Life skills that promote school health in adolescents: a concept analysis

Abstract

Background

Life skills are essential for school health in adolescents; however, their conceptual understanding remains limited, so this concept will be explored.

Objective

To analyse the concept of "life skills that promote school health in adolescents" in the literature.

Method

Concept analysis followed the eight steps described by Walker and Avant. In the evidence synthesis, an integrative review was conducted, following the PRISMA 2020 methodological guidelines. The literature review was performed on the Web of Science platform, and in the PubMed, Scopus, and ScienceDirect databases, for articles published between 2020 and 2024, written in Spanish or English, and including qualitative, quantitative, mixed-methods studies, or systematic reviews.

Results

Eighteen studies were included, from which four key attributes of life skills were identified: decision-making, effective communication, stress management, and problem solving. These skills contribute to reducing risky behaviours, improving resilience, and strengthening overall well-being.

Conclusions

Despite the limited evidence linking life skills that promote adolescent school health these can be defined as a set of essential psychosocial competencies that enable adolescents to effectively cope with health-related challenges in school and social environments. The theoretical framework for understanding life skills provided in this study can be used to develop specific educational programs and interventions for adolescents.

Introduction

The World Health Organization (WHO) defines life skills as"the aptitudes necessary for appropriate and positive behaviour that enable us to effectively face the demands and challenges of daily life" [1]. These skills are essential for personal development and fostering resilience, responsible decision-making, and conflict resolution in different social contexts [2]. In the school environment, the teaching of life skills takes on critical importance, given that adolescents face multiple challenges that can impact their physical, emotional, and social well-being [3].

School health promotion, understood as the process that empowers communities to improve their health by strengthening their personal and collective capacities [3], has proven to be an effective strategy for fostering healthy lifestyles. Using this approach, students develop skills that contribute to disease prevention and the development of sustainable habits to achieve an optimal quality of life [2].

However, the school environment is not only a space for academic learning; it is also a key setting for intervening in factors that determine health, especially during adolescence, a stage characterized by significant biological, psychological, and social changes [4]. In this context, life skills emerge as an effective means to strengthen young people's ability to cope with risky situations, manage emotions, and adopt healthy behaviours that transcend the school stage [1].

School nursing plays a fundamental role in this process. As agents of change, nursing professionals contribute to the promotion of these skills through specific interventions that include educational programs, prevention activities, and psychosocial support. These actions not only promote physical activity, healthy eating, and injury prevention but also enhance competencies related to self-care, problem solving, and informed decision-making [4].

Despite its relevance, the concept of"life skills that promote school health in adolescents"has not been fully defined or analysed in the literature. This lack of conceptual clarity can limit the effective implementation of strategies and programs aimed at promoting them. Although numerous studies address life skills in general, few focus on their impact within the school context or their relationship with adolescent health [2].

Given that adolescence is a defining stage for the development of habits and behaviours that persist into adulthood, it is essential to understand the scope and core attributes of this concept. Thus, the objective of this study is to analyse the concept of"life skills that promote school health in adolescents"using the conceptual analysis method proposed by Walker and Avant.

Method

This concept analysis was conducted using Walker and Avant's systematic method, an approach grounded in linguistic philosophy that contributes to the philosophical understanding of concepts [5]. This method, which is widely recognized within the positivist paradigm, is based on the premise that concepts are stable entities that can be decomposed, analysed, and extracted from their application contexts [6]. It is also very useful for clarifying complex concepts and establishing operational definitions that can be applied in research and clinical practice.

The method proposed by Walker and Avant offers a systematic and replicable approach to concept analysis, making it particularly suitable for clarifying complex constructs such as"life skills."This methodology was selected for its ability to stabilize and operationalize abstract psychosocial concepts, facilitating their application in nursing and healthcare contexts. Despite certain limitations, such as a lower sensitivity to context, its analytical rigor aligns with the study's objective of establishing a clear and transferable definition. Compared to other approaches, such as evolutionary analysis or critical analysis, Walker and Avant's model allows for a more precise delineation of the concept, which is essential in the initial stages of theoretical development [7].

This systematic approach allows for organizing and synthesizing information obtained from diverse sources to conceptualize"life skills that promote school health in adolescents,"which lacks a unified definition in the literature. The Walker and Avant method consists of eight clearly defined steps [5]:

1. Select a concept.

2. Determine the objectives or purposes of the analysis.

3. Identify all possible uses of the concept.

4. Determine the defining attributes of the concept.

5. Construct a case study.

6. Analyse borderline, contrary, invented, and illegitimate cases.

7. Identify the antecedents and consequences of the concept.

8. Define empirical references that allow measuring or evaluating the concept.

The application of the steps is directly reflected in the results. The literature review was conducted following the guidelines established by the PRISMA 2020 declaration to ensure transparency and methodological quality at each stage of the process. An inductive approach was prioritized throughout the analysis to avoid relying on preconceived categories and thus ensure that the findings emerged directly from the literature reviews. The procedure made it possible to establish the essential components of the concept and explore its internal dynamics and applicability in various school contexts. This contributed to the development of a clear conceptual framework to guide health promotion interventions and strengthen school nursing practices.

Results

• Step 1. Select a concept. The concept of Life Skills that Promote School Health in Adolescents was selected for its relevance, applicability, and contribution to knowledge development.

• Step 2. Determine the objectives or purposes of the analysis. The purpose of this analysis was to clarify the meaning of the concept and its implications for adolescent school health, providing a theoretical basis for future research and practical applications.

• Step 3. Identify all possible uses of the term. The possible uses were compiled from different sources, in this case from the integrated literature review. The search allowed us to capture the semantic richness of the term and avoid biases in its interpretation.

• The information search was conducted using the keywords “concept analysis,” “nursing,” “life skills,” “school health promotion,” and “adolescents,” which were found in DeCS and MeSH. To ensure comprehensiveness, studies in Spanish and English published in indexed journals within the last four years were included. The literature review was used to identify the definitions, attributes, background, and consequences of the concept, as well as its practical and theoretical applications in the context of school health.

Selection criteria

The selection criteria included documents addressing the terms"life skills,""school health promotion,""adolescent health,"or"school nursing", written in Spanish or English, and qualitative, quantitative, or mixed-methods studies or systematic reviews published in scientific journals on health, education, or nursing between 2020 and 2024.

Documents published in non-peer reviewed journals, editorials, letters to the editor, opinion pieces, and articles that did not consider the concept of life skills in the context of school health or adolescence were excluded.

Data sources

In the evidence synthesis, an integrative review was conducted, following the PRISMA 2020 methodological guidelines. A search was performed in the PubMed, Scopus, ScienceDirect databases and on the Web of Science platform, for articles published between 2020 and 2024 (Fig. 1), using the essential terms appearing in the title, abstract, and list of keywords. The search terms used in PubMed, Scopus, ScienceDirect, and Web of Science are as follows:"life skills"AND"school"AND"health"AND"adolescents"AND"nursing."

Fig. 1.

Flowchart of the concept analysis study selection process

Articles from qualitative or quantitative studies published in Spanish or English that focused on the concept of"life skills that promote school health in adolescents"were included. Three researchers independently reviewed the titles and abstracts to determine if they met the inclusion and exclusion criteria for retrieval and analysis. Following this initial step, the researchers rescreened the included articles; they confirmed they met the criteria, identified different uses of the concept, and systematically recorded characteristics of the concept that appeared repeatedly. In cases where disagreements arose between the reviewers, they were discussed until a consensus was reached. When agreement was not possible, a third author acted as arbiter to make the final decision. Definitions and examples were used in the systematic recording to explain a set of antecedents, attributes, and consequences that were associated with the concept.

Initially, 552 records were identified in the PubMed, Scopus, Science Direct, and Web of Science databases. Subsequently, 43 duplicate records were eliminated, resulting in a total of 509 studies for the screening phase. During the selection phase, 149 studies were excluded after the titles and abstracts were reviewed. During the eligibility assessment, 341 studies were excluded because they did not meet the inclusion criteria, and 1 study was discarded because of a language barrier. Ultimately, 18 studies met the established criteria, providing an empirical basis for developing a conceptual analysis of life skills and school health promotion in adolescents. In the 18 articles included, 16 are empirical studies, one is theoretical-empirical, and one corresponds to an academic column [8]. Among the empirical ones, the following designs were identified: six cross-sectional studies [9–14], three qualitative [15–17], two quasi-experimental [18, 19], two randomized controlled trials [20, 21], one feasibility study [22], one psychometric validation [23] and one factorial test protocol [24]. The theoretical-empirical article corresponds to a systematic review with meta-analysis [25].

Definition of the concept

Dictionary definitions of the concept

Life skills are defined as a set of essential competencies for decision-making, problem solving, and coping with everyday challenges. According to the WHO, life skills enable individuals to effectively confront problems and maintain optimal well-being [1]. However, this is a general definition, making it difficult to directly apply in the context of life skills education for adolescents.

Definitions of the concept reported in the literature

In their systematic review, Kirchhoff and Keller [26] specified that life skills are a set of competencies that must be developed specifically and appropriately for the age of students. These competencies enable adolescents to cope with everyday situations and make healthy decisions that promote their overall well-being. Furthermore, the study highlights that the effectiveness of educational programs is related to their ability to promote a proactive attitude towards problems and challenges. The main professionals involved in these programs are specialized school health educators who adapt the content according to the students'ages.

In their analysis of resilience and self-efficacy, Sagone et al. [27] observed that life skills are fundamental to the emotional and psychological development of adolescents. They highlighted the importance of these skills in developing resilience and self-efficacy in young people, enhancing their ability to make responsible decisions and cope with complex situations. In this study, educational psychologists are essential in evaluating the impact of these skills on adolescents'psychological well-being.

In Fallah et al. [21], life skills are understood as fundamental tools for preventing risky behaviours in adolescents, such as substance use or unprotected sex. Public health researchers play a key role in evaluating how these programs influence adolescents'overall health and in modifying risky behaviours.

Subconcepts

Subconcepts related to life skills include decision-making, stress management, problem solving, and effective communication. Research by Kirchhoff and Keller [26] highlighted the relationship between these subcomponents and the development of positive and healthy attitudes in students. Furthermore, the study established that life skills are linked to adolescents'ability to adapt to different contexts and challenges. Psychologists and educators play a fundamental role in the implementation of these skills. Similarly, in the study by Fallah et al. [21], the subcomponents studied included decision-making, stress management, and problem solving as fundamental life skills, which helped significantly reduce the tendency towards risky behaviours among participating adolescents. Figure 2 outlines the antecedents, attributes and consequences, along with the implications.

• Step 4. Attributes of the concept: identifying the core characteristics called defining attributes that consistently appear across the different uses of the concept [5]. Four attributes of the Life Skills concept were identified that promote school health in adolescents (Table 1).

  1. Decision-making: Decision-making is an essential skill that enables adolescents to evaluate options and choose the best alternative in different contexts. This competency is fundamental for the development of autonomy and responsibility in young people [12, 20]. An effective decision-making process involves identifying the problem, evaluating available options, and selecting the best solution based on the available information and potential consequences.
  2. Effective communication: Effective communication is the ability to express ideas clearly and understand others [11, 23]. This skill is important because it establishes healthy relationships and resolves conflicts in school and social settings. Effective communication involves active listening, using appropriate language, and being assertive when expressing thoughts and emotions.
  3. Stress management: Stress management is a skill that allows adolescents to manage pressure and emotions in difficult situations [9, 18]. Strategies such as meditation, time management, and developing a resilient mindset contribute to reducing stress and anxiety and promoting better academic performance and emotional well-being.
  4. Problem-solving:
  5. Problem-solving involves analysing a situation, identifying challenges, and finding effective solutions [15, 25]. This skill enables adolescents to confront conflicts and difficulties constructively, fostering informed decision-making and critical thinking.

• Step 5. Construction of a model case. A model case was developed that incorporates all the essential attributes of the concept. This hypothetical case serves as a reference to validate understanding [5].

Fig. 2.

Antecedents, attributes and consequences of Life skills that promote school health in adolescents)

Table 1.

Life Skills Attributes That Promote School Health in Adolescents

Attribute	Description	Author	Country
Decision-making	Ability to evaluate options and choose the best alternative in different contexts	Mao et al., 2022 [9] Shegog et al., 2021 [22] Sánchez-Hernando et al., 2021 [10]	China, EE. UU
Effective communication	Ability to express ideas clearly and understand others	Lee, 2020 [11] Sánchez-Hernando et al., 2022 [23]	Spain, South Korea
Stress management	Strategies for managing pressure and emotions in difficult situations	Mao et al., 2022 [12] O’Sullivan et al., 2021 [18]	China, Ireland
Problem solving	Ability to analyse and find effective solutions to challenges	Karmaliani et al., 2020 [20]	Pakistan

Tomás, a 16-year-old, faced a situation that challenged the skills he had learned in school. One Thursday, his friends invited him to an impromptu party. Tomas was familiar with the situation and knew the party would involve alcohol consumption, where he might give in to peer pressure to engage in various types of sexual activity. Aware of the situation and the risks, Tomas decided to implement his decision-making skills; after weighing the pros and cons, he decided not to attend the party and to prioritize the exam he had the following day. When he explained his decision to his friends, he used effective, clear, and respectful communication, stating,"Guys, I have an important exam tomorrow, and I need to study."On the way home, Tomas began to feel the pressure of the exam, but since he had been practising stress management for months, he used relaxation techniques that allowed him to calm down and focus on his studies. While studying the assessment topics, he realized that he did not understand an important topic, so he activated his problem-solving skills and sent a message to his professor to clarify his doubts. He also reviewed online tutorials to reinforce his knowledge. As time passed, Tomás applied time management skills, organized his study into small chunks, and took breaks to learn the content without feeling overwhelmed. Finally, on the exam day, he practised resilience and emotional well-being, which allowed him to face the situation calmly. He knew that he had worked hard and that his peace of mind was more important than the results he might obtain. Upon leaving the exam, he felt relief and pride in having handled the situation calmly.

• Step 6. Contrary case. This case allows the concept to be defined, showing what defines it and what does not, and helps refine its essential attributes through comparison. A contrary case does not include any defined attributes of the concept. There are clear examples of what the concept is not, which makes it easier to define what it is by contrast [5].

Tomás is a 16-year-old who faced a situation that challenged the skills he had learned in school. One Thursday, his friends invited him to an impromptu party. Tomás was aware that the party might involve alcohol consumption and peer pressure to experiment and engage in different types of sexual activity; nevertheless, he decided to attend the party, prioritizing having fun over the exam he had the next day. Upon arriving at the party, he felt pressure from his peers to consume alcohol, meet girls, and engage in risky sexual behaviours. During the party, Tomás began to feel a knot in his stomach because he had no strategies for managing his stress. The guilt and worry about the exam, which he had chosen to ignore, immediately consumed him because he did not know how to manage his emotions; instead of continuing to enjoy the moment, he felt overwhelmed by anxiety. As the night wore on, Tomás decided to go home, where he realized he had not solved the biggest problem: studying for the exam. He knew that he did not understand important topics and needed help in reinforcing the concepts. He felt paralysed because he did not have the skills to manage his time. Before going to the party, he thought he could study later, but he did not calculate the time or the help he needed. A few hours before the exam, he was tired and lacked the energy to take the test. When Tomás arrived at school, he knew that he was not prepared, and his lack of resilience affected him deeply. Therefore, he failed to focus on what he could do and let fear and anxiety dominate him. Unable to handle the situation, he felt defeated. Without knowing it, he would, unfortunately, also face a sexually transmitted disease in the future.

• Step 7. Identify the antecedents and consequences of the concept. This helps you understand the context of a concept and clarify its defining attributes. Antecedents are events or conditions that must occur before the concept emerges; they set the stage for its emergence but are not part of the concept itself. Consequences, on the other hand, are the outcomes or events that follow the occurrence of the concept. They help illustrate its impact or results [5].

Macro background

1. Socioeconomic and Cultural Context: Factors such as a lack of sexuality education, social influence, and limited access to health services affect the development of life skills in adolescents [14, 16].

2. Educational Systems and Public Policies: Variability in sexuality education coverage and barriers to program implementation influence the development of these skills [19, 23].

Micro Background

1. Adolescents'Prior Situation: The level of prior skills, risk behaviour, and specific context of each community influence the development of life skills [12, 20].

2. Presence or Absence of Prior Interventions: The existence of education and support programs in communities can facilitate the implementation of strategies to improve life skills [15, 25].

3. Family Conditions and Access to Resources: The influence of the family environment and access to information and services are determining factors in acquiring these skills [9, 16].

Consequences

For adolescents

1. Reduction in risky behaviours: Improved decision-making and effective communication contribute to a decrease in unintended pregnancies and sexually transmitted diseases [21, 22].

2. Better decision-making: An increased ability to assess risks and act in an informed manner enables adolescents to manage complex situations [12, 20].

For society

1. Better access to education and health care: The implementation of educational programs and improved health care infrastructure have positive impacts on the community [15, 17].

2. Greater resilience and well-being: Strengthening the mental health and overall well-being of adolescents has positive effects on their quality of life and society [9, 18].

Implications

1. Educational: The development of cognitive and emotional skills through structured programs improves the academic performance and emotional stability of adolescents [19, 23].

2. Psychological: The acquisition of these skills directly impacts young people's self-esteem and emotional resilience, reducing anxiety and depression [12, 21].

3. Social: The development of communication and problem-solving skills enhances the ability of adolescents to interact with and adapt to the social environment [14, 15, 25] (Table 2).

Table 2.

The implications of Life Skills that Promote School Health in Adolescents

Implications	Description	Author	Country
Educational	Development of cognitive and emotional skills through structured programs	Sánchez-Hernando et al., 2022 [13] Sagatun et al., 2023 [24] SIK & KM, 2022 [19]	Spain, India
Psychological	Impact on the self-esteem and emotional resilience of adolescents	Fallah et al., 2021 [21] Singla et al., 2020 [25]	Iran
Social	Influence on interaction and adaptation to the social environment	Mediawati et al., 2022 [14] Sekgobela et al., 2020 [15] Hawkins, 2024 [8] Janighorban et al., 2022 [16] Likupe et al., 2021 [17]	Indonesia, South Africa, Iran, Malawi, USA

• Step 8. Empirical references. The final step in concept analysis is to identify empirical references and observable phenomena that demonstrate the existence of the concept in the real world. These references are not measurement tools in themselves, but rather concrete indicators that show when the attributes that define a concept are present [5].

Relationship between basic human values and decision-making styles in adolescents

The Flinders Adolescent Decision-Making Questionnaire (FADMQ) by Mann was used to assess decision-making styles in adolescents, differentiating between adaptive and maladaptive styles. The Schwartz Values Scale (SVS) measures adolescents'personal values and is organized into different categories. Young people with an adaptive decision-making style prioritize values such as self-direction, stimulation, achievement, and power, whereas those with a maladaptive style tend to move away from self-direction and exhibit a more conservative orientation [28].

Development and validation of an intertemporal decision-making ability scale for early adolescents

The Intertemporal Decision-Making Capacity Scale was used to assess how adolescents weigh costs and benefits over time. It comprises three dimensions: cognitive control, reward valuation, and foresight. The developed scale is a valid and reliable tool for measuring intertemporal decision-making capacity in adolescents. This ability is related to self-control and the capacity to resist temptation [29].

Evaluation of the life skills of students during adolescence: scale development and analysis

The Life Skills Scale (LSS) was used to measure the general skills of adolescents in 10 areas: critical thinking, creative thinking, decision-making and problem solving, stress and emotion management, social responsibility, teamwork, self-esteem, self-awareness, empathy and interpersonal relationships, and communication skills. The LSS was validated as a reliable scale to evaluate life skills in adolescents. Students scored higher in empathy, self-awareness and self-esteem, whereas the lowest scores were received for teamwork, stress management and critical thinking. A significant relationship was found between certain skills and variables such as gender, academic level and performance in science [30].

Planning and management of academic time for university students

The planning subscale of the adapted Metacognitive Skills Inventory (MAI) was used to assess how students plan and organize their academic time. No significant differences were found in time planning by variables such as gender or work schedule. However, there were differences in the strategies used by high- and low-achieving students, especially in goal setting and the use of support tools [31].

Adolescence stress scale: development and standardization

The Adolescent Stress Scale was used to measure stress in adolescents in 10 dimensions, such as performance stress, interpersonal conflicts, punishment, insecurity, and unhealthy environments. These dimensions include stress induced by major loss, stress induced by imposition or conflict, phobic stress, stress induced by interpersonal conflict, stress induced by punishment, stress induced by illness or injury, performance stress, stress induced by imposition, stress induced by insecurity, and stress induced by unhealthy environments. This scale is useful for identifying and measuring sources of stress in adolescents in school and clinical settings. The stress factors were found to be interrelated and can be assessed with good reliability indices [32].

Resilience and regulation of emotions in adolescents: serial mediation analysis through self-esteem and perceived social support

A questionnaire was used to measure resilience, self-esteem, perceived social support, and emotional regulation. Resilience has a positive impact on emotional regulation, and this relationship is mediated by self-esteem and perceived social support. These findings suggest that strengthening self-esteem and social support can improve emotional regulation in adolescents [33].

Design and validation of a psychological well-being scale for adolescents (BIPSI)

The BIPSI was used to assess well-being in six dimensions: self-determination, positive self-concept, personal relationships, personal growth, self-regulation and control, and autonomy. The BIPSI is a valid and reliable scale for assessing psychological well-being in adolescents. It was found to be useful in educational and clinical settings for measuring young people's emotional and social development [34].

Adolescent problem-solving skills and their relationship to parenting styles

The Revised Social Problem-Solving Inventory was used to assess the adolescents'ability to solve problems in different contexts, and the Parenting Styles Scale was used to measures the type of parenting. There is a positive correlation between parenting styles and adolescents'problem-solving skills. Parenting styles play an important role in the formation of these skills, suggesting that parental training could be an effective intervention [35].

Design and validation of the means of resolving interpersonal conflicts (MERCI) scale for adolescents

The MERCI Scale was used to assess the tactics adolescents use to resolve conflicts. The MERCI scale is a valid instrument for measuring how adolescents handle interpersonal conflicts. Its use is effective in mediation and conflict resolution strategies in educational and social settings [36].

Definition of the concept

According to this analysis,"life skills that promote school health in adolescents"are a set of essential psychosocial competencies that enable adolescents to effectively face health-related challenges in school and social environments. These skills include decision-making, effective communication, stress management, and problem solving, facilitating the development of adaptive behaviours and the mitigation of health risks. The development and strengthening of these skills are determined by macro- and microlevel factors and by adolescents’ socioeconomic context, educational policies, access to resources, and prior experiences.

From a conceptual perspective, these skills have three fundamental dimensions:

• Educational: Emphasizes the development of cognitive and emotional competencies through structured health promotion programs.

• Psychological: Highlights the influence of self-esteem, emotional self-regulation, and adolescent resilience.

• Social: Emphasizes interaction with and adaptation to the environment, fostering healthy interpersonal relationships.

The promotion of these skills within the school environment improves adolescents'individual well-being and contributes to the development of a more equitable and healthy society. Similarly, integrating health education processes with a preventative approach strengthens self-care, promotes safe school environments, and reduces risky behaviours. Joint work between the health and education sectors enables the design of effective interventions that impact student quality of life and promote more equitable and inclusive learning conditions, as evidenced by Rodríguez Melo et al. [37] in their integrative review of the effect of public policies on school health, highlighting their role in contributing to well-being and health equity within the educational context.

Discussion

The concept of"life skills that promote school health in adolescents” has been defined as a set of essential psychosocial competencies that enable adolescents to effectively face health-related challenges in school and social environments. Adolescence is a defining stage in human development. It is characterized by physical, emotional, and social changes that require strengthening psychosocial competencies to successfully face everyday challenges [9]. In this sense, life skills are fundamental tools that promote well-being, mental health, and social adaptation in adolescents. Their development in school settings fosters comprehensive education and contributes to preventing risky behaviours, promoting resilience, and constructing protective environments [22]. Supported by the literature, a discussion of the four attributes—decision-making, effective communication, stress management, and problem solving—follows, highlighting their relevance in developing healthy and autonomous adolescents.

The first attribute is decision-making, which has emerged as an essential skill that enables adolescents to evaluate options and choose the best alternative in different contexts, fostering their autonomy and responsibility. This finding is consistent with that reported by Blankenstein et al. [38], who highlighted that independent decision-making is an increasing challenge for adolescents, which is partially attributed to normal maturational changes in brain function. Similarly, Scholz et al. [39] reported that adolescents make more impulsive and less rational decisions than adults do because of differences in brain maturation, especially in areas related to impulse control and risk assessment. On the other hand, Van-Duijvenvoorde & Crone [40] conducted a longitudinal study that revealed that improved decision-making skills during adolescence are associated with a decrease in risky behaviours related to substance use and unprotected sexual conduct.

The second attribute is effective communication, which is fundamental to adolescent development because it allows adolescents to understand others and express their ideas and emotions clearly, facilitating healthy social interactions and strong interpersonal relationships. This result is consistent with the findings of Piccerillo and Digennaro [41], who reported that adolescents with effective communication skills have greater self-esteem and healthier interpersonal relationships. Similarly, Jiménez et al. [42] reported that teaching communication skills in school programs improved empathy and conflict resolution among students, promoting a more positive school environment.

Stress management, the third attribute, enables adolescents to manage pressure and emotions in difficult situations through strategies such as meditation, time management, and resilience. This finding is in line with that of Razza et al. [43], who found that regular mindfulness practice by adolescents significantly reduces stress and anxiety levels. Similarly, Smith et al. [44] reported that school programs that teach stress management techniques, such as deep breathing and cognitive restructuring, are effective in improving student resilience.

Problem solving, the fourth attribute, is the ability to analyse a situation, identify challenges, and find effective solutions, enabling adolescents to constructively address conflicts. This finding is consistent with that of Mondal & Mallick [45], who reported that adolescents with problem-solving skills have a greater ability to cope with stressful situations and make informed decisions. Saiz [46] highlighted that effective problem solving is associated with a lower incidence of aggressive behaviour and better social adaptation among adolescents.

Although this study is based on a solid theoretical foundation, significant gaps remain in the empirical literature. There is little evidence on the effectiveness of school programs that develop skills such as decision-making, effective communication, stress management, and problem-solving. This limitation highlights the need for studies that evaluate the implementation and outcomes of these competencies in real-life school settings.

The findings allow for proposals for the design of school programs. For example, it is suggested that these skills be integrated into curricular activities using active methodologies. However, it would be important to explore this in future research and in specific sociocultural contexts.

Implications for nursing practice, teachers and school health professionals

Nursing professionals who read and apply the findings of this article, especially those working in schools, are provided a solid conceptual foundation on life skills as a key strategy for promoting adolescent health. Understanding the essential attributes of these skills, such as decision-making, effective communication, stress management, and problem solving, enables nursing professionals and school staff to identify needs in the student population and design more relevant and effective educational interventions. This analysis provides theoretical and practical tools for structuring health education programs focused on risk prevention and strengthening adolescents'psychosocial development. Furthermore, the knowledge acquired facilitates interdisciplinary collaboration with teachers and counsellors from different disciplines, fostering a comprehensive approach to youth well-being. From a health care and leadership perspective, this article enables nursing professionals to act as agents of change within the school environment, promoting safe, empathetic, and resilient spaces. Furthermore, incorporating life skills approaches into school health policies and institutional student wellness programs strengthens the role of evidence-based decision-making in schools.

In conclusion, these results have clear practical implications that can be applied by teachers and school health professionals to strengthen students'social-emotional development.

• Decision-making: use of dilemmas in the classroom to encourage critical analysis.

• Effective communication: implementation of dialogue circles to enhance emotional expression.

• Stress management: introduction of active breaks and conscious breathing exercises.

• Problem-solving: development of school projects that address real-life situations.

Limitations

These limitations are related, first, to the variability of the socioeconomic and cultural contexts of educational systems. This is because the literature review conducted to deepen the philosophical understanding and conceptual clarity of life skills that promote school health in adolescents did not reveal this result. Additionally, public policies may require further analysis based on the influences of the concept. Second, this article addressed only research studies in Spanish and English and there is limited evidence linking life skills with school health promotion. Third, future research is recommended to empirically validate the attributes of the concept and its relationships with school health.

Conclusion

This article represents a useful tool for health and education professionals, offering them a clear and well-founded understanding of the concept of"life skills that promote school health in adolescents."Its usefulness lies in providing a theoretical framework that guides the planning of effective interventions focused on strengthening psychosocial competencies during adolescence. It also provides evidence-based support for the role of life skills in promoting well-being, mitigating risk, and building protective school environments.

The analysis of the concept allowed the identification of essential attributes such as decision-making, effective communication, stress management, and problem solving. These skills contribute to reducing risky behaviours, strengthening resilience, and promoting the overall well-being of adolescents in the school environment. Using the Walker and Avant method, a conceptual foundation was consolidated to guide both the research and the design of educational programs and school health interventions. Promoting these skills is essential for providing young people with tools that enable them to face life challenges in an informed, autonomous, and healthy manner.

Life skills that promote adolescent school health are defined as a set of essential psychosocial competencies that enable adolescents to effectively address health-related challenges in school and social environments. Future research can delve deeper into the social context and develop longitudinal and comparative studies that relate life skills with educational and health indicators.

Abbreviations

WHO

World Health Organization

DeCS

Descriptors in Health Sciences

MeSH

Medical Subject Headings

FADMQ

Flinders Adolescent Decision-Making Questionnaire

SVS

Schwartz Values Scale

LSS

Life Skills Scale

MAI

Metacognitive Skills Inventory

MERCI

Means of Resolving Interpersonal Conflicts

BIPSI

Psychological Well-being Scale for Adolescents

Authors’ contributions

The study was conceptualized by G.T-D, O.R.-A.M, and F.R-A, who also contributed to the development of the methodology, analysis, and writing. The review and editing of the manuscript were carried out by G.T-D and O.R.-A.M. All authors contributed to the preparation of the original draft, as well as the review and editing of the manuscript. All authors have read and approved the published version of the manuscript.

Funding

The authors declare that they received financial support from the Universidad de La Sabana. Project code ENFMSC-19–2022.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

This article is part of a research project that required a concept analysis. It does not involve human participants but has been approved by the research ethics committee of the Universidad de La Sabana, with act 015 of 29/09/2021. The project was conducted in accordance with the Declaration of Helsinki/CIOMS and Resolution 8430 of 1993 (Colombia).

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.