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Learning Modalities During COVID-19 and Adolescent Mental Health in North Carolina 北卡罗来纳州COVID-19和青少年心理健康期间的学习方式
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-02 DOI: 10.1111/josh.70093
Justin Cole Gilbert, Martie P. Thompson, Sophia Ryan, Manan Roy

Background

The mental health of youth represents a critical public health issue and has worsened over the course of the pandemic, partially attributed to social isolation and school closures.

Methods

This analysis leveraged data on school learning modality (COVID-19 School Data Hub), emergency department (ED) visits (North Carolina SHEPS data), and school-district characteristics (National Center for Education Statistics) to investigate how school learning modality predicts mental health-related ED visitation in the state of North Carolina. Generalized linear mixed models were employed to quantify how the odds of mental health ED visitation varied with school learning modality. Models adjust for school-level covariates (e.g., broadband, student:teacher ratio) and patient-level characteristics (age, sex). Patient and school data are nested within counties, which were included as a random effect to address potential clustering within the data.

Results

In-person (odds ratios [OR]: 0.92, 95% CI: 0.85–0.99) and hybrid (odds ratios: 0.95, 95% CI: 0.93–0.98) modalities were associated with lower ORs for ED visits due to mental health compared to a virtual learning modality.

Implications for School Health Policy, Practice, and Equity

School districts should consider increasing the provision of mental health services for students during circumstances in which a virtual learning modality is utilized and consider adopting hybrid learning rather than virtual learning when feasible.

Conclusions

School administrators should seek to balance students' mental health and learning needs in times of crisis.

背景:青年的心理健康是一个重要的公共卫生问题,在大流行期间恶化了,部分原因是社会孤立和学校关闭。方法:本分析利用学校学习方式(COVID-19学校数据中心)、急诊科(ED)就诊(北卡罗来纳州SHEPS数据)和学区特征(国家教育统计中心)的数据,调查学校学习方式如何预测北卡罗来纳州与心理健康相关的ED就诊。采用广义线性混合模型来量化心理健康ED访问的几率随学校学习方式的变化。模型根据学校水平的协变量(例如,宽带、师生比例)和患者水平的特征(年龄、性别)进行调整。患者和学校数据嵌套在县内,这些县作为随机效应包括在内,以解决数据中潜在的聚类问题。结果:与虚拟学习模式相比,面对面(优势比[OR]: 0.92, 95% CI: 0.85-0.99)和混合(优势比:0.95,95% CI: 0.93-0.98)模式与心理健康导致的急诊科就诊的OR较低相关。对学校卫生政策、实践和公平的影响:学区应考虑在使用虚拟学习方式的情况下增加对学生的心理健康服务,并考虑在可行的情况下采用混合学习而不是虚拟学习。结论:在危机时刻,学校管理者应寻求平衡学生的心理健康和学习需求。
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引用次数: 0
Evaluating School-Based Substance Use Services: Insights From a Systematic Review 评估以学校为基础的物质使用服务:来自系统回顾的见解。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-02 DOI: 10.1111/josh.70095
Hannah L. Maxey, Brittany J. Daulton, Mykayla Moore, Kelsey Binion

Background

Substance use among youth can have lifelong consequences and therefore requires early and targeted services for those at risk. Schools possess a unique opportunity to provide substance use services to youth for both prevention and intervention. However, limited research exists on the school-based substance use services and their effectiveness.

Methods

Using PRISMA guidelines, online databases were searched for studies done between 2004 and 2024 on school-based substance use services, their outcomes, and the characteristics of those administering them.

Findings

Results showed school-based substance use services being offered in multiple settings. Screening and intervention were the most common services provided. Although specific outcomes varied by study, including academic performance, perceptions, and actions, most were positive.

Implications for School Health Policy, Practice, and Equity

Schools should create strategic plans for feasible and sustainable substance use services. Use of the screening, brief intervention, and referral to treatment (SBIRT) framework can be used to organize these efforts. Establishing robust referral networks is of particular importance for schools.

Conclusions

This review highlights opportunities for schools to focus on screening and brief intervention for in-school services while also building a strong referral network for times when treatment is necessary.

背景:青少年药物使用可能产生终生后果,因此需要为有风险的人提供早期和有针对性的服务。学校有独特的机会为青少年提供预防和干预药物使用服务。然而,关于以学校为基础的药物使用服务及其有效性的研究有限。方法:使用PRISMA指南,检索在线数据库,检索2004年至2024年间关于基于学校的物质使用服务、其结果和管理人员特征的研究。研究结果:结果显示,在多种环境中提供了以学校为基础的药物使用服务。筛查和干预是最常见的服务。虽然具体的结果因研究而异,包括学习成绩、认知和行动,但大多数都是积极的。对学校卫生政策、实践和公平的影响:学校应为可行和可持续的物质使用服务制定战略计划。使用筛选、短暂干预和转诊治疗(SBIRT)框架可以用来组织这些工作。建立健全的转诊网络对学校来说尤为重要。结论:这篇综述强调了学校有机会将重点放在筛查和校内服务的简短干预上,同时在需要治疗的时候建立一个强大的转诊网络。
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引用次数: 0
System-Level, Decision-Making, and Program Operations During the Implementation of the Medicaid Direct Certificate (DC-M) Pilot on Maryland Community School Meals 马里兰州社区学校膳食医疗补助直接认证(DC-M)试点实施过程中的系统级、决策和项目操作。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-02 DOI: 10.1111/josh.70096
Samantha G. Alarcon Basurto, Rishitha Reddy Chintala, Dorbor Tarley, Julia Gross, Erin R. Hager, Susan M. Gross

Background

The Maryland Department of Education participated in the USDA's Direct Certification with Medicaid (DC-M) pilot during the 2022–2023 school year. This program lets Medicaid-enrolled students automatically qualify for Free or Reduced-Price Meals (FARM) and incorporates Medicaid data into eligibility calculations for the Community Eligibility Provision (CEP), which allows high-poverty schools to offer free meals to all students. This study assesses how DC-M impacts CEP participation from a systems perspective, using a causal loop diagramming approach across 12 Maryland public school districts.

Methods

Semi-structured, in-depth interviews were conducted among stakeholders from school district offices of food and nutrition services. Inductive qualitative coding was applied to interview transcripts, identifying causal relationships among codes using Kumu software.

Results

Interview findings (n = 12 interviews) identified 36 interconnected factors organized into five reinforcing feedback loops and one balancing loop, revealing three themes: school district landscape influence on student enrollment, federal and state policies' effects on school meal funding, and school-level meal operations impacted by school meal policies.

Implications for School Health Policy, Practice, and Equity

Schools can increase meal participation through DC-M.

Conclusions

This study uses a systems approach to pinpoint barriers and facilitators that can inform strategies for improving FARM eligibility and supporting CEP programs.

背景:马里兰州教育部在2022-2023学年参与了美国农业部的医疗补助直接认证(DC-M)试点。该计划允许参加医疗补助计划的学生自动获得免费或减价膳食(FARM)的资格,并将医疗补助数据纳入社区资格条款(CEP)的资格计算中,该条款允许高度贫困的学校向所有学生提供免费膳食。本研究利用马里兰州12个公立学区的因果循环图方法,从系统角度评估了DC-M如何影响CEP参与。方法:对来自学区食品和营养服务办公室的利益相关者进行半结构化的深度访谈。对访谈笔录进行归纳定性编码,利用Kumu软件识别编码间的因果关系。结果:访谈结果(n = 12)确定了36个相互关联的因素,这些因素被组织成5个强化反馈回路和1个平衡回路,揭示了三个主题:学区景观对学生入学的影响,联邦和州政策对学校膳食资金的影响,以及学校膳食政策对学校膳食运营的影响。对学校健康政策、实践和公平的影响:学校可以通过DC-M增加膳食参与。结论:本研究使用系统方法来确定障碍和促进因素,从而为提高FARM资格和支持CEP计划的策略提供信息。
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引用次数: 0
Tracking Secondary School Students: A Qualitative Investigation of an Online Student Monitoring System With Parent Portal 中学生跟踪:基于家长门户的在线学生监控系统的定性研究。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-12-02 DOI: 10.1111/josh.70097
Eline M. Meuleman, Ina M. Koning, Danique M. Heemskerk, Vincent Busch, Maartje M. van Stralen

Background

The transition to secondary school brings academic and social challenges, with student monitoring systems offering real-time insights to enhance communication between students, parents, and teachers. While these systems improve tracking and support, their effects on student autonomy, wellbeing, and parent–child dynamics are understudied.

Methods

This exploratory research examines the perspectives of five students, seven parents, and twelve teachers using Dutch secondary school systems with parent portals, by conducting semi-structured interviews.

Results

Results of the interviews show benefits such as improved teacher communication and better parental support for students but also challenges such as increased teacher workload and concerns over student privacy, autonomy, and well-being.

Implications for School Health Policy, Practice, and Equity

Schools should balance the benefits of student monitoring systems with their impact on autonomy and well-being. While progress tracking is valuable, unrestricted parental access may lead to over-monitoring. Limiting access to designated times (e.g., four times a year) can preserve student independence while keeping parents informed.

Conclusion

The study highlights the need for balanced system design to protect students' wellbeing and autonomy while enhancing educational collaboration.

背景:向中学的过渡带来了学业和社会挑战,学生监控系统提供实时洞察,以加强学生,家长和老师之间的沟通。虽然这些系统改善了跟踪和支持,但它们对学生自主性、幸福感和亲子动态的影响尚未得到充分研究。方法:本探索性研究通过进行半结构化访谈,考察了使用荷兰中学系统和家长门户的五名学生、七名家长和十二名教师的观点。结果:访谈结果显示了诸如改善教师沟通和更好的家长对学生的支持等好处,但也显示了诸如教师工作量增加和对学生隐私、自主权和福祉的担忧等挑战。对学校健康政策、实践和公平的影响:学校应该平衡学生监控系统的好处及其对自主性和福祉的影响。虽然进度跟踪很有价值,但不受限制的家长访问可能会导致过度监控。限制在指定时间(例如一年四次)可以保护学生的独立性,同时让家长了解情况。结论:本研究强调了平衡的制度设计的必要性,以保护学生的福祉和自主权,同时加强教育合作。
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引用次数: 0
“Look at Yourself”: Teachers' Reflective Practices Toward Enjoyment in Primary School Physical Education “看你自己”:小学体育教师享受教学的反思性实践
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-10-07 DOI: 10.1111/josh.70092
Anoek Adank, Nina Bartelink, Steven Vos, Dave Van Kann

Background

Enjoyment is key in primary school physical education (PE), yet ensuring enjoyable PE experiences for all children is challenging. Reflection may help teachers improve lesson quality and foster PE enjoyment.

Methods

This cross-sectional study explored Dutch primary school teachers' perspectives on enjoyable PE and reflective practices. An online questionnaire was completed by 173 teachers (70.5% PE specialists, 29.5% generalists) who teach at least one PE lesson per week. Teacher type differences were analyzed using Chi-square tests, Mann–Whitney U tests, and logistic regressions.

Results

Perspectives on reflective practices were similar among teacher types. Generalists reported more teacher- and policy-related barriers to providing enjoyable PE, while specialists cited child-related challenges. Most teachers reflected internally, with limited use of written reflection or feedback from children and colleagues. Specialists used professional networks and peer feedback more. Time constraints and low prioritization were key barriers to reflection.

Implications for School Health Policy

Schools should allocate time and promote reflection tools. Generalists could benefit from coaching and targeted professional development. For specialists, teacher education might foster reflective practices using video and child feedback to improve child outcomes like PE enjoyment.

Conclusions

Tailored strategies are needed to strengthen reflection and improve PE quality to foster children's PE enjoyment.

背景:享受是小学体育教育的关键,但确保所有孩子都能享受体育教育是一项挑战。反思可以帮助教师提高教学质量,培养体育乐趣。方法:本横断面研究探讨荷兰小学教师对愉快体育与反思性实践的看法。173名教师(70.5%为体育专家,29.5%为通才)完成了一份在线问卷,他们每周至少教一节体育课。采用卡方检验、Mann-Whitney U检验和logistic回归分析教师类型差异。结果:不同类型教师对反思性实践的看法相似。通才们报告说,在提供愉快的体育活动方面,教师和政策方面存在更多障碍,而专家们则提到了与儿童有关的挑战。大多数教师在内部进行反思,很少使用书面反思或来自孩子和同事的反馈。专家们更多地使用专业网络和同行反馈。时间限制和低优先级是进行反思的主要障碍。对学校卫生政策的影响:学校应分配时间并推广反思工具。多面手可以从指导和有针对性的职业发展中受益。对于专家来说,教师教育可以通过视频和儿童反馈来促进反思实践,以提高儿童的成绩,比如体育乐趣。结论:加强反思,提高体育质量,培养儿童体育享受,需要有针对性的策略。
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引用次数: 0
Is There a Fun and Inexpensive Way to Train in School CPR? 有没有一种既有趣又便宜的方法来训练学校的心肺复苏术?
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-10-06 DOI: 10.1111/josh.70091
Ayşegül Güneş
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引用次数: 0
Development of the Teacher Workplace Emotional Health Scale 教师职场情绪健康量表的编制。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-09-25 DOI: 10.1111/josh.70075
Yin-Che Chen, Hui-Chuang Chu

Background

Teacher well-being in Taiwan is challenged by excessive workloads, administrative demands, after-hours digital communications, and societal expectations, leading to stress, burnout, and diminished job satisfaction. Existing tools often assess isolated constructs without integrating emerging stressors like social media pressure.

Methods

Following a six-stage scale development framework, the Teacher Workplace Emotional Health Scale was created, integrating emotional labor, emotional intelligence, job burnout, and social media pressure. Literature review, expert validation, pretesting, exploratory factor analysis, and confirmatory factor analysis were conducted with teachers from multiple regions and school levels.

Results

The final 25-item scale demonstrated good reliability (α = 0.859) and validity. The four-factor model outperformed a unidimensional model. Job burnout explained the greatest variance, while social media stress emerged as a significant factor in emotional health. Emotional labor scored highest among subconstructs, indicating frequent emotional regulation demands.

Implications for School Health Policy, Practice, and Equity

The scale offers a practical tool for monitoring teacher emotional health, guiding targeted interventions, and informing policies on workload, emotional intelligence training, burnout prevention, and digital communication boundaries, ensuring equitable support across regions.

Conclusions

The validated multidimensional scale captures both traditional and emerging emotional challenges in teaching, enabling culturally relevant strategies to improve teacher well-being and sustain educational quality.

背景:台湾教师的幸福感受到过重的工作量、行政要求、下班后的数位通讯和社会期望的挑战,导致压力、倦怠和工作满意度下降。现有的工具经常评估孤立的结构,而没有整合新出现的压力因素,如社交媒体压力。方法:采用六阶段量表编制框架,编制《教师职场情绪健康量表》,整合情绪劳动、情绪智力、工作倦怠和社交媒体压力四个维度。对来自多个地区和学校层次的教师进行了文献查阅、专家验证、前测、探索性因子分析和验证性因子分析。结果:最终的25项量表具有良好的信度(α = 0.859)和效度。四因素模型优于一维模型。工作倦怠解释了最大的差异,而社交媒体压力成为影响情绪健康的重要因素。情绪劳动在次级构念中得分最高,表明频繁的情绪调节需求。对学校卫生政策、实践和公平的影响:该量表为监测教师情绪健康、指导有针对性的干预措施、告知有关工作量、情商培训、倦怠预防和数字通信边界的政策提供了实用工具,确保了跨地区的公平支持。结论:经过验证的多维度量表捕获了教学中传统和新兴的情感挑战,使文化相关策略能够提高教师幸福感并维持教育质量。
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引用次数: 0
Food Service Professionals' Perspectives on the Barriers and Facilitators to the Implementation of Nutrition Standards for School Food: A Mixed-Methods Systematic Review 食品服务专业人员对实施学校食品营养标准的障碍和促进因素的看法:一项混合方法的系统综述。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-09-21 DOI: 10.1111/josh.70078
Breda O'Mahony, Claire Kerins, Claire Barrett, Celine Murrin, Colette Kelly

Background

Internationally, nutrition standards for school food have been implemented. Food service professionals are key to their implementation. This mixed-methods systematic review provides an overview of the barriers and facilitators faced by food service professionals when implementing food/nutrition standards and provides an important link between policy and practice.

Methods

Peer-reviewed and grey literature were searched across electronic databases and public health organization websites. The Consolidated Framework for Implementation Research (CFIR) was used as a framework in the analysis.

Findings

Twenty-nine studies met the eligibility criteria. The most frequently cited barriers to the CFIR constructs/subconstructs were linked to the internal school setting. This included staffing, materials and equipment, and funding. Frequently cited facilitators coded to CFIR included external partnerships/connections and staff motivation to implement the standards.

Implications for School Health Policy, Practice, and Equity

Our findings highlight not only well-documented challenges such as funding and staffing but also the novel and pivotal insights from food service professionals that point to practical, systems-level solutions.

Conclusion

Researchers and practitioners can utilize the results to devise strategies to heighten implementation, as well as capitalize on factors that aid in the implementation process.

背景:国际上已经实施了学校食品营养标准。食品服务专业人员是实现这些目标的关键。这种混合方法的系统审查概述了食品服务专业人员在实施食品/营养标准时面临的障碍和促进因素,并提供了政策与实践之间的重要联系。方法:通过电子数据库和公共卫生组织网站检索同行评议文献和灰色文献。在分析中使用了实施研究综合框架(CFIR)作为框架。结果:29项研究符合入选标准。最常被提及的CFIR构念/子构念障碍与学校内部环境有关。这包括人员、材料和设备以及资金。CFIR经常引用的促成因素包括外部伙伴关系/联系和员工实施标准的动机。对学校健康政策、实践和公平的影响:我们的研究结果不仅突出了资金和人员配备等有充分记录的挑战,而且还突出了食品服务专业人员提出的实用的、系统级解决方案的新颖和关键见解。结论:研究人员和从业人员可以利用这些结果来制定策略以提高实施,并利用有助于实施过程的因素。
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引用次数: 0
Applying School as a Protective Factor in the Icelandic Prevention Model 将学校作为冰岛预防模式中的保护因素。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-09-17 DOI: 10.1111/josh.70084
Anne Abbott, Megan Lorraine Smith, Meredith Spivak, Taylor Neher

Background

While research has demonstrated the importance of K-12 environments for adolescent well-being, there have been numerous challenges to measuring and addressing this social environment. The School as a Protective Factor (SPF)-Framework and Brief instrument were established to meet this gap. This study investigates SPF in an academic-community partnership with a small, rural public school district.

Methods

A school-based survey of middle and high school students was implemented to track key risk and protective factors (including SPF) and a variety of health outcomes, including depression and suicidal ideation, from 2022 to 2025. SPF data were shared annually with school employees to focus on practical ways to improve the school environment.

Results

Analyses show SPF was significantly associated with depression and suicidal ideation. Over 3 years, depression rates at the population level decreased from 66% to 24%.

Implications for School Health Policy, Practice, and Equity

Findings support (1) the use of SPF-Framework and Brief instrument as meaningful tools in school-based efforts to address youth mental health, and (2) the utility of academic-school partnerships to support robust data collection, analysis, and translation into meaningful action.

Conclusions

Schools, researchers, and other partners may benefit from the SPF tools to create a shared understanding, provide clear direction for action, and act as a means of tracking and measuring progress over time.

背景:虽然研究已经证明了K-12环境对青少年健康的重要性,但在衡量和解决这种社会环境方面存在许多挑战。学校作为保护因素(SPF)框架和简要工具的建立是为了弥补这一差距。本研究调查了一个小型农村公立学区的学术社区伙伴关系中的SPF。方法:采用校本调查方法,追踪2022 - 2025年初高中学生的主要风险和保护因素(包括SPF)以及抑郁和自杀意念等各种健康结果。每年与学校员工分享SPF数据,重点关注改善学校环境的实际方法。结果:分析显示SPF与抑郁和自杀意念显著相关。在3年的时间里,抑郁症在人群中的发病率从66%下降到了24%。对学校健康政策、实践和公平的影响:研究结果支持(1)使用spf框架和Brief工具作为学校努力解决青少年心理健康问题的有意义的工具,以及(2)利用学术-学校合作伙伴关系来支持可靠的数据收集、分析和转化为有意义的行动。结论:学校、研究人员和其他合作伙伴可以从SPF工具中受益,以建立共同的理解,为行动提供明确的方向,并作为跟踪和衡量进展的手段。
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引用次数: 0
Insights From a Survey of School Nurses: Assessing the Challenges of Constipation in Schools 从学校护士调查的见解:评估便秘在学校的挑战。
IF 1.8 4区 医学 Q2 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-09-16 DOI: 10.1111/josh.70074
Andrew S. Chu, Eric H. Chiou

Objectives

School nurses are key responders to students with constipation, yet their experiences are underreported. This study surveyed their observations regarding constipation, identified barriers to student restroom access, and assessed educational needs.

Methods

In this descriptive, cross-sectional survey study, an anonymous online survey was distributed to school nurses participating in a virtual education series. The survey assessed nurse demographics, frequency of encounters with constipation and encopresis, school restroom policies, barriers to restroom use, accommodation requests, and training in constipation management.

Findings

Of 125 respondents, 95% encountered students with constipation at least monthly and 55% reported ≥ 6 encounters monthly. Commonly perceived barriers to restroom use included unclean bathrooms (48%) and bullying (42%). Half of schools relied on teacher discretion for restroom access; only 37% of nurses were aware their schools had formal policies. While 64% received accommodation requests at least monthly, only 38% had training in constipation management. Most nurses expressed interest in additional education.

Implications for School Health Policy, Practice, and Equity

Targeted educational interventions and school-wide policy development are necessary to support school nurses and mitigate restrictions that could exacerbate constipation in students.

Conclusions

Constipation and encopresis are frequent concerns, particularly in younger grades. Environmental and policy-related barriers may contribute to toileting difficulties. School nurses reported variable communication with providers and the need for further education.

目的:学校护士是便秘学生的关键反应者,但他们的经历被低估了。这项研究调查了他们对便秘的观察,确定了学生卫生间使用的障碍,并评估了教育需求。方法:在这项描述性横断面调查研究中,对参加虚拟教育系列的学校护士进行了匿名在线调查。该调查评估了护士的人口统计数据、遇到便秘和便秘的频率、学校厕所政策、厕所使用障碍、住宿要求和便秘管理培训。结果:在125名受访者中,95%的人每月至少遇到便秘的学生,55%的人每月≥6次。人们普遍认为使用厕所的障碍包括不干净的浴室(48%)和欺凌(42%)。一半的学校依靠教师的自由裁量权来使用厕所;只有37%的护士知道他们的学校有正式的政策。虽然64%的人至少每月收到住宿请求,但只有38%的人接受过便秘管理方面的培训。大多数护士表示有兴趣接受额外的教育。对学校卫生政策、实践和公平的影响:有针对性的教育干预和全校范围的政策制定对于支持学校护士和减轻可能加剧学生便秘的限制是必要的。结论:便秘和尿潴留是常见的问题,特别是在低年级。环境和政策方面的障碍可能造成如厕困难。学校护士报告了与医疗服务提供者的不同沟通以及进一步教育的需要。
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Journal of School Health
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