School Nursing Practice and Factors Associated With Job Satisfaction Among School Nurses Supporting Children With Medical Complexity in Japanese Elementary Schools

Abstract

Aim

The number of children with medical complexity attending mainstream elementary schools in Japan has increased, highlighting the critical role of school nurses in supporting their care. We aimed to clarify the current status of school nursing practice and to explore factors associated with job satisfaction among school nurses supporting children with medical complexity in Japan.

Methods

We conducted an exploratory and descriptive cross-sectional web-based survey among school nurses working in elementary schools across nine prefectures in Japan with a high proportion of children having medical complexity (estimate of eligible nurses = 768; valid responses = 137). We measured job satisfaction levels using a visual analog scale and subsequently performed multiple regression analysis.

Results

Most school nurses were employed in non-regular positions (93.7%); 65.6% worked as the sole nurse at their school. Advanced medical procedures were more frequently performed in schools with multiple school nurses. Job satisfaction was positively associated with collaborative achievement (β = 0.539, p < 0.001) and consultations with school staff (β = 0.214, p = 0.004) and was negatively associated with developing individualized care manuals (β = −0.184, p = 0.013).

Conclusions

This study suggests that effective interprofessional collaboration, appropriate staffing, and supportive working environments may be important for sustaining the school nursing workforce caring for children with medical complexity. These findings provide empirical evidence for considering working conditions and organizational support in developing a sustainable school nursing system in Japan.