[Bridging Healthcare and Educational Participation: The Role of School Nurses in Empirical Perspective].

Abstract

Objective: The aim of this study is to provide a differentiated analysis of the uptake, range of activities, and the health and psychosocial needs of students addressed by school health nurses (SNs) within the school setting. Particular focus is on gender- and school type-specific differences, the role of SNs in medical and psychosocial care, and their contribution to educational participation.

Methods: Within a mixed-methods approach, routinely collected and software-documented data from 21 public schools in Brandenburg (2024-2025) were analysed. Quantitative analyses (including Poisson regression) were combined with qualitative content analysis of free-text entries to assess not only standardized reasons for consultation but also complex health, psychological, and social problems.

Results: A total of 27,778 contacts were documented. More than 70% of students used the service at least once. Acute complaints (approximately two-thirds) and injuries (approximately one-quarter) predominated, whereas psychosocial and complex problems occurred less frequently but increased markedly in higher grade levels. Girls were significantly more likely to use the service, particularly for health-related and psychological complaints.

Results: The additional analysis of free-text entries provided differentiated insights into psychosocial problems: in primary schools, externalizing behavioural problems predominated among boys, while girls more frequently presented with internalizing symptoms; in secondary schools, more complex and severe psychological burdens, including crisis situations, were increasingly observed.

Results: SNs provided a broad range of interventions, including counselling, emotional support, primary healthcare, and the initiation of further medical and psychosocial care. In approximately 5% of cases, specific recommendations were made. In 85.5% of contacts, a return to class was achieved, underlining the importance of SNs in ensuring educational participation.

Conclusion: SNs play a central role as a low-threshold point of care in everyday school life and represent an important interface between the education and health sectors. Standardized, software-supported documentation constitutes a key basis for quality assurance, evidence-based development, and making their contribution visible in health policy.