School nurses’ engagement and care ethics in promoting adolescent health

Background: The school is a key environment for establishing good health habits among pupils. School nurses play a prominent role in health promotion, since they meet with every single adolescent. Research aim: To describe care ethics in the context of school nurses’ health-promoting activities among adolescents in secondary schools. Research design: An explorative descriptive methodology in which semi-structured interviews were used to collect data and content analysis was performed. Participants and research context: Data were collected from eight school nurses in a municipality in Western Sweden. Ethical considerations: This study was conducted according to the ethical principles of the Swedish Research Council (2011), and the written informed consent of the participants was obtained. Findings/discussion: A caring relation, based on care ethics, is the basis for successful health-promoting activities among adolescents. The school nurses show strong engagement in and commitment to caring for and caring about adolescents by being attentive and listening to their expressed feelings and needs, both spoken and unspoken. Furthermore, the school nurses have a deep sense of responsibility in supporting and empowering adolescents to trust their own capabilities. To enhance health and well-being, school nurses emphasize low-threshold counselling, flexibility, openness, early intervention and continuity, as well as good collaboration with the health team at school and with parents. Conclusion: Strengthening person-centred healthcare can provide adolescents with the recognition and support they need to grow into healthy adults. For successful health promotion, all aspects of the ethics of care should be considered as part of an integrated whole based on the integrity of care.