Access to a school health nurse and adolescent health needs in the universal school health service in Finland.
Hanne Kivimäki, Vesa Saaristo, Kirsi Wiss and 3 others
PMID 30276842WHAT IT FOUND
Most Finnish adolescents said school health nurse access was easy, but 13% found it difficult, especially girls, and difficult access was associated with school burnout, daily symptoms, weak school support and immigrant background.
Key findings
01Most pupils reported easy access to a school health nurse, but 13% reported difficult access, and school-level difficult-access reports ranged from 0% to 75%.
02Girls reported difficult access more often than boys, at 15% and 11%.
03Difficult access was associated with school-related well-being problems, health complaints, immigrant background and difficulty talking with parents, but not with heavy drinking or parental unemployment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured pupils' perceived access, not whether they actually received help or had unmet health needs. The data were collected at one time, so the study cannot show that health or school problems caused difficult access. Pupils who were absent, disabled or weak in language may have been less likely to respond. Special needs schools, schools without nurse resource information and schools with fewer than 10 respondents were excluded. Variables were dichotomised, which may have removed detail about how risks relate to access. Results mainly generalise to universal school health systems, not all countries or school service models. There was no information on how school health nurse resources were allocated.
Declared interests
Funding was from the Juho Vainio Foundation; no other conflicts are reported in the supplied text.
The easy way to misread this
Do not read the 13% difficult-access finding as proof that school health nurse appointments are unavailable. It reports pupils' perceived difficulty getting an appointment, not actual appointment availability, help received or health outcomes.