State of health of pupils of secondary educational institutions and features of its relationship with indicators of living conditions and lifestyle

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National Pirogov Memorial Medical University

State of health of pupils of secondary educational institutions and features of its relationship with indicators of living conditions and lifestyle

Serheta I.V.

Introduction

Assessing the state of health, which involves the use of objective indicators and subjectively significant characteristics, is the most important prerequisite for the scientific substantiation of effective preventive technologies and the development of adequate methods of probabilistic prediction of possible shifts and deviations from the processes of formation of leading correlates adaptive resources of the organism of different contingents of the population [1, 2, 3]. In this regard, conducting a comprehensive assessment of the state of health of modern schoolchildren should include an in-depth study of a whole set of indicators, in the structure of which the leading place is occupied by indicators of morbidity with temporary loss of working capacity and morbidity with a chronic course of pathological changes, characteristics of physical development, parameters adaptive capabilities of the organism [2, 4, 5].

The aim of the scientifical work was to study the characteristics of the state of health of pupils of senior classes of a modern school and the characteristics of its connection with medical and social indicators of the conditions of stay and lifestyle of girls and boys.

pupil health lifestyle

Results and discussion

Data from the assessment of the prevalence of diseases with temporary disability, which was carried out, testified to the fact that during the calendar year, 31.2% of girls and 40.6% of boys aged 14 years old, 15.6% of girls and 3.1% of boys aged 15 years old, 9.3% of girls and 15.6% of boys at the age of 16 years old, 9.3% of girls and 12.5% of boys at the age of 17 years old, got sick once a year - respectively 6,3% and 9.3% of 14-y ear-old girls and boys, 21.8% and 34.3% of 15-year-old girls and boys, 28.1% and 43.7% of 16- year-old girls and boys and 43.7% and 34.3% of 17-year-old girls and boys were sick 2 times a year - respectively, 21.8% of girls and 21.8% of boys at the age of 14, 37.5% of girls and 21.8% of boys at the age of 15 years old, 15.6% of girls and 25.0% of boys at the age of 16 years old, 9.3% of girls and 21.8% of boys at the age of 17 years old, were sick 3 times a year - respectively, 28.1% and 12.5% 14 - year-old girls and boys, 12.5% and 34.3% of 15-year-old girls and boys, 28.1% and 12.5% of 16-year-old girls and boys, and 21.8% and 21.8% of 17-year-olds girls and boys, eventually got sick 4 or more times a year - respectively, 12.5% of girls and 15.6% of boys at the age of 14 years old, 12.5% of girls and 6.3% of boys at the age of 15 years old, 18.7% girls and 3.1% of boys at the age of 16 years old, 15.6% of girls and 9.3% of boys at the age of 17 years old.

Therefore, the most significant among the studied contingent should be considered the specific weight of indicators of the frequency of registration of diseases with temporary loss of working capacity, which were, respectively, 1 time per year - precisely such indicators were most often registered as the most common, being in the first position in the distribution structure, among 15-year- olds girls, 16-year-old girls and 16-year-old boys, 17-year-old girls and 17-year- old boys, and 3 times a year - these indicators were most often registered as widespread, being in the second position in the distribution structure, among 14- year-old girls, 15-year-old boys, 16-year-old girls, 17-year-old girls and 17-year- old boys. At the same time, the share of indicators of the frequency of registration of diseases with temporary loss of working capacity, which noted the absence of diseases, should be considered the least significant (it was precisely such indicators that were most often registered as the least common (were in the last position in the distribution structure) among 15-year-old boys, 16-year-old boys, as well as 17-year-old girls and 17-year-old boys).

As the prevailing duration of illnesses with temporary loss of working capacity in all age and sex groups, except for age groups consisting of young men aged 16 years old and 17 years old, it was necessary to note the duration of the illness, which ranged from 3 to 7 days. This duration of acute illnesses was the most common among 14-year-old girls (46.8%) and 14-year-old boys (50.0%), 15- year-old girls (50.0%) and 15-year-old boys (53.1 %), 16-year-old girls (43.7%) and 17-year-old girls (46.8%). At the same time, among young men at the age of 16, the most common was the duration of illnesses with a temporary loss of working capacity up to 3 days (40.6%), followed by the share of indicators of the duration of the illness in the range from 3 to 7 days (34.3%), among young men at the age of 17 years old - there was a balance of indicators of the duration of the disease in the range from 3 to 7 days (34.3%) and in the range from 7 to 14 days (34.3%).

Considering the structural features of the distribution of diseases with temporary loss of working capacity, characteristic of the studied persons during the period of stay in the senior classes of a modern comprehensive educational institution, it was necessary, first of all, to note a significant advantage during all age stages of the share of diseases of the respiratory organs, primarily due to acute respiratory infections of the upper respiratory tract ways and flu. Thus, the specific weight of diseases with predominant damage to the respiratory tract among girls and boys at the age of 14 years old was 85.2% and 86.4%, among girls and boys at the age of 15 years old - 82.2% and 88.0%, among girls and boys at the age of 16 years old - 85.2% and 84.4%, among girls and boys at the age of 17 years old - 83.8% and 83.8%, respectively. The next place in the structure of the distribution of the studied indicators was occupied by the share of diseases of the digestive organs, the value of which was 3.8% and 3.6% among 14-year-old girls and boys, 2.8% and 3.8% among 15-year-old girls and boys, 4.2% and 2.4% among 16-year- old girls and boys and 3.8% and 6.2% among 17-year-old girls and boys. This was followed by the specific weight of diseases of the skin and subcutaneous fat, the values of which were 2.4% and 2.0% among girls and boys at the age of 14 years old, 2.4% and 2.0% among girls and boys at the age of 15 years old, 1.6% and 1.6% among boys aged 16 years old and 2.2% and 1.6% among girls and boys aged 17 years old. The share of diseases with temporary loss of working capacity of other genesis and other localization was insignificant. Thus, the specific weight of diseases of the circulatory system ranged from 0% to 2.4% among girls and from 0% to 3.2% among boys, the share of diseases of the genitourinary system ranged from 0% to 2.8%, respectively among girls and from 0% to 2.4% among boys, the specific weight of infectious and parasitic diseases - respectively from 0% to 1.8% among girls and from 0% to 1.0% among boys, the share of diseases of the eye and its accessory apparatus - respectively within the range from 0% to 1.5% among girls and within the range from 0% to 2.0% among boys, the specific weight of injuries and other consequences of the action of external factors - respectively within the range of 0% to 1.5% among girls and between 0% and 1.5% among boys.

Evaluating the degree of spread of chronic diseases of various degrees of expression, which affected the functional state of the organism, the level of work capacity and adaptive capabilities of schoolchildren, attention should be paid to the fact that the presence of diseases with a chronic course of the pathological process was characteristic of 43.7% of girls and 34.4 % of boys at the age of 14 years old, 59.4% of girls and 56.2% of boys at the age of 15 years old, 68.7% of girls and 28.1% of boys at the age of 16 years old and 46.8% of girls and 34.3% of boys at the age of 17 years old.

At the same time, data on the analysis of the frequency of exacerbations of chronic pathology, which occurs, should be noted that 4 or more times a year exacerbations of diseases with a chronic course of the pathological process were registered among 7.1% of 14-year-old girls, 15.8% and 5, 6% of 15-year-old girls and boys, 13.6% and 11.2% of 16-year-old girls and boys, 11.2% and 20.0% of 17-year-old girls and boys, 3 times a year - respectively among 21, 2% and 27.3% of girls and boys at the age of 14 years old, 26.3% and 27.7% of girls and boys at the age of 15 years old, 9.1% of girls at the age of 16 years old, 26.6% and 27.3 % of girls and boys aged 17 years old, 2 times a year - respectively among 35.7% and 27.3% of 14-year-old girls and boys, 42.1% and 11.1% of 15-year-old girls and boys, 36, 4% and 44.4% of 16-year-old girls and boys, 26.7% and 18.1% of 17-year-old girls and boys, 1 time a year - respectively among 35.7% and 45.4% of girls and boys in aged 14 years old, 15.8% and 55.6% of girls and boys aged 15 years old, 40.9% and 44.4% of girls and boys aged 16 years old, 26.7% and 45.5% of girls and boys at the age of 17 years old. Therefore, the predominant frequency of exacerbations of chronic diseases should be considered the frequency of 1 time per year (only among girls aged 15 years old, exacerbations of diseases with a chronic course of the pathological process were most often observed 2 times a year). The least common frequency of exacerbations during most of the studied age periods was the frequency of 4 or more times a year (only among girls and boys aged 16 years old should be considered the frequency of exacerbations of chronic diseases - 3 times a year).

Evaluating the leading characteristics of the data distribution structure regarding the prevalence of diseases with a chronic course of the pathological process, it should be noted that diseases of the musculoskeletal system and connective tissue, primarily deforming dorsopathies (postural disorders) and arthropathies, should be considered the most widespread among the studied schoolchildren (flatfoot). Thus, the specific weight of such diseases was 33.2% and 28.0% among girls and boys at the age of 14 years old, 32.4% and 36.0% among girls and boys at the age of 15 years old, 29.6% and 27, 4% among girls and boys aged 16 years old, 30.2% and 32.4% among girls and boys aged 17 years old. This was followed by diseases of the eye and its accessory apparatus, the leading place in the structure of which was occupied by disturbances of the functions of the visual sensory system, and above all myopia, the share of which was 23.8% and 25.6% among 14-year-old girls and boys, 23.8% and 22.0% among 15-year-old girls and boys, 23.8% and 25.0% among 16-year-old girls and boys, 19.8% and 20.4% among 17-year-old girls and boys. The third place in the structure of the distribution of data regarding the prevalence of diseases with a chronic course of the pathological process belonged to diseases of the digestive organs, the specific weight of which was 15.2% and 14.8% among girls and boys aged 14 years old, 16.0% and 14.0 % among girls and boys at the age of 15 years old, 19.6% and 17.2% among girls and boys at the age of 16 years old, 16.2% and 12.4% among girls and boys at the age of 17 years old. Chronic diseases of the endocrine system, nutritional disorders and metabolic disorders were characteristic of 7.4% and 9.2% of 14-year-old girls and boys, 6.4% and 8.2% of 15-year-old girls and boys, 8.8% and 8.6% of 16-year-old girls and boys, 10.4% and 6.4% of 17-year-old girls and boys, the specific weight of chronic diseases of the circulatory system was 6.2% and 6.8% among girls and boys aged 14 years old, 4.2% and 6.0% among girls and boys at the age 15 years old 7.4% and 7.8% among girls and boys at the age 16 years old and 9.6% and 8.2% among girls and boys at the age of 17 years old, the share of chronic respiratory diseases is 6.2% and 5.0% among 14-year-old girls and boys, 8.2% and 6.0% among 15-year-old girls and boys, 5.4% and 5.6% among 16-year-old girls and boys and 5.0% and 7.8% among 17-year-old girls and boys. Finally, it should be noted that the specific weight of diseases of the genitourinary system ranged from 3.2% to 5.0% among girls and from 0% to 2.4% among boys, diseases of the skin and subcutaneous fat - from 0.8% up to 2.0% among girls and from 0% to 3.6% among boys.

The results of the generalized subjectively meaningful assessment of the state of health noted the fact that 21.8% and 21.8% of 14-year-old girls and boys, 9.3% and 37.5% of 14-year-old girls and boys considered their own health to be excellent 15-year-old girls and boys, 6.3% and 25.0% of 16-year-old girls and boys, 18.7% and 28.1% of 17-year-old girls and boys, good - 46.8% and 43.7%, respectively girls and boys at the age of 14 years old, 65.6% and 43.7% of girls and boys at the age of 15 years old, 43.7% and 53.1% of girls and boys at the age of 16 years old and 56.2% and 50.0 % of girls and boys at the age of 17 years old, satisfactory - respectively 28.1% and 28.1% of 14-year-old girls and boys, 21.8% and 3.1% of 15-year-old girls and boys, 40.6% and 18 .7% of 16-year-old girls and boys, 6.3% and 12.5% of 17-year-old girls and boys, poorly - only 3.1% of girls at the age of 14, 9.3% and 3.1% of girls and boys at the age of 16 and 15.6% and 9.2% of girls and boys at the age of 17, very bad - only two (6.3%) 14-year-old boys, one (3.1%) 15-year-old girl, one (3.1%) 15-year-old boy and one (3.1%) 17-year-old boy.

Thus, the studied students, regardless of their age, most often defined their own health as good, while the lowest frequency of choosing a fixed characteristic of their own health was characteristic of such an interpretation of their state as bad and very bad. Quite interesting data were determined during the application of the procedures of descriptive statistics and correlation analysis, which were aimed at evaluating the features of the relationship between indicators of the state of health and a number of medical and social indicators of the anamnestic content, as well as objective characteristics of the morpho-functional state and adaptive resources of the body of high school students, which were determined.

In particular, among girls at the age of 14 years old, statistically significant correlations were observed between the characteristics of the level of health and data on: general assessment of living conditions (r=0.32, p<0.05), features of intrafamily relationships in to the family of schoolchildren (r=0.45, p<0.01), the need to perform additional paid work outside of school hours (r=-0.35, p<0.05), the average score of academic performance (r=0.37, p<0.05), the presence of learning problems (r=-0.36, p<0.05), indicators of physical development, primarily chest circumference (r=0.44, p<0.01), and the number of diseases with temporary disability (r=-0.45, p<0.01).

At the same time, among 14-year-old boys, significant correlations were registered between the characteristics of the level of health and data on: general assessment of living conditions (r=0.36, p<0.05), duration of night sleep (r =0.41, p<0.05), time spent in the fresh air on school days (r=0.38, p<0.05), availability of time to organize sleep during daylight hours (r=0.48, p <0.01), the peculiarities of the diet (r=0.49, p<0.01), the average score of academic success (r=0.38, p<0.05), the level of educational adaptation (r=0.66 , p<0.001) and the number of diseases with temporary disability (r=-0.66, p<0.001).

Among girls at the age of 15 years old, statistically significant correlations were observed between the characteristics of the level of health and data on: general assessment of housing conditions (r=0.42, p<0.05), time spent in the fresh air in educational days (r=0.38, p<0.05), features of free time organization and, above all, features of activities in sports sections (r=0.45, p<0.01), presence of harmful habits, in particular smoking (r= -0.45, p<0.01) and features of alcohol consumption (r=-0.35, p<0.05), the average score of academic success (r=0.36, p<0.05), indicators physical development, especially body weight (r=-0.56, p<0.01) and the number of diseases with temporary disability (r=-0.49, p<0.05).

At the same time, among 15-year-old boys, significant correlations were registered between the characteristics of the level of health and data regarding: the general assessment of living conditions (r=0.43, p<0.05) and, above all, the generalized assessment of microclimatic conditions ( r=0.40, p<0.05), features of the transport radius of movement during the day (r=-0.35, p<0.05), the need to perform additional paid work outside of school hours (r=-0.43, p<0.05), duration of night sleep (r=0.49, p<0.01), time spent outdoors on weekends (r=0.35, p<0.05), presence of bad habits, in particular, smoking (r=-0.45, p<0.01) and features of alcohol consumption (r=-0.33, p<0.05), indicators of physical development, primarily body weight (r=-0.47, p<0.01) and chest circumference (r=0.42, p<0.01), the number of diseases with temporary disability (r=-0.45, p<0.01) and the number of disease exacerbations with a chronic course of the pathological process (r=-0.35, p<0.05).

Among girls at the age of 16 years old, statistically significant correlations were observed between the characteristics of the level of health and data on: general assessment of living conditions (r=0.39, p<0.05), characteristics of the family the state of families in which schoolchildren live (r=0.45, p<0.05), the need to perform additional paid work outside school hours (r=-0.37, p<0.05), the use of hardening procedures (r=0.44, p<0.05), time spent outdoors on weekends (r=0.45, p<0.05), presence of harmful habits, in particular smoking (r=-0.37, p<0 .05), the average score of academic success (r=0.38, p<0.05), the degree of intensity of schooling (r=-0.41, p<0.05) and the number of exacerbations (r=0.45, p<0.05) with a chronic course of the pathological process (r=-0.35, p<0.05).

At the same time, among 16-year-old boys, significant correlations were registered between the characteristics of the level of health and data on: general assessment of living conditions (r=0.49, p<0.01), time spent at fresh air on school days (r=0.41, p<0.05), features of the diet (r=0.72, p<0.001), performing morning gymnastics exercises (r=0.35, p<0.05 ), the presence of learning problems (r=-0.376, p<0.05), the presence of harmful habits, in particular smoking (r=-0.32, p<0.05), the number of diseases with temporary disability (r=- 0.47, p<0.05) and the number of exacerbations of diseases with a chronic course of the pathological process (r=-0.39, p<0.05).

Finally, among girls at the age of 17 years old, statistically significant correlations were observed between the characteristics of the level of health and data on: features of living in an area with polluted atmospheric air (r=0.44, p<0.05), general assessment of living conditions (r=0.34, p<0.05), the need to perform additional paid work outside of school hours (r=-0.40, p<0.05), performing morning gymnastics exercises (r=0 .31, p<0.05), time spent outdoors on weekends (r=0.41, p<0.01), level of educational adaptation (r=0.51, p<0.01), availability harmful habits, in particular smoking (r=-0.49, p<0.01), number (r=-0.39, p<0.05) and duration (r=-0.37, p<0.05 ) of diseases with temporary loss of working capacity and the number of exacerbations of diseases with a chronic course of the pathological process (r=-0.59, p<0.001).

At the same time, among 17-year-old boys, significant correlations were registered between the characteristics of the level of health and data on: general assessment of living conditions (r=0.35, p<0.05), the need to perform additional paid extracurricular work (r=-0.40, p<0.05), duration of night sleep (r=0.44, p<0.01), duration of educational activities at school (r=0.46, p<0.01), performing morning gymnastics exercises (r=0.40, p<0.01), characteristics of well-being at the end of the school day (r=0.37, p<0.05), degree of intensity of school studies (r=- 0.48, p<0.01), the presence of harmful habits, in particular smoking (r=-0.39, p<0.05), the number of diseases with temporary disability (r=-0.47, p<0, 01) and the number of exacerbations of diseases with a chronic course of the pathological process (r=-0.56, p<0.001).

Conclusions

Thus, one of the leading places, both primarily in the structure of morbidity with temporary loss of working capacity, and in the structure of morbidity with a chronic course of the pathological process, is occupied by indicators of morbidity of respiratory organs. The most significant relationship with the characteristics of the health level of girls and boys during their studies in senior classes had 4 groups of indicators that reflected the peculiarities of the living conditions of stay (1st group), the peculiarities of the students' stay in the fresh air both in the educational and on weekends (2nd group), features of educational adaptation (3rd group) and features of morbidity with temporary loss of working capacity (4th group). Attention was drawn to the fact that in the graduation classes, it was necessary to add 3 more groups of such indicators as the characteristics of the course of diseases with a chronic course of the pathological process (5th group), the characteristics of the spread of harmful habits and, above all, smoking (6th group) and the characteristics of the use of health-improving means, such as morning gymnastics exercises and hardening procedures (7 th group).

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