{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T10:29:06Z","timestamp":1763807346446,"version":"3.45.0"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>School nurses are key responders to students with constipation, yet their experiences are underreported. This study surveyed their observations regarding constipation, identified barriers to student restroom access, and assessed educational needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this descriptive, cross\u2010sectional survey study, an anonymous online survey was distributed to school nurses participating in a virtual education series. The survey assessed nurse demographics, frequency of encounters with constipation and encopresis, school restroom policies, barriers to restroom use, accommodation requests, and training in constipation management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Of 125 respondents, 95% encountered students with constipation at least monthly and 55% reported \u2265\u20096 encounters monthly. Commonly perceived barriers to restroom use included unclean bathrooms (48%) and bullying (42%). Half of schools relied on teacher discretion for restroom access; only 37% of nurses were aware their schools had formal policies. While 64% received accommodation requests at least monthly, only 38% had training in constipation management. Most nurses expressed interest in additional education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for School Health Policy, Practice, and Equity<\/jats:title>\n                    <jats:p>Targeted educational interventions and school\u2010wide policy development are necessary to support school nurses and mitigate restrictions that could exacerbate constipation in students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Constipation and encopresis are frequent concerns, particularly in younger grades. Environmental and policy\u2010related barriers may contribute to toileting difficulties. School nurses reported variable communication with providers and the need for further education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/josh.70074","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T04:15:24Z","timestamp":1758082524000},"page":"1082-1090","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Insights From a Survey of School Nurses: Assessing the Challenges of Constipation in Schools"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8824-2914","authenticated-orcid":false,"given":"Andrew S.","family":"Chu","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition Baylor College of Medicine\/Texas Children's Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric H.","family":"Chiou","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition Baylor College of Medicine\/Texas Children's Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_10_2_1","DOI":"10.1016\/j.jpeds.2008.07.060"},{"doi-asserted-by":"publisher","key":"e_1_2_10_3_1","DOI":"10.1111\/j.1572\u20100241.2006.00771.x"},{"doi-asserted-by":"publisher","key":"e_1_2_10_4_1","DOI":"10.1186\/s13052\u2010024\u201001623\u2010y"},{"doi-asserted-by":"publisher","key":"e_1_2_10_5_1","DOI":"10.1053\/j.gastro.2016.02.015"},{"doi-asserted-by":"publisher","key":"e_1_2_10_6_1","DOI":"10.1542\/pir.36\u20109\u2010392"},{"doi-asserted-by":"publisher","key":"e_1_2_10_7_1","DOI":"10.1542\/peds.2004\u20100537"},{"doi-asserted-by":"publisher","key":"e_1_2_10_8_1","DOI":"10.1097\/MPG.0000000000000882"},{"doi-asserted-by":"publisher","key":"e_1_2_10_9_1","DOI":"10.1155\/2016\/7828576"},{"doi-asserted-by":"publisher","key":"e_1_2_10_10_1","DOI":"10.1542\/peds.2005\u20101773"},{"doi-asserted-by":"publisher","key":"e_1_2_10_11_1","DOI":"10.1093\/epirev\/mxr024"},{"doi-asserted-by":"publisher","key":"e_1_2_10_12_1","DOI":"10.1016\/j.jpeds.2013.05.012"},{"doi-asserted-by":"publisher","key":"e_1_2_10_13_1","DOI":"10.1080\/19325037.2019.1642814"},{"doi-asserted-by":"publisher","key":"e_1_2_10_14_1","DOI":"10.12775\/QS.2024.31.55135"},{"doi-asserted-by":"publisher","key":"e_1_2_10_15_1","DOI":"10.7812\/TPP\/17\u2010047"},{"doi-asserted-by":"publisher","key":"e_1_2_10_16_1","DOI":"10.1093\/pubmed\/24.2.85"},{"key":"e_1_2_10_17_1","first-page":"50","article-title":"Drinking Water in Schools","volume":"99","author":"Brander N.","year":"2003","journal-title":"Nursing Times"},{"doi-asserted-by":"publisher","key":"e_1_2_10_18_1","DOI":"10.1177\/1059840511429685"},{"doi-asserted-by":"publisher","key":"e_1_2_10_19_1","DOI":"10.1177\/1942602X13500994"},{"doi-asserted-by":"publisher","key":"e_1_2_10_20_1","DOI":"10.1111\/j.1746-1561.1995.tb06232.x"},{"unstructured":"J.RogersandJ.Perez \u201cHelping Schools to Manage Continence Problems \u201d(2024). Nursing Times https:\/\/www.nursingtimes.net\/bladder\u2010and\u2010bowel\/helping\u2010schools\u2010to\u2010manage\u2010continence\u2010problems\u201025\u201004\u20102014\/.","key":"e_1_2_10_21_1"},{"doi-asserted-by":"publisher","key":"e_1_2_10_22_1","DOI":"10.1016\/j.jpurol.2011.01.013"},{"key":"e_1_2_10_23_1","first-page":"30","article-title":"Educational Needs and Accommodations for Children With Bowel and\/or Bladder Dysfunction","volume":"30","author":"Filce H. 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