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Impact of cultural and philosophical beliefs on school nursing policy

Erin Maughan, PhD(c) APRN, BC, College of Nursing, Brigham Young University, 552 SWKT, Provo, UT 84602, 801-422-4893, erindel1@yahoo.com

Purpose: The purposes of this study were 1) to identify social and political factors that influence school nurse/student ratios, and 2) to identify underlying beliefs and values of communities that affect policies relating to school nurse staffing.

Method: This descriptive study involved 30 taped telephone interviews with school nurse consultants, legislators, and other school nursing advocates from 11 different states. Participating states were purposefully chosen to ensure representation of various factors including: school nurse/student ratio, geographic region, population density, political ideology, and consultants from state departments of health and departments of education. Data were transcribed and analyzed to identify common themes. Themes were then converted into dichotomous variables and Qualitative Comparative Analysis (QCA), an analytic technique that uses boolean algebra, was performed. QCA helps to identify the minimum combination of unique factors necessary for a specific outcome to occur.

Findings: No single factor was found to have the greatest influence of school nurse/student ratios. Various combinations of factors facilitate or impede school nursing staffing. Positive factors include the approach taken to obtain more school nurses, the degree of understanding and value society places on school nurses, the local support and grassroots efforts for school nurses, a fear of litigation, and dynamic leadership. Barriers to school nurse staffing include funding, misunderstanding/confusion regarding the role of the school nurse, and philosophical opposition (including beliefs regarding the rights and responsibilities of parents and families, the role of education, and the role of government). The role of culture and values were also found to also influence school nurse to student ratios, however additional studies are needed to better understand this relationship.

Conclusion: There is not a "one size fits all" model that school nurse advocates can use to obtain more school nurses. The approach must address the particular needs and beliefs of each state and local area. Each nurse can make a difference, but he/she must acknowledge these varying cultural and philosophical beliefs in order to create change.

Dissertation Chair: Mary E. Duffy

Institution: University of Utah, anticipated graduation May 2006 with a Doctorate of Philosophy (dissertation successfully defended November 21, 2005).

Learning Objectives: At the conclusion of this session, the participant will be able to

Keywords: Public Health Nursing, Policy/Policy Development

Presenting author's disclosure statement:

Not Answered

Handout (.ppt format, 440.0 kb)

Public Health Nursing Student Poster Session I

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA