Schroeder Krista, Young Ally, Adman Gail, Ashmeade Ann Marie, Bonas Estherlyn, Day Sophia E, Konty Kevin
Department of Nursing, Temple University College of Public Health, Philadelphia, PA, USA.
New York City Department of Health and Mental Hygiene, Office of School Health, Long Island City, NY, USA.
J Sch Nurs. 2023 Aug;39(4):305-312. doi: 10.1177/10598405211012957. Epub 2021 Apr 28.
This study assessed associations between school nurse workload and student health and academic outcomes. We hypothesized that lower school nurse workload would be associated with better student outcomes, with associations being greater for members of groups who experience health disparities. Our methods entailed secondary analysis of data for New York City school students in kindergarten through 12th grade during 2015-2016 ( = 1,080,923), using multilevel multivariate regression as the analytic approach. Results demonstrated lower school nurse workload was associated with better outcomes for student participation in asthma education but not chronic absenteeism, early dismissals, health office visits, immunization compliance, academic achievement, or overweight/obesity. Our findings suggest school nurses may influence proximal outcomes, such as participation in disease-related education, more easily than downstream outcomes, such as absenteeism or obesity. While contrary to our hypotheses, results align with the fact that school nurses deliver community-based, population health-focused care that is inherently complex, multilevel, and directly impacted by social determinants of health. Future research should explore school nurses' perspectives on what factors influence their workload and how they can best impact student outcomes.
本研究评估了学校护士工作量与学生健康及学业成绩之间的关联。我们假设学校护士工作量较低会与更好的学生成绩相关联，且对于经历健康差距的群体成员而言，这种关联会更强。我们的方法包括对2015 - 2016年纽约市幼儿园至12年级学生的数据进行二次分析（n = 1,080,923），采用多水平多元回归作为分析方法。结果表明，学校护士工作量较低与学生参与哮喘教育的更好结果相关，但与长期缺勤、提前放学、去医务室就诊、免疫接种依从性、学业成绩或超重/肥胖无关。我们的研究结果表明，学校护士可能比缺勤或肥胖等下游结果更容易影响诸如参与疾病相关教育等近端结果。虽然与我们的假设相反，但结果与以下事实相符，即学校护士提供基于社区、以人群健康为重点的护理，这种护理本质上是复杂的、多水平的，并且直接受到健康的社会决定因素的影响。未来的研究应探讨学校护士对哪些因素影响其工作量以及他们如何能最佳地影响学生成绩的看法。
