Lisbeth Gravdal Kvarme

Associations between general self-efficacy and health-related quality of life among 12-13-year-old school children: a cross-sectional survey

BackgroundWhile research on school childrens health has mainly focused on risk factors and illness, few studies have examined aspects of health promotion. Thus, this study focuses on health promotional factors including general self-efficacy (GSE) and health-related quality of life (HRQOL). GSE refers to a global confidence in coping ability across a wide range of demanding situations, and is related to health. The purpose of this study was to examine associations between GSE and HRQOL, and associations between HRQOL and socio-demographic characteristics. Knowledge of these associations in healthy school children is currently lacking.MethodsDuring 2006 and 2007, 279 school children in the seventh grade across eastern Norway completed a survey assessing their GSE and HRQOL. The children were from schools that had been randomly selected using cluster sampling. T-tests were computed to compare mean subscale values between HRQOL and socio-demographic variables. Single and multiple regression analyses were performed to explore associations among GSE, HRQOL and socio-demographic variables.ResultsRegression analyses showed a significant relationship between increasing degrees of GSE and increasing degrees of HRQOL. In analyses adjusted for socio-demographic variables, boys scored higher than girls on self-esteem. School children from single-parent families had lower scores on HRQOL than those from two-parent families, and children who had relocated within the last five years had lower scores on HRQOL than those who had not relocated.ConclusionThe strong relationship between GSE and HRQOL indicates that GSE might be a resource for increasing the HRQOL for school children.

The effect of a solution-focused approach to improve self-efficacy in socially withdrawn school children: A non-randomized controlled trial

BACKGROUND Socially withdrawn children can improve their social skills through increased self-efficacy. Previous studies have shown that socially withdrawn children are prone to low self-efficacy and problems at school. Therefore, we investigated the effects of an intervention on the self-efficacy of these school children. A solution-focused approach may be an appropriate tool in such interventions. OBJECTIVES To explore the effects of a group intervention based on a solution-focused approach on the self-efficacy of a group of socially withdrawn children and to explore possible sex-based differences. DESIGN This interventional study was a non-randomized controlled trial, with experimental and control groups. SETTING The study was performed within the school health services of 14 primary schools in eastern Norway from 2006 to 2008. PARTICIPANTS School children who were aged 12-13 years and identified as socially withdrawn participated: 156 at baseline, but 6 dropped out before the first measurement and an additional 6 did not complete the second measurement. METHODS The participants completed questionnaires assessing general self-efficacy, social self-efficacy, and assertive self-efficacy at three different times. The first time was at baseline, the second was immediately after the 6-week intervention period, and the third was 3 months after the intervention. RESULTS The general self-efficacy scores increased significantly among girls in the experimental group immediately after the intervention compared with those of the control group. The effect size was 0.60. No significant change was observed among the boys at the same time. From baseline to 3 months after the intervention, the general self-efficacy scores increased for both sexes in the experimental group and also in the control group. The assertive self-efficacy of the boys in the experimental group also increased (effect size, 0.29). CONCLUSION This study demonstrates that socially withdrawn children can benefit from a solution-focused approach group intervention and reach their goals, probably because they learn from each other and share their feelings, experiences, and support. These results indicate that a solution-focused approach may be suitable for school nurses in their work with children with special needs. Solution-focused groups are also recommended for use in school health services.

School children’s experience of being bullied – and how they envisage their dream day

Bullying may have a number of negative health impacts on children. Previous studies have mainly explored negative health consequences related to being bullied. A different approach is to explore how these phenomena are related to the school childs quality of life (QOL). The role of the school nurse is to promote health and prevent sickness, and school nurses therefore need knowledge of what promotes or threatens QOL in children. No previous research has explored how bullied children envisage their dream day or a day with good QOL. There is a need for more qualitative research on how school children experience being bullied and the kind of help they need from their school, and school nurse, to realize their dream day. The aim of this study was to explore how school children experience bullying in their everyday lives, what constitutes their dream day and what kind of help they need. An explorative qualitative design was chosen, and data were collected through focus group interviews. Data collection was conducted throughout 2007 and during the spring of 2008. The sample consisted of 17 school children, aged 12-13 years, in four different groups. An interview guide was used, and the group responses were audio-taped, transcribed and coded into themes. The data were analysed according to Kvales three contexts of interpretation within a phenomenological and hermeneutic framework. Four main themes were identified: teasing and fighting, emotional reactions to being left alone or excluded, the need for friends to achieve the dream day and stopping the bullying immediately. The participants said that being bullied made them feel helpless, lonely and excluded. They wanted the bullying to be recognized, assistance from the school staff to stop the bullying, and to be included by their peers.

High‐frequency use of over‐the‐counter analgesics among adolescents: reflections of an emerging difficult life, a cross‐sectional study

AIMS To examine characteristics of 15- to 16-year-old adolescents who used over-the-counter analgesics daily to weekly (high-frequency users) as compared to those who used less or no analgesics (low-frequency users). Further to analyse the differences in pain experience, lifestyle, self-esteem, school attendance and educational ambition. METHODS An anonymous cross-sectional questionnaire-based study. The questionnaire covered the use of over-the-counter analgesics, pain experience, sociodemographics, lifestyle factors, self-esteem, school absence and future educational plans. The study took place in the 10th grade in six junior high schools in a medium-sized town in Norway. The local sales data for analgesics and antipyretics were close to the national average. We invited 626 adolescents to participate. Of the 367 adolescents (59%) who responded, 51% were girls. Associations between the frequency of use of over-the-counter analgesic and the mentioned variables were analysed using multiple logistic regression. RESULTS In total, 26% (42 boys and 48 girls) used over-the-counter analgesics daily to weekly. These high-frequency users experienced more widespread pain, slept less, had more paid spare-time work, drank more caffeinated drinks, participated more often in binge drinking, had lower self-esteem, less ambitious educational plans and more frequent school absence than did the low-frequency users. These associations remained significant when controlling for gender, cultural background and self-evaluated economic status. CONCLUSION Adolescent, who are high-frequency users of over-the-counter analgesics, suffer more pain and have identifiable characteristics indicative of complex problems. Their ability to handle stress appears to be discordant with the kind of situations to which they are exposed. The wear and tear associated with allostatic mechanisms counteracting stress may heighten their pain experience.

On duty all the time: health and quality of life among immigrant parents caring for a child with complex health needs.

AIMS AND OBJECTIVES To provide knowledge about how immigrant parents of children with complex health needs manage their family lives and how this affects their own health and quality of life. BACKGROUND Caregivers of children with complex health needs have additional risk for general health problems and mental health problems and immigrant parents may be more vulnerable to mental distress and failing health and quality of life. DESIGN This qualitative study used an exploratory design with individual and focus group interviews. Data collection and analysis followed phenomenological hermeneutic guidelines. METHODS Individual and group interviews with 27 parents: 18 mothers and 9 fathers from Pakistan, Poland and Vietnam. RESULTS Immigrant parents of children with complex health needs experience their own health and quality of life challenges. They described the burden of dealing with their childs needs and special care, which affects their sleep and physical and mental health. Single mothers are particularly vulnerable. CONCLUSION Parents reported positive and negative effects of their caregiving experience that may affect their health and quality of life. Mothers were the primary caregivers and reported more health problems than did fathers. The lack of respite care, social networks and support impacted maternal health. Immigrant parents struggle to access resources for their child with complex health needs. RELEVANCE TO CLINICAL PRACTICE Hospital nurses, schools and community health care can play a valuable role in supporting the parents of children with complex health needs. It is important that parents are informed about their rights and receive a coordinator and interdisciplinary group to ensure that their needs are met with assistance and respite care. That maternal health was worse in this sample implies that health care professionals should pay more attention to reducing stress among these caregivers.

“I feel I mean something to someone”: solution-focused brief therapy support groups for bullied schoolchildren

The aim of this study was to investigate how bullied schoolchildren experience solution-focused brief therapy support groups, and to examine how members of the support group experience their participation in the group. An explorative qualitative design, with individual and focus group interviews, was used. The sample consisted of 19 schoolchildren, aged 12–13 years, three of whom were bullied. Six individual interviews were conducted with the bullied children and three focus group interviews were held with the support groups. The bullied children reported that the bullying stopped after they received help from the support group and the improvements remained after three months. Their daily lives at school changed and they felt safer and happier and made friends. Members of the support groups reported that they were doing a meaningful job in helping the victims. It is important that school nurses, educational psychologists and teachers, together with parents, follow up bullied children, to prevent further bullying.

High use of over-the-counter analgesic; possible warnings of reduced quality of life in adolescents - a qualitative study

BackgroundUse of over-the-counter analgesics among adolescents has increased markedly. High consumption of over-the-counter analgesics among adolescents is associated with frequent pain, lower self-esteem, reduced sleep, lower educational ambition, binge drinking, higher caffeine consumption, and part-time employment. Knowledge about life experiences of adolescents who frequently use over-the-counter analgesics may be useful to prevent health problems. The purpose of the study was to increase knowledge about adolescents who suffer from frequent pain and have a high consumption of over-the-counter analgesics.MethodsA qualitative study, employing one-on-one, in-depth interviews using a thematic interview guide. Data were collected in Norway in 2013–2014. Three boys and sixteen girls; aged 14–16 years, who continuously consumed over-the-counter analgesics were recruited from ten high schools in urban and suburban districts. Candidate participants were excluded if they were medically diagnosed with an acute or chronic illness, requiring extended use of over-the-counter analgesics within the last year. The interviews were taped, transcribed and analysed as text according to Kvale’s three contexts of interpretation: self-understanding, common sense and theory.ResultsAll participants disclosed unresolved physical and psychosocial distress characterized as pain. Frequent pain from various body parts made everyday life challenging. Methods of pain self-appraisal and over-the-counter analgesics use often mimicked maternal patterns. Participants reported being raised under unpredictable circumstances that contributed to long lasting family conflicts and peer-group problems. Participants wanted to feel appreciated and to be socially and academically successful. However, pain reduced their ability to manage everyday life, hampered experienced possibilities for success, and made social settings difficult.ConclusionsChildhood experiences influence how adolescents experience pain and use over-the-counter analgesics. Coping with difficult situations or attempting to mask symptoms with over-the-counter analgesics can perpetuate and amplify underlying problems. High consumption of over-the-counter analgesics and frequent pain may be warning signs of adolescents with possible health threatening conditions and reduced quality of life. These adolescent might be in need of support from school nurses and General Practitioners. This study identifies new perspectives that may lead to novel approaches to identify, guide, and support adolescents with frequent pain and high consumption of over-the-counter analgesics.

Long-time sickness absence among parents of pre-school children with cerebral palsy, spina bifida and down syndrome: a longitudinal study

BackgroundTaking care of a child with special needs can be draining and difficult and require a lot of parental time and resources. The present study investigated the long-term sickness absence of parents who have children with spina bifida, cerebral palsy and Down syndrome compared to that of parents without a child with special needs.MethodsThe sample consisted of primiparae women who gave birth between 2001 and 2005 and the fathers of the children (N = 202,593). Data were obtained from the Medical Birth Registry of Norway (MBRN), which is linked to the Central Population Register, education and income registries and Historical Event Database (FD-Trygd) of Statistics Norway (SSB). The linkage data provide longitudinal data, together with annual updates on children and their parents. Statistical analyses were performed using difference-in-difference (DD) study design.ResultsCaring for a child with special needs affected maternal sickness absence, particularly in the first year after the birth. The level of sickness absence of mothers caring for a child with spina bifida and cerebral palsy was greater than that of mothers caring for a child with Down syndrome. In contrast, the sickness absence of fathers caring for a child with special needs was, on average, comparable to that of fathers without a special-needs child in the post-birth period.ConclusionsCaring for a child with special needs affected the long-term sickness absence of mothers but not fathers. The findings indicate that the burden of care in the case of children with special needs falls especially on the mother.

Evidence-based solution-focused care for school-age children experiencing cyberbullying: using the Omaha System to guide and document psychiatric nursing interventions.

Cyberbullying is a global phenomenon. The experiences of bullied children are the same across cultures and languages, and psychiatric nursing interventions are known to be effective. It is critical to widely disseminate effective interventions to identify and address cyberbullying. Therefore, evidence-based care plans addressing cyberbullying at the individual and community levels were developed using the Omaha System, a terminology that is used internationally to guide and document care. This article presents a case study in which an evidence-based intervention was used to help a bullied child arrive at a solution, and demonstrates the use of the Omaha System to document evidence-based cyberbullying interventions with individuals and communities.

Hvordan hjelpe ungdom med depressive symptomer

Tre av ti elever fullfører ikke videregående skole innenfor fem år. I mer enn halvparten av tilfellene skyldes dette psykiske vansker. Psykiske vansker har sammenheng med svakere prestasjoner på skolen. Hensikten med studien var å undersøke helsesøsters rolle i å oppdage og forebygge depressive symptomer hos ungdom tidlig. Nedstemthet påvirker ungdommers evne til å følge opp skolen. Tidlig intervensjon, tverrfaglig samarbeid og «skreddersydd» tilpasning kan bidra til å opprettholde elevers overskudd og motivasjon. FAGUTVIKLING