Adolescents' Experiences of Existential Loneliness Regarding Receiving and Providing Support.

Among adolescents, loneliness is common. One kind of loneliness, existential loneliness, is understood as a painful part of the human condition. During adolescence, existential loneliness has been shown to be challenging to navigate independently. Therefore, this study aimed to explore Swedish adolescents' experiences of existential loneliness regarding receiving and providing support. This study had an exploratory qualitative design based on focus group discussions (n = 9) comprising 30 Swedish adolescents (median age 18). The data was analysed inductively using thematic analysis. The adolescents' experiences of existential loneliness regarding receiving and providing support were represented in four themes: Wanting to face existential loneliness alone, but seeking relief and support when needed; Wanting to share the experiences, but not knowing how or being afraid to bare the vulnerability; Wanting to share the experiences, but nobody is there; Supporting friends by trying to be there, but feeling insecure. In conclusion, knowledge of existential loneliness and a sensitivity to adolescents' personal needs is crucial. Supporting and being there for adolescents may increase their ability to encounter ̶ their own or others' ̶ experiences of existential loneliness, which could be promotive for their well-being and personal growth.

Swedish schoolchildren's voices of health-promoting factors: a focus group study.

Children have the right to express their views on all issues related to their health and development. The aim was to explore health-promoting factors voiced by 8- to 12-year-old children, to determine how the children prioritize those factors and inform school personnel how to develop health-promoting approach based on those findings. Focus groups, with the use of photographs, were conducted with 15 children. A deductive content analysis was used, with overall results showing that health-promoting factors are meaningful relationships and recreational activities. The results add new perspectives to the earlier model of health-promoting factors. By highlighting children's experience of what promotes health, measures at the individual, group and community level can be adapted to children's priorities, based on their own needs.

Adolescents' Experience of Pain: A Focus Group Study in Sweden.

The purpose of this study was to describe experiences of pain among students at upper secondary schools (adolescents aged 16-19 years) in Sweden. Focus group (n = 9) interviews with 41 adolescents were conducted in southern Sweden in 2021. The interviews were analyzed by qualitative content analysis, which identified four categories encompassing the theme how pain expressed itself: (1) a warning bell-the body's way of saying that something is wrong; (2) school- and work-related pain; (3) interpersonal physical and emotional pain; and (4) heartache-a sign of humanity; and four categories describing the theme ways of dealing with pain: (1) turn your attention elsewhere; (2) "bite the bullet" and endure the pain; and (3) use painkillers or complementary treatments; and (4) ask for help from others. Findings are linked to the crucial role of school nurses in supporting students who experience pain.

Longitudinal Study on Correlations Between Body Image, Physical Activity, and the Subjective Well-Being Among Adolescents Aged 14-16.

This study examined the relationship between physical activity, body image, and subjective well-being among Swedish adolescents over time. Surveying 2308 students, with 137 providing longitudinal data, we conducted a multivariate logistic regression analysis. No significant correlations were found between physical activity (p = .268), body functioning (p = .567), or body appearance (p = .075) at age 14 and subjective well-being at age 16. Among control variables, sex (p = .038) and subjective well-being at age 14 (p = .013) showed significant correlations, while economic status did not (p = .39). The correlation between a positive subjective well-being at age 14 and age 16 indicates the importance of impacting the sense of well-being early. Further longitudinal studies are needed to explore the potential long-term correlation between body image and adolescent subjective well-being.

School Nurses' Perspectives on Health among School-Aged Children and Adolescents During the COVID-19 Pandemic.

The aim of this study was to investigate school nurses' perspectives on students' health during the COVID-19 pandemic in Sweden in 2021. A cross-sectional survey design was used with school nurses (n = 225) working in schools in Sweden from elementary to upper secondary levels. The Clausson School Nurse Perception Questionnaire was used with two additional questions about the COVID-19 pandemic. The school nurses rated students' physical health as very good or good in 78% of the cases and their mental health as very good or good in 64%. There was also a negative trend in mental health during the pandemic, especially among girls. School nurses working in vulnerable areas (i.e., areas with a high proportion of immigrants and those receiving financial assistance) rated students' physical and mental health significantly worse compared other areas.

Experiences of Stress - A Focus Group Interview Study Among Swedish Adolescents During the COVID-19 Pandemic.

Adolescence can be a stressful period in life. The period contains challenges associated with the transition from childhood to adulthood (body changes, changes in interpersonal relationships, and identity changes). The aim was to investigate experiences of stress among adolescents in addition to stress related to the COVID-19 pandemic. Focus group interviews (n = 8) were conducted with girls (n = 22) and boys (n = 19) aged 13-15 in southern Sweden. The transcribed interviews were analyzed with qualitative content analysis. Analysis of the collected material resulted in two categories with four sub-categories each of which highlights adolescents' experiences of stress. The results show that adolescents' have a variety of experiences of stress, i.e., what they mean are the sources of stress and how stress is manifested. The adolescents experienced how stress was manifested both physically and emotionally. This affected both their sleep and performance. The adolescents reflected on both positive and negative manifestations of stress.

School Nurses' Perceptions About Student's Wellbeing During the Covid-19 Pandemic in Sweden.

The coronavirus 2019 (Covid-19) pandemic has affected both the private and public lives of people worldwide. Countries have chosen different strategies to reduce the spread of infection, including school closures and distance learning. This study aimed to describe school nurses' perceptions about the wellbeing of students during the Covid-19 pandemic in Sweden. Interviews in five focus groups and one individual were conducted with 17 school nurses in Sweden. The interviews were analyzed using a qualitative content analysis. According to the school nurses' perceptions, students were concerned about spreading infection, becoming infected themselves, their academic performances, and longing for socialization. The change in the school situation involved a slower pace and less anxiety for some students, more or less physical activity, and an increase in screen time.

Schoolchildren's experience of pain-A focus group interview study.

AIM: To explore the experience of pain in 10- to 12-year-old children. METHODS: This interview study included students (n = 42) in grade 4-6 in focus groups (n = 10) in southern Sweden (52% girls); mean age, 11.3 years (range 10-12 years). The interviews were audio-recorded and transcribed verbatim and analysed with qualitative content analysis. RESULTS: The analysis resulted in one theme: Pain as a unique experience for each individual, which was divided into five categories: (a) Feeling bodily pain; (b) Pain related to the school environment and schoolwork; (c) Internal pain related to sorrow and grief; (d) Pain related to conflicts and remorse; and (e) Pain can be good. CONCLUSION: The children made distinctions between physical pain and emotional pain. Bullying, noisy school environments, grief and remorse were reported to be linked with headaches, stomachache and heartache.

Nurse assistants' experiences of encountering patients in grief due to the death of a loved one - a qualitative study in municipal health and social care.

PURPOSE: The aim was to explore nurse assistants´ experiences of paying attention to and encountering patients receiving municipal health and social care, who are in grief due to the death of a loved one. METHODS: A qualitative study with focus group interviews (n = 6) was conducted with nurse assistants (NAs) (n = 28) in municipal health and social care (n = 5) in southern Sweden. The data were analysed inductively using qualitative content analysis. RESULTS: Three categories (1) Noticing changes in the patient, (2) Using different strategies to create a dialogue with the patient, (3) Experiencing challenges when encountering patients in grief, included eight sub-categories were identified. The result is captured in the theme of Having to be attentive to signs of grief after patients´ loss of loved ones, sensing the right time to approach and comfort, while having to cope with emotional challenges. CONCLUSIONS: The NAs encountered expressions of strong emotions from patients in grief, and even expressions of a desire to end their lives. Additionally, the NAs had to deal with their own emotions that were evoked when meeting patients in grief. These challenges indicate the need for enhanced conditions in the work culture, and improved training and supervision in health and social care.

Mothers' experience of infant massage in child health care: A qualitative interview study.

AIM: To investigate mothers' experience of infant massage. DESIGN: This was an exploratory-descriptive qualitative study based on individual interviews. METHODS: A qualitative interview study with an inductive approach was used according to the COREQ guidelines. The participants in the study were mothers (n = 11) residing in Sweden who received training in infant massage from the child health care nurse in the child health care services. The transcribed interviews were analysed using a qualitative content analysis. RESULTS: The collected material resulted in two categories and eight subcategories. The categories were learning infant massage and using infant massage as a tool. The eight subcategories were massaging in a parent group, massaging at home, massage movements and the child health care nurse's supporting hand, reading the child's signals, creating time and relaxation together, interaction and connection between the child and the parent, relief from stomach problems and anxiety and continuing to massage the older child. The study showed that mothers experienced that the relationship created through infant massage brought more joy, tenderness and security to the child. The child health care nurse had an important role in supporting the mothers, especially when it came to different views on doing infant massage at home and in groups. PATIENT OR PUBLIC CONTRIBUTION: Mothers with experience of infant massage were interviewed.

Psychometric evaluation of a Swedish version of Minneapolis-Manchester quality of life-youth form and adolescent form.

BACKGROUND: It has become important to measure long-term effects and quality of life in survivors of childhood cancer. The Minneapolis- Manchester Quality of Life (MMQL) instrument has been proven to better capture the quality of life (QoL) perspective of health than other instruments. The instrument has age appropriate versions and is therefore favourable for longitudinal studies of QoL of children surviving from cancer. The aim of this study was to evaluate the psychometric properties of the Swedish version of MMQL-Youth Form and the Adolescent Form focusing on: 1) face and content validity 2) the internal consistency and 3) the test-retest reliability. METHODS: The sample consisted of 950 pupils (11-16 years old) from 7 schools in the western Sweden who completed the questionnaire. For the test-retest evaluation 230 respondents completed the questionnaire two weeks later. RESULTS: Face and content validity was supported and internal consistency was found to be acceptable for the total scale for both the MMQL-Youth Form (8-12 years of age) and the Adolescent Form (13-20 years of age). Test-retest reliability for the MMQL-Youth Form was moderate for 50% of the items and good for the remaining. For the MMQL-Adolescent Form the test-retest showed moderate or good agreement for 80% of the items and fair for 20%. CONCLUSIONS: The result indicated that the Swedish version of the MMQL-Youth Form and Adolescent Form was valid and reliable in a sample of healthy children in a Swedish context. It is recommended to test the instrument among diverse samples of children such as survivors of childhood cancer in order to validate its usefulness in research and clinical settings.

School nurses' experiences of health-promoting work to prevent stress in Swedish adolescents.

Aim: To investigate school nurses' experiences of health-promoting work to prevent stress in Swedish adolescents. Materials and methods: Swedish school nurses (n = 225) responded to a web survey with open-ended questions. The results were subjected to a qualitative content analysis. Results: Six categories were identified from the analysis: (1) Knowledge of body and soul, (2) Identifying stress and ill health, (3) Collaborative working within/outside school, (4) Make yourself (i.e., school nurses) visible to the students, (5) Support students' learning, and (6) Tools for stress management. One of the most important themes in preventing and counteracting stress in school-aged children and adolescents was promoting healthy living habits. That school nurses were easily accessible and visible were important for them to identify stress as early as possible. The close collaboration with the school health care team and building relationships with the students were emphasized. The stress in adolescents was largely linked to schoolwork and performance anxiety. To counteract this, the dialogue with the teachers was important to increase their knowledge of mental health problems and stress and influence the scheduling of school exams. Conclusion: The study contributes to increased knowledge in the field and provides concrete strategies for how school nurses can work to counteract stress in students.

Adolescents' Experience of Stress: A Focus Group Interview Study with 16-19-Year-Old Students during the COVID-19 Pandemic.

The purpose was to investigate stress among adolescents (16-19 years old) during the coronavirus disease 2019 (COVID-19) pandemic. Focus group (n = 9) interviews with students at upper secondary schools (16-19 years old, n = 41) were conducted in southern Sweden during the COVID-19 pandemic in 2021. The interviews were analyzed by qualitative content analysis. The analysis revealed five categories of experience of stress: (1) School-related stress, (2) Stress in relationships and leisure, (3) How stress manifests itself, (4) Stress can increase performance, and (5) Experiences of counteracting stress. The adolescents in the study experienced stress linked to school and relationships, partly due to the COVID-19 pandemic. Distance education during the COVID-19 pandemic increased stress levels. The adolescents stated that high stress levels were experienced negatively and impaired their ability to perform, while moderate stress could contribute to achieving goals and improving performance. School nurses and other health professionals who meet with adolescents are important to support adolescents experiencing stress.

Deeply lonely in the borderland between childhood and adulthood - Experiences of existential loneliness as narrated by adolescents.

BACKGROUND: Adolescence is associated with different feelings and experiences that can negatively affect adolescents' health and well-being. In the transition between childhood and adulthood, experiences of loneliness are common. A deep form of loneliness is described as existential loneliness. Studies among adults have shown that existential loneliness often arises in connection with transitions and is related to suffering, but may lead to positive experiences when acknowledged and addressed. Therefore, the aim of this study was to explore adolescents' experiences of existential loneliness. METHODS: This was an exploratory-descriptive qualitative study based on narrative interviews with 16 adolescents (median age 17.5). The data were analysed inductively using qualitative content analysis. FINDINGS: Existential loneliness among adolescents was related to experiences of social exclusion and "in-betweenness". To alleviate their suffering, the adolescents tried to avoid burdensome feelings and thoughts, and they chose between sharing or not sharing their inner lives with someone else. CONCLUSIONS: It is important to support adolescents' sense of belonging, and they may need assistance in dealing with existential loneliness, as well as with finding constructive and healthy ways of recuperating from the suffering. Professionals need knowledge of existential loneliness to promote adolescents' existential health and well-being.

School Nurses' Experience of Working in School Health Service during the COVID-19 Pandemic in Sweden.

The COVID-19 pandemic has had a vast influence on Swedish society. Related recommendations and political decisions have greatly affected schools. This study aimed to describe school nurses' experience working in Sweden during the pandemic in 2020. The study used a qualitative method with an inductive approach. Interviews with 17 school nurses in five focus groups and one individual interview were conducted. Qualitative content analysis was used. The impact of the pandemic on school nurses can be described through three categories: "Changes in working methods in relation to the students/guardians", "Impact on cooperation with school staff", and "The school nurse's prerequisites for major changes." Overall, school nurses experienced a transition to a digital way of working. Policies and decisions on global and local levels affected the work situations of school nurses as well as the school nurses' social, cultural, and professional experience. The highest priority for school nurses is students, and school nurses adapted their working methods to give support to students during the changing circumstances. School nurses are both pragmatic and highly creative. Cooperation with other school professions is critical, as is support and guidance during crisis situations.

Sadness and Other Health Complaints among Swedish Adolescents: A Cross-Sectional Study.

Health complaints are increasing among adolescents and are recognized as a global public health issue. Health complaints are an indicator for subjective ill-being, but little is known about the relationship between sadness and other health complaints. The aim of this study was to investigate sadness and other health complaints among Swedish adolescents. A survey with a cross-sectional design was completed by adolescents (n = 1489, 15-17 years old) in the south of Sweden. A logistic regression analysis was used to analyze the relationship between sadness and other health complaints. The result show that sadness and other health complaints were common among adolescents, and sadness was related to health complaints (headache (OR: 1.58), sleeping difficulties (OR: 2.00), reduced appetite (OR: 1.43), tension (OR: 2.44), and concentration difficulties (OR: 2.75)). When adolescents express sadness or other health complaints it is important to reflect on what these complaints are an expression of, and take into account the body as physical and psychological intertwined. This might entail person-centered support that hopefully leads to an improvement in adolescents' well-being. Future research that profoundly highlights adolescents' existential health is needed.

Nurse Documentation of Child Weight-Related Health Promotion at Age Four in Sweden.

(1) Background: Overweight and obesity in children have increased worldwide and tend to persist into adolescence and adulthood. The Child Health Service (CHS) has an important role in providing health-promotive interventions, and such interventions are required to be documented in a child's health record. The aim of the study was to investigate Child Health Care (CHC) nurses' documentation of weight-related, health-promotive interventions in the Child Health Care Record (CHCR) regarding lifestyle habits in connection to the four-year visit. (2) Methods: A record review of 485 CHCRs using a review template was accomplished. Of the included CHS units, four used electronic records and two used paper records. Chi-square tests and Spearman's rank-order correlations were used to analyse data. (3) Results: The results showed that CHC nurses document interventions regarding lifestyle habits to a low extent, although children with overweight/obesity seemed to undergo more interventions. There was also a difference between electronic and paper records. (4) Conclusions: The consequences of not documenting the interventions in the CHCR make it difficult to follow up and demonstrate the quality of the CHC nurse's work. There is a need for more research to gain a deeper understanding of the reasons that the work of CHC nurses is not visible in children's health records.

A Philosophical Review of School Nursing Framed by the Holistic Nursing Theory of Barbara Dossey.

This article is a philosophical review of school nursing and its constructs framed by Barbara Dossey's holistic nursing theory. The author describes the application of holistic nursing theory within the school nurse's area of activity. The review suggests that holistic nursing theory can be applied in several areas of school nursing. School nurses have a multifaceted occupation that includes meetings with students, parents, and school staff. Barbara Dossey's holistic nursing theory offers the school nurse tools to deal with people's varied experiences, feelings, and needs.

A Focus Group Interview Study of the Experience of Stress amongst School-Aged Children in Sweden.

The study explored experiences of stress in children aged 10-12. An inductive qualitative design was used. Ten focus group interviews were conducted with Swedish schoolchildren (n = 42) aged 10-12. The interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis. The study identified one theme-"Body and mind react"-and three subthemes: (1) Friendships matters, (2) Parental stress affect, and (3) Trying to do my best. Stress often occurred in the children's everyday environment. The children had experienced how stress could be expressed both physically and mentally, inside and outside school. The children also had the experience of seeing people in their environment being stressed, which could create feelings that affected the children. The experience of the children was also that stress can sometimes be good. Stress related to peers, family, school, and society was commonly experienced by children aged 10-12. Both positive and negative stress was reported.

Supporting Students with Neurodevelopment Disorders in School Health Care-School Nurses' Experiences.

Students with neurodevelopmental disorders (NDDs) are present in every school, and most likely, there are a few students in every class. School health care is responsible for providing support to all students, especially those with special needs. The aim of the study was to describe school nurses' experiences of supporting students with NDDs. A qualitative method consisting of seven focus group interviews (that included a total of 35 school nurses) in Southern Sweden was conducted. Three themes were identified in the findings: helping students with NDDs to interpret sensations, detecting early signs of distress among students with NDDs, and using an inclusive design for health education. This study highlights the importance of school nurses in identifying the needs of students with NDDs and promotes a person-centered approach to achieve a healthy and safe learning environment for all students.