Hybrid Concept Analysis of Self-Management Support: School Nurses Supporting Students with Psychogenic Nonepileptic Seizures

Abstract

Self-management support has been identified as an effective nursing intervention for improving outcomes for people with chronic conditions, yet this concept lacks a clear definition. Furthermore, the concept has not been used in school nursing literature despite the clear connection between school nursing practice and tenets of self-management support. Additionally, the concept has not been explored in the context of difficult-to-manage mental health concerns, such as psychogenic nonepileptic seizures. A conversion disorder in which seizure events in the absence of abnormal brainwave activity result from stress, psychogenic nonepileptic seizures affect the quality of life and school experience for students experiencing them and could be addressed through self-management support. This hybrid concept analysis included a review of extant literature and semi-structured interviews with school nurses to ascertain a definition of self-management support in the context of school nursing using care of students with psychogenic nonepileptic seizures as an exemplar.

Adolescents' qualitative expressions of functional seizure illness representation

“…In addition to approaching adolescent functional seizure care from a healthcare perspective, this study, and other related studies (Tanner, von Gaudecker, Buelow, & Miller, 2022; Tanner et al, 2023) demonstrate the need for developmentally appropriate care with a heavy emphasis on the school environment and academic context. Because adolescent functional seizures often occur at school, it is imperative that all healthcare providers treating functional seizures include adolescents' school nurses and other school personnel in developing and implementing a plan of care.…”

“…However, during an inductive conceptual analysis of findings, the theme of illness representation was identified. The full details of the study methods used for this qualitative study and initial findings from the data set (including overall experience attending school with functional seizures and self‐management experiences) have been published in prior publications (Tanner, von Gaudecker, Buelow, & Miller, 2022; Tanner et al, 2023). We then conducted a separate content analysis using expressions within the theme of illness representation as described below.…”

“…Roughly 59.5/100,000 adolescents experience this stress‐induced condition (Villagrán et al, 2021) that occurs in the absence of abnormal brainwave activity. Self‐management for functional seizures includes such activities as seeking a safe space or position before a seizure beginning, practicing coping strategies (mindfulness, breathing techniques, or biofeedback), and monitoring progress after instituting such activities and strategies (Tanner et al, 2023). Self‐management of functional seizures is especially difficult in the school setting, where adolescents have reported experiencing stress, bullying, accusations of faking seizures, and stigma (Tanner, von Gaudecker, Buelow, & Miller, 2022).…”

The Skill of Self-Management for School Principals in Digital Education

“…In order for the school's self-management to be more effective in the midst of the massive knowledge and technological explosion, it must be in line with contemporary administrative trends represented by investing modern technologies in enhancing administrative work, communicating with team members, exchanging experiences, receiving feedback, documenting data, classifying and preserving it, and applying quality standards (Parandekar, 2014, Tanner et al, 2022. Abadzi (2013) identified the obstacles that low-income countries face in activating school self-management.…”