| Summary: | This study examined the effect of self-referral instruction on Grade 4 students' utilization of school nursing services. Self-referral is a skill needed for self-care. Adult self-care has received emphasis by consumers and health professionals. The focus on adult self-care has not, however, achieved the goal of consumers taking more responsibility for their health. It has been suggested that childhood may be the most appropriate time to teach self-care skills. A review of the literature demonstrated, however, that little is known about child self-care and childrens’ learning and use of the specific skills and knowledge needed to practice self-care. This study therefore contributes to a currently inadequate knowledge base and enhances the ability of nurses to make objective decisions about Instruction of children in the use of a self-care skill, self-referral, in the school setting when nursing time is limited.
This experimental study involved 78 Grade 4 students from four schools. The students were randomly assigned to a group that either would or would not be taught self-referral to the school nurse. There were two 20 minute lessons given to the experimental group, a pre and post study questionnaire was given to both groups prior to the lessons and nine weeks later at the conclusion of the study.
The questionnaire collected data about the students' knowledge of the school nurse's accessibility, their willingness to self-refer, and their knowledge concerning appropriate reasons to use self-referral, information was also collected from the nurses regarding what students used self-referral and the problems they presented. Analysis of variance and chi-square were selected as appropriate statistical methods of analysis. The findings demonstrated that children who were given instruction in self-referral had significantly greater knowledge about how, when, and why to self-refer. Instruction in self-referral did not, however, encourage a significant number of children to practice this skill as only four children from the experimental group self-referred. It is speculated from comparing the number of self-referrals between the schools that the placement of the self-referral appointment books in the schools was a factor that affected the students' decisions to self-refer, it appears it is important that the book be placed where the children feel comfortable writing in it. Such a place may be away from the scrutiny of adults while providing as much privacy as possible.
Based upon this study's findings, implications for nursing practice and recommendations for further research were described. === Applied Science, Faculty of === Nursing, School of === Graduate
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