Stated and unstated reasons for visiting a high school nurse's office.

Purpose: To determine the presenting complaints of students visiting a high school nurse's office and seek associations between specific presenting complaints and psychosocial problems.
Methods: One hundred eighty-six students visiting the school nurse in a suburban high school were surveyed with a questionnaire developed by the investigators. Categorical data were compared utilizing chi-square or Fisher's Exact Test. Associations were determined by the Kruskal-Wallis Test.
Results: Headaches (25%), infections (17%), stomach aches (12%), and dizziness or tiredness (12%) were the most common presenting complaints. Students indicated that "not sleeping well" and "stress" were two factors that most frequently played a role in their visits. Most students wanted either to rest or await going home; few were interested in receiving medical care or talking to the nurse. Specific complaints of headache, dizziness or tiredness, and no specific symptom were associated (p < .05) with not sleeping well, family problems, stress, school problems and depression.
Conclusions: Complaints of headache, dizziness or tiredness, and no specific symptoms may be used as markers for exploring possible psychosocial problems underlying a visit to the school nurse. If school nurses are to address psychosocial issues, they will need to look beyond stated reasons to unstated reasons for visits. Ways to achieve this expanded level of care are discussed.