"Headache Tools to Stay in School": Assessment, Development, and Implementation of an Educational Guide for School Nurses

More Than a Headache: Lived Experience of Migraine in Youth

BACKGROUND

Migraine is the leading cause of disability among adolescents and young adults. We aimed to characterize the impact of migraine on the experience of children, adolescents, and caregivers.

METHODS

This descriptive qualitative study recruited youth aged four to 18 years with migraine and their caregivers from the multicenter, prospective Pediatric Migraine Registry between 2020 and 2021. Participants completed semistructured interviews targeting the lived experience of migraine. A conventional content analysis approach was used to analyze data.

RESULTS

Thirty enrolled dyads (n = 30 children and adolescents, n = 29 caregivers) completed 59 interviews (n = 29 child and adolescent interviews, n = 30 caregiver interviews). Children and adolescents had a median age of 15 years and experienced a median of 13.5 headache days per month. Caregivers had a median age of 44 years and predominantly identified as mothers (n = 28). We identified three themes: (1) Impact on emotional well-being: participants described how their migraine experience included feelings of isolation, depression, and irritability alongside the need for social support; (2) Impact on daily life: participants described how symptoms and unpredictability impacted their ability to perform activities of daily living; and (3) Impact on school: participants described how migraine impacted their school experience, including threatened attendance and worsened performance.

CONCLUSIONS

In this cohort of youth and their caregivers, we identified salient themes to characterize the experience of migraine. Our findings underscore the urgent need for effective migraine treatments and interventions targeting co-occurring mental health conditions, peer relationships, and school support.

Exploring School Nurse Interventions and Health and Education Outcomes: An Integrative Review

School nurses intervene with students, parents, and school staff to advance the health and academic success of students. We conducted an integrative literature review of published research to describe the types of school nurse interventions and health and education outcome measures and to examine how school nurse interventions were linked to student outcomes. Sixty-five studies met the inclusion criteria. We used the National Association of School Nurses' Framework for 21st Century School Nursing Practice to categorize school nurse interventions and health and education outcome measures. The majority of interventions were categorized under the care coordination principle, most commonly, motivational interviewing and counseling. In 17 studies, school nurse interventions were linked to improved student outcomes. Most studies (80%) were descriptive. To advance school nursing science, researchers can build on this foundation with more rigorous research methods to evaluate the impact of school nurse interventions and activities on student health and education outcomes.