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The number of adolescents experiencing pain is increasing. Pain has a major impact on several areas of daily living, such as function at school and school absenteeism, loss of appetite and socializing. One out of ten pupils in Norwegian schools is immigrants, and surveys have shown that immigrants suffer from poor health more often than the general population. The purpose of this study was to explore how school nurses and teachers experience pain in young immigrants in the school setting.

A qualitative design using focus group interviews was chosen for data collection. A total of 11 focus groups (17 school nurses and 25 teachers) consisting of school nurses and teachers in junior high schools (age: 13-16 years) in Southern Norway were conducted. Data were analyzed using a qualitative content analysis.

School nurses and teachers experienced communication of pain with young immigrants as characterized by cultural differences and language problems. Immigrants waiting for residency permits experienced pain more often than others. They also experienced that young immigrants often were absent from school and used pain as an excuse for not participating in classes, but this was not the case at the special school for immigrants. During Ramadan, they experienced that immigrant pupils had an increase of pain, especially headaches.

Culture affects the assessment and management of pain and different strategies may assist school nurses and teachers in their encounter with young immigrants with pain. There is a need for education in cultural competence among teachers and school nurses.

The purpose is to share strategies, rationales and lessons learnt from user involvement in a quality and safety improvement research project from the practice field in nursing homes and homecare services.

This is a viewpoint paper summarizing how researchers and co-researchers from the practice field of nursing homes and homecare services (nurse counsellors from different municipalities, patient ombudsman and next-of-kin representatives/and elderly care organization representant) experienced user involvement through all phases of the research project. The project included implementation of a leadership intervention.

Multiple strategies of user involvement were applied during the project including partnership in the consortium, employment of user representatives (co-researchers) and user-led research activities. The rationale was to ensure sound context adaptation of the intervention and development of tailor-made activities and tools based on equality and mutual trust in the collaboration. Both university-based researchers and Co-researchers experienced it as useful and necessary to involve or being involved in all phases of the research project, including the designing, planning, intervention implementation, evaluation and dissemination of results.

User involvement in research is a growing field. There is limited focus on this aspect in quality and safety interventions in nursing homes and homecare settings and in projects focussing on the leadership' role in improving quality and safety.