Theory of help interconnectivity: Grounded theory of school nursing care for adolescents

Background School nursing lacks global visibility and clear evidence, particularly in Portugal. This study sought to define its nature within adolescent care to provide scientific visibility and professional legitimacy. Objectives This study aimed to characterise the school nursing care process with adolescents and develop a substantive theory to legitimise this practice. Methods This qualitative study utilised Grounded Theory and Symbolic Interactionism, grounded in intermodernism. Initial purposive sampling included 8 school nurses, followed by a case-specific sample of 84 community stakeholders to achieve theoretical sufficiency. Data collection (2015-2022) involved narrative interviews, focus groups, and 107 observation hours. Analysis followed Strauss and Corbin's method. National and local committees granted ethical approval. Results The core phenomenon, “Interconnecting the Simultaneity of Worlds”, underpins the Theory of Helping Interconnectivity. It comprises three constructs: (1) Knowing-Situating oneself; (2) Interconnecting Therapeutic Care (including the WAKES Model); and (3) Constructing Reliability Relationships, a longitudinal process that identified twelve professional roles. Nursing care was characterised as a dynamic, relational, and multidimensional phenomenon. Conclusion School nursing is defined as an emancipatory process requiring a paradigm shift toward education for self-care. This theory provides an important framework for public policy and quality indicators. Despite socio-cultural limitations, the findings establish a foundation for international research.