CARE OF CLIENTS IN THE SCHOOL SETTING

Reasons for Concern for School Health The health of the school population affects overall community health. Healthy children learn better. The school setting is an excellent avenue for developing health attitudes and behaviors that affect health in later life.

Goal of School Health To reduce or eliminate health-related barriers to learning

Objectives of a School Health Program - 1 Decrease morbidity and absenteeism Identify and treat existing health problems Manage special health needs Promote employee health Integrate school, home, and community health efforts

Objectives of a School Health Program - 2 Contribute to staff development Provide a resource on school health and safety issues Assure quality of and accountability for school health services

Comprehensive School Health Program “An integrated set of planned, sequential school-affiliated strategies, activities, and services designed to promote the optimal physical, emotional, social, and educational development of students” (Allensworth et al., 1997)

Traditional Components of a School Health Program Health services Health education Healthy environment Physical education Nutrition services Staff health promotion Counseling, psychological, social services Parent and community involvement

Figure 23–1 Components of the School Health Program

Health Services Component Assessment and screening Case finding Counseling Health promotion and illness prevention Case management Remedial or rehabilitation services Specific nursing procedures Emergency care

Education for Health Literacy - 1 Develop abilities to: Comprehend health promotion and disease prevention information Access health information and health promoting products and services Engage in behaviors that promote health and reduce risk

Education for Health Literacy - 2 Develop abilities to: Analyze influences on health Use interpersonal communication to enhance health Set goals and make decisions regarding health Advocate for personal, family, and community health (Breckon, 1998)

Assessing Health in the School Setting Biophysical considerations Psychological considerations Physical environmental considerations Sociocultural considerations Behavioral considerations Health system considerations

Biophysical Considerations - 1 Maturation and aging Age Developmental stages and tasks Genetic inheritance Gender Race/ethnicity Genetic predisposition to disease in population

Biophysical Considerations - 2 Physiologic function Incidence and prevalence of communicable diseases Incidence of injury and other problems Prevalence of chronic and handicapping conditions Immunization levels

Psychological Considerations Organization of the school day Peer relationships Teacher-student relationships Teacher-teacher relationships Discipline and grading practices Parent-school relationships

Physical Environmental Considerations Internal environment External environment

Sociocultural Considerations Community attitudes to education Crime Racial unrest/violence Working parents Socioeconomic status Culture and language Homelessness

Behavioral Considerations Consumption patterns Diet and nutrition Substance use and abuse Rest, exercise, and recreational activity Sexual activity Health and safety behaviors

Health System Considerations Availability of internal and external sources of health care Relationship of school to external health care resources Organizational structure for school health care delivery

Planning Health Care in the School Setting Macrolevel planning Development of the overall school health program Microlevel planning Planning to address specific health problems in the population or to meet health needs of individual members of the population

Components of Macrolevel Planning Population to be served Categories of health services Health-related personnel Program resources Health records Program evaluation Program budget

Components of Microlevel Planning Primary prevention Secondary prevention Tertiary prevention

Primary Prevention Immunization Interpersonal skills Safety Exclusion from school Health education Food and nutrition Exercise and physical activity Self-image Coping Interpersonal skills

Secondary Prevention Screening Referral Counseling Treatment

Tertiary Prevention Preventing recurrence of acute conditions Preventing complications Promoting adjustment to chronic and handicapping conditions Dealing with learning disability