Public health nurses' perceptions of interprofessional collaboration related to adolescents' mental health problems in secondary schools: A phenomenographic study

Abstract

Aims and objectivesTo describe the variation in public health nurses' perceptions of interprofessional collaboration related to adolescents' mental health problems in secondary schools in Norway.BackgroundMental health problems among adolescents account for a large portion of the global burden of disease and affect 10%–20% of adolescents worldwide. Public health nurses in school health services play an important role in disease prevention and promotion of physical and mental health. In order to serve adolescents with regard to mental health problems, public health nurses are dependent on collaboration with other professionals in schools.DesignQualitative interviews were conducted with 18 public health nurses working in the school health services.MethodA phenomenographic approach was used for interviewing and for analysing the qualitative interviews. This study is presented in line with COREQ's checklist.ResultThe analysis resulted in three descriptive categories based on eight identified conceptions. The categories are as follows: “The formal structure has an impact on interprofessional collaboration”; “The public health nurse is an important, but not always self‐evident, partner in interprofessional collaboration”; and “The primary players are the teachers in collaboration.”ConclusionThe public health nurses describe that they had limited impact on collaboration and were dependent on both the school principal and the teachers for achieving good collaboration. Teachers have the power to decide whether to collaborate with the public health nurse, and public health nurses regard teachers as the most important collaborative partners. The public health nurses need to make themselves and their competence visible.Relevance to clinical practiceThe findings demonstrated that public health nurses are important collaborators, but are not always included in interprofessional collaboration. This knowledge is essential to strengthen public health nurses' roles and presence in schools, which could most certainly benefit adolescents with mental health problems in secondary school.

Overcoming barriers to reach for a helping hand: adolescent boys’ experience of visiting the public health nurse for mental health problems

“…The importance of the PHN's accessibility in the school health service is emphasized in several studies (O'Connor, Martin, Weeks, & Ong, 2014;Skundberg-Kletthagen & Moen, 2017;Steffenak et al, 2015). However, one study found that the PHN's presence in schools in Norway varied from 20% to 90% of full time (Granrud et al, 2019. This variation is in line with reports from other countries (Bains & Diallo, 2016).…”

“…In one recent study, it was reported that PHNs spent more than 50% of their time working on mental health issues (Skundberg-Kletthagen & Moen, 2017). PHNs seldom work full-time in the school health service (Granrud, Anderzén-Carlsson, Bisholt, & Steffenak, 2019;Waldum-Grevbo & Haugland, 2015) and adolescents describe PHNs in the school health services as being inaccessible; they could not find the office and did not know when the PHN was there (Steffenak, Wilde-Larsson, Hartz, & Nordström, 2015).…”

Perceptions of School Nurses in Addressing Student Mental Health Concerns: An Integrative Review

“…Based on the appraisal, a quality score of high, medium, or low was assigned to each article after review by the primary author. Diverse methodologies are represented in this review, including level I inductive and exploratory qualitative design (Anttila et al, 2020;Garmy et al, 2014;Granrud et al, 2019;Jönsson et al, 2019;Littler, 2019;Pigozi & Bartoli, 2016;Pryjmachuk et al, 2011;Reuterswärd & Hylander, 2016;Rosvall & Nilsson, 2016;Sherwin, 2016;and Skundberg-Kletthagen & Moen, 2017) and level II designs using surveys (Haddad et al, 2010;Moen & Skundberg-Kletthagen, 2018;Muggeo & Ginsburg, 2019). No studies were excluded due to design or reporting quality.…”

Application of an Online Combination Exercise Intervention to Improve Physical and Mental Health in Obese Children: A Single Arm Longitudinal Study

“…These findings need to be further confirmed by high-quality randomized controlled trials (RCT) in the future. The mental health problems of children and adolescents have become a major public health issue (Granrud et al, 2019) that seriously affects the physical and mental health of adults (Halfon et al, 2013). Previous studies have shown that physical activity can improve young children's cognition (Xiong et al, 2019;Gao et al, 2019a) and that moderate to intense physical activity can improve mental health problems (Rodriguez-Ayllon et al, 2019).…”