Hälsosamtal som metod att främja barns och ungdomars hälsa : en utmanande uppgift

Sammanfattning: The overall aim of this thesis was to explore and describe health dialogues from pupils’ and nurses’ perspectives as well as the verbal interaction between them, in the context of a structured health and lifestyle tool.                      Seventy-four pupils and 23 school nurses participated in focus group interviews, and further 14 nurses participated in individual interviews. To explore the verbal interaction, 24 health dialogues with pupils and school nurses were recorded using a video camera. The data from the interviews were subjected to qualitative content analysis and the verbal interactions were analysed using the paediatric version of the Roter Interaction Analysis System.                      Health dialogues based on the pupil’s own situation were described as a process that provided them opportunities to influence their own health. Prerequisites for a pupil-centered health dialogue were that the pupils were prepared, felt respected and like active participants, and that their own experiences were in focus. How the nurses acted was crucial to the pupils’ experience of and possibility to benefit from of the health dialogue based on their own needs and wishes. A health and lifestyle tool could support the dialogue by constituting a structure, open up for discussion and contribute to an understanding of the individual’s situation. The tool could also facilitate the transmittal of health information on an individual as well as a group level. In terms of utterances in the dialogues, the school nurses were the ones who talked the most. The pupils most frequently gave information about their lifestyle and agreed with the nurses. The nurses asked questions and provided information about lifestyle, and checked that they had understood the pupils. Just over a third of the nurses’ verbal interaction approaches were aimed to make the pupil more active and participatory in the dialogues.                      In conclusion, the health dialogues were described as an opportunity to gain knowledge about and insight into health and lifestyle, but a pupil-centered dialogue was considered crucial. The challenge is to adapt the health dialogue based on each pupil’s needs and wishes, and a health and lifestyle tool could contribute structure and support the dialogue.