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  • 1.
    Holmström, Malin
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Folkhälsocentrum, Landstinget Västernorrland, Härnösand, Sweden.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Exploring the development of school children´s health2012Ingår i: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 7, nr 4, s. 189-197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To explore the association between positive self-reported health (SRH) in pre-school and 4th grade SRH in a long–term prospective population-based study in Sweden.

    Methods: Data originated from the Health Dialogue (HD) a structured instrument used by school nurses. 1084 children participated. Odds ratios were analyzed.

    Results: In 10-year-old children’s SRH, comfort in school, normal BMI and absence of headaches were shown to be significantly important health indicators. Normal BMI showed to have a potentially causal effect on 10-year-old girls and absence of headaches showed a potentially causal effect among 10-year-old boys.

    Conclusion: Schools should be designed to meet the children’s needs so that they are perceived as comfortable, safe and secure places. Schools should advocate physical activity and play, serve healthy nutritious food in order to motivate, support and promote a healthy lifestyle. Schools are a unique arena for health promotion as they reach practically all school-age children.

  • 2.
    Holmström, Malin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Folkhälsocentrum, Härnösand, Sweden.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Assessing the validity and reliability of the "Health Dialogue" in 10-year-olds2013Ingår i: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 8, nr 8, s. 384-391Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim:

    The aim was to assess the concurrent, construct and convergent validity of the Health Dialogue questionnaire (HD) in 4th grade in compulsory school, through comparison of the HD questionnaire with Pediatric Quality Of Life Inventory (PedsQL), and Health Behavior in School-aged Children (HBSC).

    Methods:

    A sample was created from the HD n=1956, HBSC, n=1500 and PedsQL n=425. An exploratory factor analysis was performed in order to evaluate the construct validity of HD.

    Results:

    A majority of the questions show acceptable concurrent validity and the results support the HD as a valid 16-item three factorial model for school children aged 10 years old (grade 4). The HD's three factorial model's degree of explanation was 39% of the school children's health in school settings.

    Conclusion:

    The HD questionnaire is a valid instrument for measuring 10-year-old school children's self-reported-health and to identify positive health factors.

  • 3.
    Kristiansen, Lisbeth
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Karlström, Annika
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Rising Holmström, Malin
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Boman, Niklas
    Jonsson, Cathrin
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Avdelningen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    A health promotion intervention strengthening Swedish high school students' wellbeing: A feasibility study2018Ingår i: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 13, nr 6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The majority of Swedish school children enjoy a general good health. Still, mental health problems are increasing among young people in Sweden. According to Swedish law all school staff members (teachers and student health professionals) have mutual responsibility to provide a safe school environment and health. Since 2010, there is an emphasis on health promotion in schools. The aim of this study is to describe the feasibility and pilot outcomes of a health promoting intervention targeting healthy high school students (the Strengthening Adolescent Wellbeing [SAW] project).

    A descriptive design was used with an intervention group that was assessed before and after the implementation of the programme using quantitative methods. The study was based on the Medical Research Council Framework. The study and the data collection were performed during the autumnof 2016 and the early spring of 2017.

    Public high school students' health professionals, that is school nurses, student counselors and specialist educators, facilitated a research-based intervention consisting of eight sessions with education and mind-body practices. Pre- and post-testing were carried out.

    The main findings showed enhanced levels of wellbeing among the participating students and the student-related measures all showed improvements.

    The intervention seems to have been feasible in this context. Findings from this study indicate that the SAW methodology contributed to an improvement in high school students' wellbeing. The study will provide a base for a full-scale evaluation study intended to evaluate the effect of this health-promoting programme.

  • 4.
    Kristiansen, Lisbeth
    et al.
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Rising Holmström, Malin
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Olofsson, Niclas
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Assessing the Construct Validity and Reliability of School Health Records Using the 'Health Dialogue Questionnaire' in the Eleventh Grade2016Ingår i: AIMS Public Health, ISSN 2327-8994, Vol. 3, nr 3, s. 470-486Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and aims: The aim for this study was to assess the construct validity and reliability of the Health Dialogue Questionnaire (HDQ (c)) for eleventh grade in school through comparison of the HDQ (c) with Paediatric Quality Of Life Inventory (PedsQL (TM)), Local monitoring of youth policy questionnaire (LUPP (R)), Health behaviour in Swedish school-aged children (HBSC (c)), Equal health (EH (c)) and The Swedish Survey Youth on Alcohol Consumption (SSYAC (c)). Methods: Cross-sectional samples of eleventh graders from the academic year 2009/2010 was used from the HDQ (c) (n = 2752), the HBSC (c) (n = 2090), the PedsQL (TM) (n = 666), the "LUPP (R)" questionnaires (n = 2400), EH (c) (n = 258), and SSYAC (c) (n = 1748) in the academic year 2009/2010. A comparison between HDQ (c) and the different proxies was done. Exploratory and confirmatory factor analyses were performed as well as a Multitrait-Multimethod Matrix (MTMM), in order to evaluate the construct validity and reliability of HDQ (c). Results: An average disagreement between HDQ (c) and proxies with 10 percentages was found. Exploratory factor analysis of HDQ (c) on the 2009/2010 sample suggested a four factor solution (girls factor solution 65% of total variance explained, and in the boys' solution 59% of total variance explained). A second sample 2010/2011 of eleventh graders were used for the confirmatory solution. Almost perfectly similar four factor solutions with were found (girls 58% of total variance explained and boys 56% of the total variance explained). Using MTMM the reliability was generally high and HDQ (c) and showed agreeable validity. Discussion and conclusions: The HDQ (c) questionnaire is a reliable and valid instrument for measuring eleventh graders self-reported-health in school.

  • 5.
    Olofsson, Niclas
    et al.
    Department of Research and Development, Västernorrland County Council, Sundsvall Hospital, Sweden.
    Rising Holmström, Malin
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Assessing the Construct Validity and Reliability of School Health Records of the ‘Health Dialogue Questionnaire,’ in 7th Grade in Compulsory School2015Ingår i: MOJ Public Health, ISSN 2379-6383, Vol. 2, nr 1, artikel-id 00010Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim for this study was to assess the construct validity and reliability of the Health Dialogue Questionnaire (HDQ), 7th grade in compulsory school through comparison of the HDQ, with Paediatric Quality Of Life Inventory (PedsQLTM), Local monitoring of youth policy questionnaire (LUPP®) and Health behaviour in Swedish school-aged children (HBSC).Design and methods: A sample was created from HDQ (n= 2008), PedsQLTM (n=477), LUPP (n=2648), HBSC, (n=1500) andan exploratory factor analysis was performed in order to evaluate the construct validity of HDQ of the school children´s health in school settings.Results: The results supported the HDQ as a valid 24 items factorial model, for girls a five factorial model and for boys a four factorial model for school children aged 13 years old (grade 7). The girls' model explained 63 % of the variance, while the boys' model explained 58 % of the variance. A majority of the questions showed an agreeable concurrent and discriminant validity.Conclusions: The HDQ questionnaire is a valid instrument for measuring 13-year-old school children's self-reported-health.

  • 6.
    Rising Holmström, Malin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Promoting a relationship-based health practice: A challenge for school nurses2013Ingår i: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 8, nr 1, s. 30-38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    School nurses have a unique opportunity to promote health when they meet school children during the Health Dialogue. The Health Dialogue concept is used by all the school nurses in a county in Mid Sweden.

    Aim:

    To describe school nurses' experiences of the Health Dialogue concept.

    Methods:

    A qualitative descriptive study with latent content analysis of interviews performed during February–April 2012, where 16 school nurses participated.

    Findings:

    The school nurses experienced the Health Dialogue concept as a useful tool to work with school children's health in a relationship-based, child focused, structured, and systematic way, which was reflected in one overarching theme: 'To be in a relationship-based, health-promoting practice.' However, school nurses also experienced loneliness and frustration from the many difficult situations with school children, and they indicated needs for further collaboration.

    Conclusions:

    The Health Dialogue concept is child-focused, systematic and structured, but it requires further development and continuing work on statistical feedback. School nurses indicated a need for collaboration with teachers, parents, and other health professionals, as well as professional-reflective supervision.

  • 7.
    Rising Holmström, Malin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Marie, Häggström
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Skolsköterskans rolltransformering till den nya hälsofrämjande positionen [The transformation of the school nurse’s role towards the new health-promoting position]2015Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, nr 4, s. 210-217Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim The aim of this study was to describe the role transformation of school nurses towards primary health promotion, and secondary preventive and health treatment work.Background According to the Swedish educational act, the school nurse profession has changed towards being mainly health promotion and secondary preventive and health treatment work.Method The study consisted of a qualitative study design with content analysis inspired by Elo and Kyngäs. Sixteen individual interviews were conducted with school nurses from across one county.Findings The role transformation towards a more health promotion was described by school nurses' statements. The process of the transformation differed among the school nurses. Three categories illuminated their work; professional approach, student-centred and collaboration.Conclusion The role transformation process required enhanced relation and communicational skills. Structured collegial supervision might support the process.

  • 8.
    Rising Holmström, Malin
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Olofsson, N.
    Public Healthcare Center Härnösand, County Council Västernorrland, Härnösand, Sweden.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Health among 6-year-old children in a Swedish county: Based on the Health dialogue2011Ingår i: Acta Paediatrica. Supplement, ISSN 0803-5326, Vol. 100, nr 463, s. 105-106Artikel i tidskrift (Refereegranskat)
  • 9.
    Rising Holmström, Malin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Folkhälsocentrum, Landstinget Västernorrland, Härnösand, Sweden.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Transitions in the Swedish school system and the impact on student's positive self-reported-health2014Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, artikel-id 1045Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To explore three school based transitions and their impact on positive self-reported-health (SRH), pre-school to elementary school (6-10 y), elementary school to junior high school (10-13y), and junior high school to upper secondary school/high school (13-16y), in a long-term longitudinal population based study. Methods: The study followed three cohorts through one school transition each. A longitudinal study with data from 6693 Health Dialogue questionnaires were used. Data were collected in the middle of Sweden during 2007-2012 with school children age 6-16 years old. Results: Several significant factors were identified with an impact for a positive self-reported-health among children age 6-16y; not feeling sad or depressed, afraid or worried, positive school environment (schoolyard and restrooms), not bullied, good sleep, daily physical activity and ability to concentrate. There was no single factor identified, the factors differed according to gender and age. Conclusion: The study have identified several gender and age specific factors for successful school transitions relevant for a positive SRH. This is valuable information for school staff, parents and school children and provides a possibility to provide support and assistance when needed.

  • 10.
    Rising Holmström, Malin
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Landstinget Västernorrland.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Health among 6-year-old children in a Swedish county: based on the health Dialogue2012Ingår i: Vulnerable Groups & Inclusion, ISSN 2000-8023, E-ISSN 2000-8023, Vol. 3, nr 1, artikel-id 8416Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To explore the experiences of self-reported health (SRH) of 6-year-old boys and girls.

    Background: The goals for the Swedish School Health Services (SHS) are to identify health problems, take measures to prevent illness, and promote health. One approach used to achieve this is the use of the Health Dialogue (HD) questionnaire. The HD is offered at three occasions during compulsory school and once in high school; it follows the child’s development and growth from 6 to 16 years old.

    Methods: The HD is a structured questionnaire consisting of 15 questions related to health, each phrased in a positive manner. The HD represents a cross-sectional image of the child’s SRH according to the child and parents. The SRH in this study is based on the results from the 5259 HD questionnaires conducted during 20062009 with 6-year-old children and parents. OR were analyzed for the HD.

    Results: Experiencing comfortableness in preschool, good sleep, absence of severe headaches, being physical active/play every day, and not being a victim for bullying shows to be important preschool indicators for boys and girls. Discussion: The most important health variable tagging in the preschool children’s positive SRH was comfortableness in preschool. Both boys and girls need to feel comfortable in preschool to report a positive SRH in school. The girls seem to be more dependent on comfortableness, being physical active, and not being bullied while the boys need to have lunch in school every day and not to show symptoms like severe headaches.

    Conclusion: The most important health variable tagging the preschool children’s SRH is comfortableness in school. The HD can increase the knowledge of 6-year-old children’s SRH and also be a tool to gain further insight into children’s health by highlighting patterns in children’s SRH

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