoting factors, receiving necessary help from teachers was associated with lower prevalence of stomach ache in girls (odds ratio, 0.51, 95% CI 0.30 to 0.87).ConclusionsThese findings suggest that perceived loneliness may be strongly related to both internalizing and somatic symptoms among school children, and for girls, the associations of loneliness appear to be particularly strong.

Gender Differences in Predictors of School Wellbeing

Objective: Although welfare in childhood and adolescence is of great public concern, individual or other resources have not been extensively studied in relation to wellbeing in schools. In this longitudinal study, factors that may promote girls’ or boys’ school wellbeing as well as factors that may have an adverse effect were assessed. Methods: Altogether, 149 boys and 119 girls in public primary and secondary schools completed questionnaires twice, two years apart (T1 and T2). The impact of potentially promoting and potentially adverse factors at T1 were investigated in relation to school wellbeing at T2 using logistic regression. Results: No gender differences were revealed in self-rated school wellbeing whereas factors associated with school wellbeing showed substantial gender differences. Boys who experienced necessary academic help from teachers were 2–3 times more likely to report good school wellbeing compared to other boys. For girls, perceived loneliness at school demonstrated a strong and negative association with school wellbeing both in crude and multivariable analyses. Conclusions: There may be gender differences in predictors of students’ school wellbeing that health-promoting strategies need to take into account. Academic support from teachers, an example of resources in close surroundings, appears to be of great importance for boys. Among girls, perceived loneliness may indicate reduced school wellbeing. Later research must aim at identifying resources that prevent loneliness in school or ease the burdens of lonely students.

A two-year perspective: who may ease the burden of girls' loneliness in school?

BackgroundLoneliness is negatively related to good health and wellbeing, especially among girls. There is little research, however, on factors that may ease the burdens of loneliness in the school setting. Thus, we explored the relationship between girls’ loneliness and later school wellbeing adjusted for other adversities. Furthermore, we assessed the significance of having someone whom the girl trusted by investigating possible modifying influences on the addressed association.MethodsAltogether, 119 girls in grades 1–8 provided baseline data and answered the same set of questions two years later. Logistic regression models including perceived academic problems, victimisation by bullying, loneliness and trusted others were tested with bad versus good school wellbeing two years later as outcome using SPSS.ResultsIn the multivariable analysis of loneliness, academic problems, and victimisation, loneliness was the only variable showing a strong and negative contribution to later school wellbeing. Next, demonstrated in separate models; the inclusion of having a trusted class advisor fully attenuated the association of loneliness with later school wellbeing. In contrast, other trusted teachers, trusted parents, or trusted students did not affect the association.ConclusionsLoneliness in girls strongly predicted school wellbeing two years later. However, having a class advisor whom the girl trusted to contact in hurtful situations clearly reduced the burden of loneliness. This finding highlights the clinical importance of stability, long-lasting relations, and trust that main teachers may represent for lonely girls.

Characteristics of Female and Male Visitors to Practitioners of Acupuncture in the HUNT3 Study

Characteristics of female and male visitors to practitioners of acupuncture were investigated in a large cross-sectional adult population in Central Norway. A total population health survey, HUNT3, conducted in 2008 with 50,827 respondents provided the data. Demographic variables, lifestyle, health, and use of conventional medicine were analyzed using multivariable logistic regression models. The one year prevalence of visiting a practitioner of acupuncture was 5.7% for females and 2.2% for males. Visitors of both genders were five times more likely to have had somatic complaints in the preceding year and were 2-3 times more likely to report poor global health than female or male non-visitors. Also, visitors of both genders were more likely to do hard physical activities every week, and they were less likely to live alone or be daily smokers. Further, female visitors were characterized by having higher education and were more likely to have a paid job than other females. Corresponding differences were not seen among males. Age showed limited associations with being a visitor, and for females only. Valid for both genders, our findings draw a picture of visitors to acupuncture treatment as persons who actively contribute to promoting their health through lifestyle choices of physical activity and non-smoking while simultaneously having worse global health and higher burdens of somatic complaints than other adults. In contrast to males, it is suggested that females may be more dependent on personal income, as indicated by higher education and being in a paid job, in choosing acupuncture treatment in addition to conventional medicine.

Disease-specific clinical pathways – are they feasible in primary care? A mixed-methods study

Abstract Objective: To explore the feasibility of disease-specific clinical pathways when used in primary care. Design: A mixed-method sequential exploratory design was used. First, merging and exploring quality interview data across two cases of collaboration between the specialist care and primary care on the introduction of clinical pathways for four selected chronic diseases. Secondly, using quantitative data covering a population of 214,700 to validate and test hypothesis derived from the qualitative findings. Setting: Primary care and specialist care collaborating to manage care coordination. Results: Primary-care representatives expressed that their patients often have complex health and social needs that clinical pathways guidelines seldom consider. The representatives experienced that COPD, heart failure, stroke and hip fracture, frequently seen in hospitals, appear in low numbers in primary care. The quantitative study confirmed the extensive complexity among home healthcare nursing patients and demonstrated that, for each of the four selected diagnoses, a homecare nurse on average is responsible for preparing reception of the patient at home after discharge from hospital, less often than every other year. Conclusions: The feasibility of disease-specific pathways in primary care is limited, both from a clinical and organisational perspective, for patients with complex needs. The low prevalence in primary care of patients with important chronic conditions, needing coordinated care after hospital discharge, constricts transferring tasks from specialist care. Generic clinical pathways are likely to be more feasible and efficient for patients in this setting. Key points Clinical pathways in hospitals apply to single-disease guidelines, while more than 90% of the patients discharged to community health care for follow-up have multimorbidity. Primary care has to manage the health care of the patient holistically, with all his or her complex needs. Patients most frequently admitted to hospitals, i.e. patients with COPD, heart failure, stroke and hip fracture are infrequent in primary care and represent a minority among patients in need of coordinated community health care. In primary care, the low rate of receiving patients discharged from hospitals of major chronic diseases hampers maintenance of required specific skills, thus constricting the transfer of tasks to primary care. Generic clinical pathways are suggested to be more feasible than disease-specific pathways for most patients with complex needs.

The Expectancy-Value Questionnaire in Physical Education: A Validation Study Among Norwegian Adolescents

ABSTRACT One of the main aims of the school subject physical education (PE) is to promote a lifelong healthy lifestyle. The expectancy-value theory represents an essential theoretical perspective to examine and understand adolescents’ learning and motivation in PE. Based on this theory, the Expectancy-Value Questionnaire (EVQ) measures students’ expectancy-related beliefs and perceived task values related to a subject like PE. The aim of the present study was to examine the dimensionality, reliability, and construct validity of the Norwegian version of the EVQ among adolescents in PE. In total, 338 students from six schools completed the EVQ in their PE classes during the spring of 2016. Explorative and confirmatory factor analyses were conducted, suggesting the four-dimensional construct of the EVQ to be superior the two-factor-model. The EVQ measurement model of adolescents’ expectancy-related believes and subjective task values in PE demonstrated satisfying reliability and construct validity.