Barriers to and Facilitators of School Health Care for Students with Chronic Disease as Perceived by Their Parents: A Mixed Systematic Review

Abstract

Understanding parental perspectives through mixed systematic reviews is imperative for developing effective school health care for children and adolescents with chronic disease. A mixed systematic review was conducted to explore barriers to and facilitators of school health care for students with chronic disease as perceived by their parents. Four databases (2010–2020) were searched, following which critical appraisals were conducted to determine the validity of the selected studies using the Mixed Method Appraisal Tool, version 2018. Twenty articles were synthesized using the convergent integrated approach from the Joanna Briggs Institute’s mixed method systematic review methodology. We examined 20 articles regarding parents’ perceived barriers and facilitators and found views across four levels: intrapersonal, interpersonal, institutional, and public and policy. Parents perceived more barriers than facilitators. Barriers on the institutional level were the most frequently reported of all levels of barriers. These results suggest that multi-level school health interventions could be a valuable resource to facilitate effective school guidelines and public policies for students with chronic diseases.

Education‐related needs for children with cystic fibrosis: Perspectives of US pediatric care teams

“…CF center targeted education and enhanced access to standardized materials may help to meet education-related needs with currently available clinic staff and resources. 20 This survey also highlights the need for further targeted resources to assist CF centers in assessing educational needs.…”

“…Lack of clarity about who is responsible for their child's care, the level of education among school staff about their child's condition, and their child's own abilities to provide care independently may contribute to stress around school. 20 Reducing redundant work is essential as many tasks, such as communicating with schools or coaching parents, may be time consuming. Additional staff training may be warranted to ensure staff are aware of these issues.…”

“…For example, all centers indicated needing additional education, training, and materials related to CF school concerns; 10% of centers reported “absolutely needing” standardized materials. CF center targeted education and enhanced access to standardized materials may help to meet education‐related needs with currently available clinic staff and resources 20 …”

“…Staff providing education‐related support should remain cognizant that parents of children with CF may have challenges navigating relationships with schools and care providers, supporting their child's emotional health, and ensuring physical needs are being met while at school. Lack of clarity about who is responsible for their child's care, the level of education among school staff about their child's condition, and their child's own abilities to provide care independently may contribute to stress around school 20 . Reducing redundant work is essential as many tasks, such as communicating with schools or coaching parents, may be time consuming.…”

Factors influencing school nurse service utilization in selected schools of Kathmandu district: a mixed method study

“…8 A systematic Review published in Healthcare in 2020 showed that parental engagement has been a facilitator for school health care services which contrasts with findings from qualitative phase of current study that negligence of parents of some students has been a barrier for better service utilization among students. 9 As this study used non-random sampling and has small sample size i.e. 30, extreme caution must be used when evaluating results of this study.…”