The article analyzes the characteristics of the neuro-mental health of preschool children. A natural hygiene experiment assessing visual thinking and anxiety levels revealed the influence of intra-environmental factors on the mental health of three- and six-year-old children in children's educational institutions. The “objectless drawing” technique revealed a predominance of children with a low level of mastery of colors, lines and shapes, as well as an increase in anxiety and the frequency of neurotic reactions in three-year-old children in the observation group. The integral use of techniques allows for the diagnosis and prevention of changes in mental health at the stage of preschool education. The search for new promising technologies for protecting and strengthening the mental health of preschool children is urgent. Achieving positive changes in the mental health of children is possible only on the basis of close integration of medical workers, representatives of preventive medicine with psychological and pedagogical services.
FEATURES OF PSYCHOLOGICAL HEALTH OF CHILDREN IN CHILD CARE EDUCATIONAL INSTITUTIONS
Semenova N.V. 1 Shcherba E.V. 11 Omsk state medical academy
Abstract:
In article the analysis of features of psychological health of children of preschool age is carried out. Natural hygienic experiment according to visual thinking and level of uneasiness taped influence of intra environmental factors on mental health of children of three and six years in child care educational institutions. The technique of “pointless drawing” found prevalence of children with low level of development of color, lines and forms, and also augmentation of uneasiness and frequency of neurotic reactions in children of three years of group of observation. Integrated application of techniques allow to carry out diagnostics and prophylaxis of changes in mental health at a stage of preschool education. Search of new perspective technologies of protection and strengthening of mental health of children of preschool age is actual. Achievement of positive shifts in mental health of children is possible only on the basis of close integration of medical workers, representatives of a prokfilaktic link of medicine with pedagogical service.
Keywords:
Bibliographic link
Semenova N.V., Shcherba E.V. FEATURES OF CHILDREN'S NERVO-MENTAL HEALTH IN CHILDREN'S EDUCATIONAL INSTITUTIONS // Scientific review. Medical Sciences. – 2014. – No. 2. – P. 129-130;URL: https://science-medicine.ru/ru/article/view?id=424 (access date: 01/31/2020). We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"
Z and over the past decade, the incidence of childhood diseases has been growing catastrophically. High growth rates were noted in the number of diseases among children under 14 years of age, such as anemia (1.3 times), diseases of the endocrine (1.5 times) and musculoskeletal system (1.5 times), allergic diseases (1.5 times). .3 times), diseases of the circulatory system (1.3 times), neoplasms (1.3 times).
The most serious situation is registered among adolescents. There is an increase in anemia by 1.8 times, diseases of the endocrine system by 1.9 times, allergic diseases by 1.6 times, diseases of the circulatory system by 1.5 times, neoplasms by 1.8 times, diseases of the genitourinary system by 1.5 times , musculoskeletal system by 1.9 times.
Due to the increase in the proportion of long-term somatic diseases, psychosomatic pathology doubled during this period. As a response to the impact of negative environmental factors, the number of reactive states and psychopathy increased by a third.
The number of drug addiction disorders in the 90s increased 3.7 times, drug addiction - 15 times, alcoholic psychoses - 15.5 times, chronic alcoholism - 2 times. According to special studies, the real number of adolescents suffering from alcoholism has increased by 2-3 times, those suffering from drug addiction and substance abuse - by 6-10 times, and substance abusers - by 5.6 times.
There is convincing evidence of a slowdown in the previously observed accelerated physical development of children and adolescents and even of their deceleration.
The disability indicator can be considered a concentrated reflection of the level and quality of health of the younger generation. It most clearly illustrates the sharp decline in children and adolescents in the body’s functional capabilities, adaptation and defense reactions. Over the past 10 years, the number of disabled children has increased 4 times and reached 600 thousand. According to expert estimates, the number of disabled children will double in the next 5 years. The number of healthy children, according to various studies, currently does not exceed 4-9%.
In general, in Russia the health status of the younger generation is characterized by the following features:
Increased chronic morbidity
Increasing level of disability
Violation of the development of the reproductive system
Mental health disorders
Increasing number of maladjusted children
Decrease in physical development indicators.
The listed trends in the health of children are associated with a complex of factors that adversely affect the growing body.
Deterioration of the social status of most children
Change in food quality
Impact of environmental factors
Increasing severity of endemic goiter
Medicinal “aggression”
Introduction of new forms of training.
The deterioration of the social status of the majority of children is evidenced by the increase in the number of socially disadvantaged children. Thus, 600 thousand children have no parents, 500 thousand annually “lose” one of their parents, 300 thousand children are born out of wedlock every year. 160 thousand children are refugees and migrants, 12 million children live in families with incomes below the subsistence level, 10 million - in poor families, 2 million - neglected. Given this state of affairs in the country, the social background can be a serious prerequisite for the formation of diseases and their progression.
Change in food quality
According to numerous studies, in recent years children have not only received less protein, fats and food sufficient to replenish energy, but also experience a deep deficiency of vitamins, minerals and microelements. Thus, specialists from the Research Institute of Nutrition of the Russian Academy of Medical Sciences, who examined Moscow schoolchildren, found that the concentration of ascorbic acid in the blood was below normal in 40%, vitamin E in 33%, vitamin A in 28% of schoolchildren. In Orenburg, 95% of children had vitamin C levels significantly below normal, including 10% who were severely deficient. Similar indicators were noted in other regions of Russia.
A sharp decrease in the consumption of milk and dairy products, meat, vegetables and fruits has created a new problem - the body of a modern child is forced to work in a mode of insufficient supply of calcium, iron, and many other macro- and micronutrients. Calcium supply currently requires the greatest attention, which is associated with an increase in the number of children and adolescents with osteoporosis, the prevalence of which has reached, according to our data, 44%.
It is necessary to take into account that in a number of regions of Russia, not only children, but also 40-90% of pregnant women experience varying degrees of deficiency of one or another macro- or micronutrient.
Disorders arising in health due to malnutrition are one of the first places. These primarily include: an increase in the number of low birth weight children, starting from birth, a decrease in resistance to environmental factors, repeated respiratory diseases, an increase in diseases of the digestive system, deterioration in physical endurance, rapid fatigue, weakening of cognitive and motor activity, delayed puberty, increased proportion of children with decreased visual acuity.
Impact of environmental factors
The role of ecopathogenic factors in the deterioration of the health of modern children is indisputable. This is due to the constantly increasing technogenic load on a growing organism. Industrial pollution of places of residence increases the level of chronic pathology by 60%, including diseases of the respiratory system - by 67%, digestive diseases - by 77.6%, musculoskeletal diseases - by 21%, neoplasms - by 15%.
Increasing severity of endemic goiter
The cessation of iodine prophylaxis in Russia led not only to the prevalence of endemic goiter, but also to an increase to 9-12% in the number of children with stunted growth, to 14% of schoolchildren with learning difficulties, and to 5-12% in the proportion of adolescents with disorders of puberty.
Drug-induced “aggression”
The still widespread practice of unjustified inclusion of potent antibiotics in therapy and the high drug burden on children leads to many negative changes in the children's body, primarily to a decrease in natural protective mechanisms and the development of multiple organ pathologies.
Introduction of new forms of training
Reforming school education without taking into account the health status of children has significantly increased the incidence of illness. With the introduction of new forms of education, when hundreds of new programs literally fell upon students, daily school classes exceeded the permissible norms by 3-5 hours. With this “anti-child” reform, the school has turned into a factor destroying health. This is evidenced by the fact that the number of healthy children in modern educational institutions from the first to the eleventh grade of school decreases by at least a third.
Already today, the quality of health of children and adolescents has significantly reduced the social opportunities of adolescents and young people. 30% of them have restrictions in obtaining a decent education, 26% - to serve in the Armed Forces. Every fourth person has a high risk of reproductive dysfunction.
Problems and solutions
It is quite obvious that maintaining and restoring the health of children in modern conditions requires the widespread implementation of mass preventive programs, the creation of optimal conditions for education and training, on the one hand, and the optimization of nutritional support, harmonious development and competent treatment of diseases, on the other. Pediatric science and practice have extensive experience in solving these problems. The importance of assessing the importance of prevention in preserving the health of children can be judged by the results that the implementation of some of these programs promises to bring.
The introduction of mass iodine prophylaxis ensures:
Reduction by 10-20% in the number of preschool children with disharmonious physical development
30% reduction in the number of children with chronic diseases
Reducing by 20-25% the number of children who do not master the basic curriculum
Reduction by 15% in the number of children at risk of antisocial behavior
Preventing severe forms of mental retardation in up to 1,000 children annually
Reducing the incidence of thyroid cancer by 3 times.
Prevention of calcium deficiency in children and adolescents, it can reduce the incidence of musculoskeletal diseases in people of working age to 40-45%.
Improving medical care for adolescents 15-18 years old can:
Reduce the incidence of adverse outcomes of chronic diseases by a third
Increase the detection of functional disorders and chronic diseases by 5 times, especially the cardiovascular system, digestive organs and musculoskeletal system
Reduce the incidence of disability in working age by 18-20%.
Organizing children's health improvement directly at school will allow:
Reduce by 2 times the number of children with underweight
Reduce the incidence of ARVI by 2.2 times
Reduce the number of relapses of chronic diseases by 22%
Reduce by 2 times the frequency of ENT pathologies
Improve school performance by 15%.
Nowadays, it is more important than ever to intensify scientific research in pediatrics. The child is dynamic, he is distinguished by the ability to react sharply to all changes in the environment. Therefore, at each stage of the development of society, pediatrics faces new scientific tasks, the solution of which determines the effectiveness of preventive and organizational technologies.
The priority scientific tasks include:
Assessment of the adaptive capabilities of children of different ages to the influence of environmental factors: feeding characteristics, micronutrient provision, inadequate physical activity, xenobiotics, stress, increased school loads, etc.
Development of new technologies for preserving and promoting health, based on age-specific forecasts of adaptation, increasing the body’s functional reserves to the effects of risk factors.
Justification and assessment of the quality of children's health.
Development of new algorithms for the treatment of various diseases of the newborn period, providing for a reduction in the drug burden on immature (premature) children.
Study of the modern etiological structure of infectious pathology in newborns and the development of effective methods for their prevention and treatment.
To successfully implement the results of scientific research and effective preventive technologies, little is needed: to make the protection of the health of children and adolescents a national priority of the state.
1In the last decades of the 20th century, psychological support for children in kindergartens, schools and additional education institutions became widespread in Russia. This is due to the stressful life of adults, their preoccupation primarily with work, which leads to an increase in psychological and psychosomatic disorders in children. Enormous loads as a consequence of the early education of preschoolers and intensive education of schoolchildren, which is so popular in our time, also have a negative impact on the child’s health. An imbalance in the development of children, caused by the desire of adults to give them as much knowledge as possible to the detriment of the formation of intuition, imagination, and creative abilities, can also be noted as a risk factor.
It is necessary to distinguish between the concepts of mental and psychological health. Mental health is understood as a set of characteristics that provide an integral element of health as a whole. Mental health is an important component of a person’s adaptation in society. Psychological health is an important characteristic of a person’s personality. It is closely related to mental development throughout his life, i.e. Psychological health is an opportunity for human development throughout his entire life journey. The concepts of mental and psychological health are closely related to each other.
The psychological health of a child is evidenced by the formation of his basic age-related personal formations, and certain difficulties in their formation indicate certain violations of psychological health.
Thus, already the first year of life makes an important contribution to the formation of the child’s self. By the end of this period, he develops a prerequisite for self-respect, a primary image of the world around him arises, in which he feels trust. But an unstable or negative attitude towards oneself, a need for constant help, care, as well as distrust of the world around us, and a feeling of insecurity can also develop. We can say that the foundations of emotional development are being laid - optimism and cheerfulness, emotional responsiveness. But it is also possible to develop apathy or an inability to experience emotional contagion, to make emotional contacts in general (the “loss of feelings” syndrome).
The most important condition for the formation of positive neoplasms in infancy is the interaction of the mother with him that is appropriate for the age and temperament. In relation to the first three to four months, many psychologists talk about the need for a mother-child “ensemble”, in which the child “solos”, and the mother listens to his desires and needs and builds her behavior in accordance with this.
At an early age (from one to three years), the child’s self develops due to the initial awareness of himself. By the end of early childhood, an autonomous position is formed, that is, the ability to independently make one’s own choices and achieve its implementation. However, difficulties may arise in its development, resulting in passivity, dependence on the assessments of adults, or a constant desire to assert one’s freedom with all one’s might. This period is important for the development of the child’s ability to obey socially accepted norms. The child learns to follow some “dos” and “don’ts,” and consciously accept the simplest rules (dressing independently, cleaning up scattered cubes, etc.).
At an early age, the child’s emotional sphere begins to develop. In case of impaired development, the child hides his aggressiveness from others and becomes emphatically peaceful. In another variant, destructive aggressiveness develops, i.e. the desire to destroy objects (break toys, tear books, personal belongings) or violate norms of behavior, and first of all, disobey adults.
At preschool age, the child’s self stabilizes; he begins to think about whether he is good or bad. The most important role in this is played by the process of identification with the parent of the same sex, i.e. not simple imitation or partial acceptance of the qualities of the parent, but the desire to feel strong, confident or gentle, caring - the way the child would like to see himself. Self-awareness also actively develops in preschool age. The child realizes that in general he is good, but has some shortcomings, and begins to understand: in order to be good, he must meet parental requirements. We can talk about the so-called phenomenon of parental programming - the formation, under the influence of parental directives, of the child’s basic life scenarios. If the child does not feel good enough to receive the attention he needs in positive ways, then he may develop and consolidate various forms of receiving attention through negative manifestations, such as behavior disorder, fighting, lying, etc. In this case, the child prefers to be punished, but definitely noticed by adults.
There are objective (independent of the child) and subjective (correctable) factors in the deterioration of the psychological health of modern children.
Objective ones include:
1. Parents’ workload and lack of communication between parents and children. Now the family does not carry the social functions that it carried before (there is no close circle of relatives and there are no people nearby who would emotionally protect the child).
2. Information overload of children. Children watch a lot of TV (including scenes of violence). The child associates with the main characters. From here, the child develops fears, phobias, low self-esteem, and a high level of anxiety, often leading to neuroticism.
3. Most parents are characterized by such a style of parent-child relationships as hyper-custody and hyper-protection. Parents try to isolate their children from any problems and matters. Raising a child is done using verbal methods, not visually effective ones.
4. Disharmony of family relationships and family education within parental relationships or disturbances in the sphere of child-parent relationships (conflicts, quarrels, frequent swearing), from which children often take a model of behavior. Preschool age is characterized by a child’s close emotional attachment to his parents (especially his mother), not in the form of dependence on them, but in the form of a need for love, respect, and recognition. Therefore, firstly, very often quarrels between parents are perceived by the child as an alarming event, a situation of danger (due to emotional contact with the mother), and secondly, he is inclined to feel guilty for the conflict that has arisen, the misfortune that has occurred, since he cannot understand the true reasons what is happening and explains everything by saying that he is bad, does not live up to his parents’ hopes and is not worthy of their love. Thus, frequent conflicts and loud quarrels between parents cause preschool children a constant feeling of anxiety, self-doubt, emotional stress and can become a source of their psychological distress and psychosomatic problems (tics, stuttering, enuresis, motor disinhibition).
5. Disorders of child development in the perinatal period (asphyxia, low level of maternal health).
6. The mother goes to work early and the child is placed in a nursery.
Placing children at an early age (up to three years old) in a preschool institution or hiring a nanny to raise them is a strong psychotraumatic event, since such children are not yet ready for separation from their mother: a two-year-old child has a highly developed sense of attachment to his mother, community, and unity with her (considers himself only in unity with his mother - the “WE” category). With frequent and long-term separations from their mother (placement in a nursery or sanatorium), the need for affection increases in young children, which can lead to neurotic reactions. On average, only by the age of three does a child develop a desire to “break up” with his mother and become more independent. In addition, at this age there is already a strong need to communicate with peers and play together with other children. Therefore, a child at the age of three can be placed in kindergarten without risking his mental health.
Subjective reasons can be corrected and include:
The nature of parent-child relationships;
Moral values of the family and adults involved in raising a child.
In general, modern preschool children differ significantly from children of past years, namely:
1. Large differences in calendar, physiological and psychological age.
2. Children have different levels of development, degrees of emotional and psychological readiness to start school.
3. Children have extensive, but unsystematic information on almost any issue. But it is often contradictory in nature, resulting in anxiety and uncertainty.
4. Children have a freer sense of self and independent behavior.
5. Today's children have poorer physical health.
6. Modern children play less role-playing games, which often replace TV and computers.
Bibliographic link
Michurina Yu.A., Drobyshevskaya D.A., Vasilchenko K.A. MODERN ASPECTS OF PSYCHOLOGICAL HEALTH OF PRESCHOOL CHILDREN // International Student Scientific Bulletin. – 2015. – No. 5-2.;URL: http://eduherald.ru/ru/article/view?id=13306 (date of access: 01/31/2020). We bring to your attention magazines published by the publishing house "Academy of Natural Sciences" 1
An analysis of foreign and domestic studies on the health status of the children's population in different age groups was carried out. General trends in the incidence of children and leading nosologies (diseases of the musculoskeletal system, respiratory and digestive organs, diseases of the nervous system, ENT pathology) have been identified. Many studies note a reduction in the number of healthy children to 7.0-10.0% and an increase in functional impairments among children already in the early stages of development. The WHO European Office has developed a prevention strategy, which, according to experts, is the most effective investment in the health of children and society as a whole. A review of domestic research showed that in modern conditions an interdisciplinary and integrative approach is needed with the introduction of new disciplines into the educational process in preventive pediatrics.
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According to the European Community, prevention at all stages of life is the most effective approach (from an economic and medical point of view) to investing in health and the development of a harmonious society. Of course, the individual characteristics of a child largely determine the degree of exposure to risk factors (gender and ethnicity; genetic predisposition; emotional stability), among which social, economic and environmental determinants (level of income and education of the family, living conditions) take the first place in the future. and labor).
It is social determinants, according to WHO experts, that play a leading role in shaping population health. With a decrease in the adaptive and compensatory capabilities of the body against the background of high aggressiveness of environmental factors and an unfavorable social portrait of the mother (alcoholism, smoking, poverty), social predictors contribute to an increase in morbidity and disability in children during critical periods of growth and development.
In the perinatal period, the foundation for the health of the adult population is laid, determining the further development of the body. According to WHO research, young mothers with a disadvantaged social status are more likely to give birth to children with low body weight, which, in turn, is a predictor of many age-related pathologies and is directly associated with an increased risk of developing coronary heart disease, stroke, arterial hypertension and insulin-dependent diabetes mellitus. At the earliest stages of life, the family plays an important role in shaping the physical and mental health of the child. Thus, according to the European Community, people who experienced childhood abuse have a higher risk of tobacco smoking, abdominal obesity and alcoholism later in life.
The current state of child health in the European Region is characterized by high child mortality under the age of five, especially in the first month of life, which accounts for 50.0% of cases. The leading causes are neonatal pathological conditions (prematurity, sepsis, birth asphyxia), trauma, pneumonia and diarrhea. At the age of 5-19 years, road traffic injuries take first place. In the structure of unintentional injuries, road accidents account for 39.0%, drownings - 14.0%, poisonings - 7.0%, fires and falls - 4.0% each. Unintentional injuries account for 42,000 deaths between ages 0 and 19. Along with this, more than 10.0% of adolescents have mental disorders; neuropsychiatric disorders are the dominant cause of disability among this age group. In terms of prevalence among children 0-17 years old, severe depressive disorders are in first place, followed by anxiety disorders, behavioral disorders and disorders associated with the use of psychoactive substances.
The study showed that every third child aged 6-9 years suffers from overweight or obesity. In the group of 11-13 year old children, similar figures range from 5.0 to 25.0%. According to forecasts, more than 60.0% of children who are overweight before puberty maintain a similar trend in early working age, which contributes to the development of indirect interdependent pathologies - cardiovascular diseases and insulin-dependent diabetes mellitus.
The health status of children of different age groups and the factors that determine it are the subject of study by domestic authors. So, V.S. Merenkova et al. We studied 50 mother-child pairs of the first year of life with an average maternal age of 24.46±5.57 years and 50 mother-child pairs of the second year of life with an average maternal age of 25.54±4.9 years. The work revealed that the deterioration of children's health is directly related to maternal factors: in the first year of life - with fetoplacental insufficiency, threat of miscarriage and the presence of preeclampsia (r = 0.44; 0.38 and 0.35 at p<0,01, соответственно); на первом-втором годе - с преждевременными родами (r = 00,63 при p<0,001), и на 2 году жизни - с анемией, венозными осложнениями и болезнями почек у матери (r = 0,51 при p<0,01; 0,48 при p<0,01, соответственно) .
Study of the health of children in the first year of life in Samara for the period 2012-2014. showed that in the structure of morbidity, respiratory diseases are in the lead; there is a high level of intestinal infections, diseases of the nervous system and nutrition-dependent pathologies (anemia, rickets).
An expert assessment of the health status of children aged 3-7 years attending a preschool educational institution in Yekaterinburg (n = 322) revealed that none of them belonged to health group I; 58.7 ± 2 were assigned to group II. 7%, and in group III there were 41.3±2.7%. In general, the incidence of this age group was characterized by multimorbidity, with diseases of the respiratory system in the first ranking place, diseases of the musculoskeletal system in the second, and diseases of the digestive system in third. A fairly high percentage were children with chronic diseases - 41.3±2.7%, of which multisystem lesions accounted for 52.8±4.3%.
Monitoring the health of children aged 5-9 years (n = 738, of which 418 boys and 320 girls) found that already at the preschool stage no more than 10.0% of healthy children; In 70.0% of those examined, multiple functional disorders were recorded. Among nosologies, diseases of the musculoskeletal system prevail (46.1%); diseases of the digestive system and circulatory system (16.7%); ENT pathology (17.8%).
Similar data were obtained in a two-stage study of the health of children and the health of interdependent sequential groups in Primorsky Krai and Vladivostok. The study involved 626 children aged 4-17 years; 226 children 4-6 years old; 224 5th grade students and 176 high school students. Families expecting a child (n = 54), infants (n = 60), preschoolers (n = 126) and adolescents (n = 123) were simultaneously analyzed. The results of the study made it possible to develop effective preventive measures at each stage of ontogenesis: family - newborn - preschooler - schoolchild - teenager - family. The result of the work was an increase in the number of physiologically occurring pregnancies from 38 to 90.0%; Acute respiratory diseases were recorded less frequently among children in the first year of life - from 50 to 75.0%; There was an improvement in the health of children in all age groups.
As noted above, the course of the perinatal period largely determines health resources. A follow-up study of 136 children aged 4 years (n = 48; for children born in 1994) and 11 years old (n = 88; children born in 1991), who were at the initial stage of life in intensive care units, revealed a close relationship between the severity of the newborn's illness and overall health status, determined by the NTISS scale (Neonatal Therapeutic Intervention Scoring System, Gray J.E. et al., 1992). It was also found that the degree of functional disintegration during the neonatal period and at follow-up directly correlate with each other. Consequently, the cross-interaction of a set of health parameters and perinatal factors on the individual characteristics of constitution and reactivity determines the characteristics of the course of pathology in the perinatal and subsequent periods of ontogenesis.
A large study based on preventive examinations was carried out by the Scientific Research Institute of Health and Wellness of the Russian Academy of Medical Sciences in 6 preschool institutions in Moscow (n = 383 children, of which 200 boys and 183 girls) and in schools among students from grades 1 to 9 (n = 426 children; 216 boys and 210 girls). The final data showed that 5.0-7.0% of children belong to health group I, 40.0-45.0% to II, and 50.0-55.0% of preschoolers to III. In this age group, functional disorders of the musculoskeletal system, pathology of the oropharynx, and functional mental and behavioral disorders are registered. Among schoolchildren, there is a progressive deterioration in health: in grade 1, health group I is 4.3%, and in grade 9 only 0.7%. According to gender distribution, boys are more susceptible to functional disorders and diseases. Chronic disease occurs already in grades 7-9. The leading positions among functional disorders are occupied by cardiovascular, bronchopulmonary pathology and disorders of the digestive tract.
The health of adolescents and ensuring their normal growth and development determines the level of well-being and regional stability of the country for decades to come. Multidimensional study by A.A. Baranova et al. states that over a 20-year period, there has been a continuing trend towards an increase in morbidity among the child population by 2.0-4.0% per year, an increase in chronic pathology has been recorded, and the number of healthy children in all gender and age groups has been decreasing. As the authors note, according to government statistics, the overall incidence of children aged 0 to 15 years exceeds 2400‰, and the overall incidence of children aged 15-17 is approaching 2000‰. There is an increase in primary morbidity among children aged 15-17 years for all classes of diseases by 66.0-64.6%. At the same time, the most significant increase in the indicator was detected in neoplasms (+97.7%), blood diseases (+99.2%), circulatory system (+103.1%), digestive organs (+80.7%), musculoskeletal system and connective tissue (+96.9%), genitourinary system (+77.2%), consequences of external causes (+71.8%). As the authors note, an unfavorable trend is the deterioration of the reproductive health of children, especially in older age groups. Thus, more than 30.0% of boys and girls exhibit delayed puberty, the frequency of menstrual dysfunction in girls aged 15-17 years is increasing (+ 96.5% for the period 2001-2008); inflammatory diseases of the genital organs (+46.2%); about 40.0% of boys and young men aged 15-17 years suffer from diseases that can disrupt reproductive function. Another alarming point, according to the authors, is that one of the leading ranking places in the structure of morbidity among adolescents is occupied by mental disorders and behavioral disorders, the rate of which for the period 2001-2008. increased by 43.4% and 25.3% (total and newly diagnosed incidence, respectively). Their structure is dominated by behavioral syndromes, non-psychotic and neurotic disorders associated with stress; somatoform dysfunction of the autonomic nervous system. Against this background, the incidence of children with mental disorders of organic origin and mental retardation does not tend to decrease.
Preserving and strengthening children's health is a multifaceted problem. According to the basic principles of prevention of the WHO Regional Office for Europe, 2006, spending on the prevention of diseases in childhood is an investment in the health and development of the country. To achieve these goals, it is necessary to create a favorable living environment for children’s health with instilling the need for a healthy lifestyle; ensure universal accessibility of health care services and government support in the implementation of preventive programs. Children's exposure to behavioral, social and environmental risks should also be monitored, with the aim of using this data to identify and address the social determinants of children's health.
According to a number of domestic authors, it is first of all necessary to strengthen the legislative framework regarding the protection of children's health; carry out prevention and monitoring of infant mortality, childhood morbidity and disability; create protocols for the preventive activities of medical organizations at all levels with an interdisciplinary and integrative approach; resolve personnel issues with the introduction of the specialty “social pediatrician”; introduce new forms of rehabilitation; attract the media to inform the population on the main elements of a healthy lifestyle.
In addition, improvement of education is required, for which an additional professional development program for pediatricians and health care managers “Topical issues of preventive and social pediatrics” is provided; introduction into the educational process of the section “Fundamentals of the development of children’s health” (which provides basic knowledge on preventive medicine, including the concept of a healthy lifestyle, and on the prevention of addictive behavior; recommendations for maintaining the health of preschoolers and schoolchildren; children involved in sports; concepts of mental health) and the discipline “ Fundamentals of medical knowledge and protection of children’s health”, carried out in accordance with the Concept of medical education of teaching staff based on curricula for students.
Thus, an analysis of domestic and foreign studies has shown that today there remain unfavorable trends in the health of children. Solving this problem requires an interdisciplinary approach aimed at introducing a set of preventive measures throughout ontogenesis, but specific to each age group and taking into account the existing functional reserves of the child’s body. An important role in achieving this goal also plays the introduction of new professional programs for training pediatricians in the basics of child health from the standpoint of preventive and social pediatrics.
Bibliographic link
Sokolovskaya T.A. CHILDREN'S HEALTH: MAIN TRENDS AND POSSIBLE WAYS TO PRESERVE IT // Modern problems of science and education. – 2017. – No. 4.;URL: http://site/ru/article/view?id=26572 (access date: 01/31/2020).
We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"
1This article presents the results of scientific and practical research on assessing the nutrition of children of preschool and primary school age.
health
menu layout
organization of school meals
physical development
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An indispensable condition for maintaining the health of the nation, one of the most important factors in preventing diseases and increasing the adaptive capabilities of the body is nutrition, especially proper, healthy, rational nutrition. The importance of rational nutrition of the younger generation is great for ensuring the processes of growth and development, physical and neuropsychic development. In addition, it is necessary to keep in mind the fact that the formation of a number of nutrition-dependent diseases occurs in childhood, while being obviously preventable.
But what is the actual situation with the nutrition of children and adolescents? For this purpose, we conducted a number of studies. The object of the study is children of preschool and primary school age. A set of methods was used (hygienic, clinical, sociological), more detailed information about which is presented in the relevant parts of the article. All studies were conducted with the informed consent of children and their parents in accordance with the World Medical Association Declaration of Helsinki on ethical principles for medical research involving human subjects.
At first glance, it may seem that the problem of nutrition for organized preschoolers (i.e., children attending preschool educational institutions) does not exist - four nutritious meals are provided for them. However, an analysis of the 10-day menus of pupils in one of the kindergartens in our city (children aged from 3 to 7 years) showed a clear discrepancy with existing standards.
The nutrition model is built without taking into account the physiological needs of children. The energy value of dishes in the vast majority of analyzed days is below the recommended value for a given age. Significant deviations from existing norms of consumption of macro- and micronutrients were revealed, which was accompanied by an imbalance in the diet. When compiling the diets, seasonal features were not taken into account - the menus of the two seasons were almost the same, the changes concerned only the volume of products. In addition, significant deviations in indicators characterizing the daily diet were noted, beyond the recommended values (± 5%). For example, the fat content ranged from 37.7 to 130.6 g/day, with the latter value being 2 times higher than the norm. Fourfold fluctuations in the daily content of carbohydrates (149 - 488 g) and ascorbic acid (14 - 71 mg) were noted.
To reduce the possible risk of developing nutrition-related diseases in kindergarten students, it is necessary to change the diet. Therefore, the practical result of this work was the preparation of an approximate menu for 10 days using technological maps.
Difficulties in compiling an optimal cyclic menu for organizing children's nutrition of different age groups in children's schools are most often due to ignorance of modern principles of rational nutrition and the inability to rationally use food products recommended for children of different age groups.
As is known, the period of school education is associated with the risk of health problems. The contribution of “school” to health is large - from 12.6% in primary school to 20.5% by the end of school. Nutrition is the most important and controllable health factor; It is believed that nutrition underlies or has a significant role in the formation and characteristics of the course of about 80% of all known pathological conditions. The two postulates above determine the importance of nutrition for school-age children.
As for feeding schoolchildren at home, this, figuratively speaking, lies on the conscience of the parents. (But in this direction, educational work is also necessary, creating conditions for the implementation of the developed principles of the concept of rational nutrition). But children spend a significant part of their time in schools, and the problem of organized meals for schoolchildren is not new and has not been completely resolved, despite a number of measures being taken. The Decree of the Government of the Novosibirsk Region approved the concept and is developing a draft long-term target program “Improving the organization of school meals in the Novosibirsk Region for 2012-2016.” The problem of organizing high-quality and affordable hot meals in educational institutions is one of the most significant for both the state and society as a whole. The period from 7 to 18 years, when a child spends most of his time at school, experiences the most intense somatic growth of the body, accompanied by increased mental and physical stress.
In this regard, in one of the studies, we set a goal to study the impact of organized nutrition on the physical and mental state of schoolchildren. This study was conducted on junior schoolchildren (age 9 - 10 years). Children (40 people) were divided into two groups. The division is based on the characteristics of nutrition during the period at school. Children of the first group received hot breakfast and lunch in an organized manner in the school canteen, while children of the other group ate independently in the buffet.
To identify the contribution of different dietary variations, we carried out;
Based on our own anthropometric studies, assessment of physical development using the screening test according to Vorontsov I.M. .
Based on the analysis of medical records, assessment and distribution of children into health groups in accordance with the generally accepted approach.
In addition, the color-drawing test by A.O. was used to diagnose mental states. Prokhorova, G.N. Gening. The test has high correlates with reference methods for diagnosing mental states (Luscher test, Lutoshkin technique), is accessible and easy to use.
The color-drawing test revealed a positive mental state in the majority of schoolchildren, however, there were minor differences in the presence of signs of fatigue and tiredness - in the first group in 1 child, and in the second - in 3.
As for health and its components, the analysis of the results showed more significant, statistically significant (non-parametric test, chi-square, P = or less than 0.05), differences between groups (table).
Characteristics of physical development of schoolchildren’s health
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Indicator under study |
contingent |
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Health, distribution by health groups. Share of children, % |
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Group 1 - healthy children. |
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Group 2 - children with reduced resistance and functional impairments. |
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Group 3 - children with chronic diseases in the compensation stage. |
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Physical development, distribution by physical development groups. Share of children, % |
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Group 1 - without pronounced anthropometric deviations. |
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Group 2 - with minor anthropometric deviations, “risk” group, “borderline” group. |
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Group 3 - children with severe anthropometric disorders. |
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In both samples, the proportion of children of health groups I and II prevailed - 84% (in the first group of subjects) and 63% (in the second). It is necessary to note the small number of healthy children in the first group and the absence of them in the second. The main difference between the groups was the proportion of children with chronic diseases, 16% and 37%, respectively. The distribution of schoolchildren in terms of physical development was also unequal. The proportion of children without pronounced deviations in anthropometric signs in the second group was almost two times less compared to the first group (63% and 37%), respectively, there were more children classified as “borderline” (26% and 42%, respectively) and the group with pronounced deviations of anthropometric characteristics (11% and 21%, respectively).
Thus, schoolchildren who receive organized hot meals during the school day have better health, develop harmoniously and experience more positive emotions. For a more accurate assessment of health, an additional in-depth examination of schoolchildren of the second group is necessary with the involvement of specialized specialists and dispensary monitoring by a school pediatrician.
The results of the conducted research serve as one of the “building blocks” in the large pyramid of knowledge on the issue of “Nutrition and Health” and indicate the need to continue work to substantiate and implement theoretical and practical recommendations for rational, adequate nutrition.
Bibliographic link
Semenova V.N., Galuzo N.A., Lutkovskaya N.A., Zyryanova E.L., Kolchenko N.V. ABOUT CHILDREN'S NUTRITION // Rational nutrition, food additives and biostimulants. – 2016. – No. 3. – P. 58-60;URL: http://journal-nutrition.ru/ru/article/view?id=35764 (access date: 01/31/2020). We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"
