The Role of School Leaders' Health Literacy for the Implementation of Health Promoting Schools.

BACKGROUND: The promotion of health literacy is seen as an urgent goal in public health and education and, hence, should be integrated in the school context as a component of the holistic health promoting school (HPS) approach. However, only limited empirical studies have addressed health literacy of school staff so far. Hence, this study aimed to examine the level of health literacy among school leaders and its association with the extent of HPS implementation. METHODS: A cross-sectional study with n = 680 school principals and members of the school management board from Germany was carried out at the end of 2018. Individual health literacy, attitudes, and competencies towards HPS and occupational self-efficacy served as independent variables and the level of HPS implementation was the dependent variable. Data were analyzed using univariate and bivariate analysis as well as multiple binary logistic regression. RESULTS: 29.3% of school leaders show a limited health literacy with significantly higher values found for male respondents. Regression analyses revealed that male gender (OR: 1.91, 95% CI: 1.22-2.99), HPS attitudes (OR: 3.17, 95% CI: 2.13-4.72), and HPS competencies (OR: 3.66, 95% CI: 2.43-5.50) were associated with a lower level of HPS implementation. Furthermore, regression analyses differentiated by gender showed that limited health literacy is associated with a low level of HPS implementation for male school leaders only (OR: 2.81, 95% CI: 1.22-6.45). CONCLUSIONS: The promotion of health literacy especially for male leaders would not only result in positive effects on an individual level but also could contribute to a stronger implementation of activities on school health promotion. We suggest integrating health literacy, HPS attitudes, and competencies more strongly into the qualification and in further training of school leaders.

Effect of flower essence therapy on teachers' stress: a randomized clinical trial / Efeito da terapia floral no estresse docente: ensaio clínico randomizado / Efecto de la terapia floral en el estrés docente: ensayo clínico aleatorizado

RESUMO Objetivo: avaliar a efetividade das essências florais de Bach na redução dos níveis de estresse docente. Método: ensaio clínico controlado, randomizado, duplo-cego, com delineamento prospectivo. Foram utilizados na coleta de dados um formulário validado à luz da teoria de Betty Neuman e três instrumentos, um na perspectiva perceptiva (PSS-14), o outro na prevalência dos sinais e sintomas (LSS) e um de avaliação dos aspectos bioeletrográfico (FAAB). A amostra foi constituída de 27 professores da rede básica de ensino com estresse médio e alto, distribuídos em dois grupos: intervenção (GI) e que recebeu floral e placebo (GP). Resultados: o GI mostrou-se efetivo na redução do estresse, sendo estatisticamente significante intragrupo com a diminuição das médias dos escores do PSS-14 (p=0,004, LSS - p = 0,000) e da bioeletrografia (p=0,011); bem como entre grupos com p-valor de 0,035 para LSS e FAAB com p= 0,001. Conclusão: as essências florais do sistema Bach mostraram-se efetivos no cuidado do estresse docente com a reestruturação da linha flexível de defesa, refletindo melhor relacionamento do professor com os estressores intra, inter e extrapessoais. Este estudo está registrado no ReBEC com o nº. UTN: U1111-1208-4987.

RESUMEN Objetivo: evaluar la efectividad de las esencias florales de Bach para reducir los niveles de estrés del personal docente. Método: ensayo clínico controlado, aleatorizado, doble ciego con diseño prospectivo. En la recogida de datos se utilizó un formulario validado a la luz de la teoría de Betty Neuman y tres instrumentos: uno en la perspectiva perceptiva (PSS-14), otro en la prevalencia de signos y síntomas (LSS) y otro para la evaluación de aspectos bioelectrográficos (FAAB) La muestra consistió en 27 profesores de educación básica con estrés medio y alto, divididos en dos grupos: intervención (GI), que recibió esencias florales, y placebo (GP). Resultados: el GI demostró ser efectivo para la reducción del estrés, siendo estadísticamente significativo dentro del grupo con disminución en las puntuaciones medias del PSS-14 (p = 0.004, LSS - p = 0.000) y bioelectrografía (p = 0.011); así como entre grupos con un valor de p de 0.035 para LSS y FAAB con p = 0.001. Conclusión: las Flores de Bach demostraron ser efectivas en el manejo del estrés de los docentes con la reestructuración de la línea flexible de defensa, reflejando una mejor relación entre el profesor y los estresores intra, inter y extrapersonales. El presente estudio está registrado en ReBEC bajo el nº. UTN: U1111-1208-4987.

ABSTRACT Objective: to evaluate the effectiveness of Bach flower essences in reducing teachers' stress levels. Method: a controlled, randomized, and double-blind clinical trial with a prospective design. In data collection, a form validated in the light of Betty Neuman's theory and another three instruments were used, one in the perceptive perspective (PSS-14), the second in the prevalence of the signs and symptoms (LSS), and the third for the evaluation of the bio-electrographic aspects (FAAB). The sample consisted of 27 teachers from the basic education network, with medium and high levels of stress and divided into two groups: intervention group (IG), the one that received Bach flower essences, and placebo group (PG). Results: the IG proved to be effective in reducing stress, being statistically significant intra-group with the decrease in the mean scores of PSS-14 (p=0.004), LSS (p=0.000), and bioelectrography (p=0.011); as well as between groups with a p-value of 0.035 for LSS, and FAAB with p=0.001. Conclusion: the Bach flower essences proved to be effective in the care of teachers' stress with the re-structuring of the flexible line of defense, reflecting in a better relationship between the teacher and intra-, inter-, and extra-personal stressors. This study is registered in the ReBEC under UTN Nº U1111-1208-4987.