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Updated: Aug 8, 2026
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Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
Published on: August 29, 2025
The School Health Intensity Rating Scale: establishing reliability for practice
J K Klahn1, B J Hays, C J Iverson
1Box Butte General Hospital, Alliance, Nebraska, USA.
Summary
School nurses need tools to assess student health needs. The School Health Intensity Rating Scale (SHIRS) showed moderate reliability for most parameters, aiding in identifying student health care intensity.
Area of Science:
- Pediatric Nursing
- Health Services Research
- Educational Health
Background:
- Effective school nursing requires accurate assessment of student health needs.
- Identifying necessary nursing resources is crucial for achieving desired health outcomes in school-age populations.
- Existing tools may lack sufficient reliability for assessing the intensity of student health care requirements.
Purpose of the Study:
- To evaluate the interrater reliability of the School Health Intensity Rating Scale (SHIRS).
- To determine if SHIRS can consistently assess the intensity of health care needs among school-age students.
- To provide evidence for the utility of SHIRS in school health settings.
Main Methods:
- The study involved four school nurses assessing 20 fictitious student records.
- The School Health Intensity Rating Scale (SHIRS) was used for the assessments.
- Interrater reliability was quantified using kappa coefficients for each parameter of the SHIRS.
Main Results:
- SHIRS demonstrated moderate kappa coefficients for over half of its 15 parameters.
- Two additional parameters approached moderate kappa values, suggesting potential reliability.
- The findings indicate a degree of consistency in how nurses apply the SHIRS tool.
Conclusions:
- The School Health Intensity Rating Scale (SHIRS) shows promising interrater reliability for assessing student health care needs.
- SHIRS can be a valuable tool for school nurses to quantify the intensity of health requirements.
- Further validation may enhance the reliability of all SHIRS parameters for comprehensive school health management.
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