P indicators of the health status of children and adolescents are:
- general morbidity,
- infectious morbidity,
- health index,
- percentage of long-term and frequently ill people,
- prevalence and structure,
- percentage of people with normal physical development;
- percentage of people with disabilities in mental and physical development.
Monitoring the health status of class students is carried out by the class teacher together with medical worker.
In the cool magazine the last page summarizes student health information during academic year in the form of the following indicators:
- Health index - the percentage of children who did not get sick during the school year (normally 70 - 80%, in fact - 17-30%).
- Number of frequently ill children (more than 3 - 4 times per year).
- Number of children with chronic diseases and a list of these diseases (feature recent years- increase in the number of “adult diseases”: chronic gastritis, gastric ulcer, hypertension, etc.).
Information about the health status of students in the class and school is discussed at the pedagogical council and, together with a medical worker and the State Sanitary and Epidemiological Surveillance Center, is compiled comprehensive plan on the health of schoolchildren.
Every year, millions of children and adolescents undergo medical examinations. The purpose of these examinations is to identify persons in need of medical and recreational measures. In addition, they make it possible to determine the need for medical personnel and a network of treatment and preventive institutions (HCI). Taken together, their results characterize the health status of the entire younger generation.
A comprehensive assessment of the health status of each child or adolescent with assignment to one of the “health groups” is given with mandatory consideration of all the listed criteria. This grouping allows for a comparative assessment of the health status of various populations, both at the time of examination and during dynamic monitoring, to check the effectiveness of ongoing preventive and therapeutic measures.
The main 5 groups of children's health.
There are five health groups of the children's population. Depending on their membership in a particular health group, children and adolescents need a differentiated approach when developing a set of treatment and preventive measures.
The first group - healthy children, with normal development And normal level functions - children who do not have chronic diseases; those who were not ill or rarely ill during the observation period; having normal, age-appropriate physical and neuropsychic development (healthy children, without deviations).
For persons included in the first health group, educational, work and sports activities are organized without any restrictions. The pediatrician carries out their preventive examination in planned dates, and medical appointments usually consist of general health measures that have a training effect on the body.
The second group - healthy children, but having functional and some morphological abnormalities, as well as reduced resistance to acute and chronic diseases - children who do not suffer from chronic diseases; having some functional and morphological deviations; often (4 times a year or more) or for a long time (more than 25 days for one disease) sick (healthy, with morphological abnormalities and reduced resistance).
Children and adolescents included in the second health group (the so-called risk group) require closer attention from doctors. This contingent needs a complex of health measures aimed at increasing the body’s resistance by nonspecific means:
- 2) hardening by natural factors;
- 4) additional fortification of food products, etc.
The timing of repeated medical examinations is set by the doctor individually, taking into account the direction of deviations in the state of health and the degree of resistance of the body.
The third group - children with chronic diseases in a state of compensation, with preserved functional capabilities of the body - children with chronic diseases or with congenital pathology in the stage of compensation, with rare and not severe exacerbations of a chronic disease, without a pronounced disturbance in the general condition and well-being (patients in a state of compensation).
Fourth group- children with chronic diseases in a state of subcompensation, with reduced functional capabilities - persons with chronic diseases, congenital malformations in a state of subcompensation, with disturbances in general condition and well-being after an exacerbation, with a protracted period of convalescence after acute diseases (patients in a state of subcompensation).
The fifth group - children with chronic diseases in a state of decompensation, with significantly reduced functional capabilities of the body - children with severe chronic diseases in the stage of decompensation, with a significant decrease in functional capabilities (patients in a state of decompensation). As a rule, children in this group do not attend child care institutions and are not covered by mass medical examinations.
Children and adolescents of the 3rd, 4th and 5th health groups are at dispensary observation from doctors of different specialties, they receive one or another therapeutic and preventive care, depending on the existing pathology and the degree of compensation. In children's institutions, a gentle daily routine is created for them, the duration of rest and night sleep is extended, the volume and intensity are limited. physical activity etc. If necessary, they are sent to special children's and adolescent institutions, where, taking into account the characteristics of the pathology, treatment and education are targeted.
Examples:
Functional heart murmur, tachycardia, bradycardia, sinus arrhythmia, extrasystole, decreased blood pressure (8-12 years old - up to 80 - 85 mm Hg, 13-16 years old - up to 90 - 95 mm Hg) - 2nd health group. Vegetovascular dystonia- 3rd health group. Hypertension- 4th health group. Congenital heart disease - 3rd or 4th health group. Dental caries, malocclusion - 2nd or 3rd health group. Chronic gastritis, colitis - 3rd or 4th health group. Dysmenorrhea - 3rd health group.
Allergic reactions (repeated allergic skin reactions to food products, medications, etc.) - 2nd health group. Eczema, dermatitis - 3rd or 4th health group. Logoneurosis, enuresis, tics - 3rd or 4th health group. Mild myopia, astigmatism - 2nd health group. Moderate and high myopia - 3rd or 4th health group. Poor posture - group 2, scoliosis - group 3 or 4.
Adult population. Each of them differs not only in the patient’s condition, but also in the frequency of his dispensary observation.
Adult health groups: classification
The need to create a full division of patients into various categories arose almost immediately after the advent of clinical examination. The fact is that it involves a different number of studies depending on what kind of diseases a person has.
Currently, there are 3 main health groups of the adult population. Each of them is characterized by certain criteria indicating the presence or absence of certain diseases.
First health group
About the first and second groups
Patients from the first adult health group can visit doctors only once a year and undergo only standard tests. If, as a result of such a commission, they do not reveal any chronic non-communicable diseases or additional factors to their formation, they remain in the same category.
As for the second health group of the adult population, those who belong to it can also undergo examination only once a year, however, they need a more serious examination. Its volume will depend on what risk factors the patient already has. The fact is that the primary detection of chronic non-infectious diseases is typical specifically for this health group in adults. The characteristics of this category of patients do not imply the presence of diseases, so after identifying an illness, the person automatically moves to the next health group.
The presence of a chronic disease is a sufficient reason to visit the doctor not once, but at least twice a year. In this case, it is necessary to undergo appropriate tests. Thanks to them, the doctor will see how active the chronic pathological process is, and whether it is currently affecting the functioning of a particular organ. Ultimately, the doctor will understand whether it is necessary to carry out any serious therapeutic measures or whether ordinary prevention is sufficient.
About the third group
Patients from the third health group of the adult population can be examined more often than 2 times a year. The frequency of observations depends on the severity of chronic pathological process. At the same time, for patients with certain diseases, according to dispensary observation, it is recommended to take a course inpatient treatment 1-2 times a year.
About children
The health groups of adults and children differ significantly. The fact is that children are usually divided not into 3, but into 5 categories. This is due to the great attention paid to children's population. So the adult health groups and their characteristics are not applicable to minor patients.
The first group is characterized by the absence of any diseases or abnormalities in the child. This baby can get sick sometimes acute form any pathology, but at the time of examination he does not have it. In addition, such a child should have sufficient high level body resistance.
Second group children's health includes children who do not have any chronic diseases, but at the same time have minor deviations. An example would be complications during childbirth in the mother. At the same time, these deviations have absolutely no effect on the child’s functional abilities.
Children from the third health group have one or another chronic disease. Moreover, this category of small patients is characterized by its full compensation. That is, despite the presence of the disease, the child does not experience any special problems with normal loads.
If we talk about the fourth group of children’s health, then it includes those kids who have quite serious chronic illnesses, who are in the stage of subcompensation. That is, the child has the ability to maintain full functional activity, but at the same time his organs and systems are forced to work, constantly straining, which ultimately leads to morphological changes and further deterioration in performance. As a result, such a child has to be transferred to the next health group.
The fifth group of children usually includes those children who have serious chronic pathology. Moreover, in order to be transferred to this category, there must also be decompensation of the activity of a particular organ. Such a child clearly needs serious medical care.
In terms of medical examination, doctors naturally have to pay the greatest attention to children from the 3rd, 4th and 5th groups.
6.2. Concept of health groups and medical groups
In the Russian Federation, there is a system for early identification of children in need of therapy and further organization of their life activities. In particular, annual medical examinations of students make it possible to divide them into medical groups in accordance with four criteria:
The presence or absence of chronic diseases;
The nature of the functioning of the main functional systems of the body;
Degree of resistance to adverse effects;
The level of physical development and the degree of its harmony.
Health groups. In accordance with the specified criteria, the following health groups are distinguished:
Group 1 – healthy, normally developing, without functional abnormalities. This includes schoolchildren without chronic diseases, who were not ill or rarely ill during the observation period and who have normal, age-appropriate physical and neuro-psychological development. This group includes 20–25% of schoolchildren, and this content of the first group has not changed over the past 50 years. But now the characteristics of the health of these children are not entirely objective, since the first group most often includes those who simply have not been diagnosed, although they undoubtedly have reduced adaptive capabilities, i.e. they are in the "third state".
Group 2 – healthy, with functional or minor morphological deviations. These are schoolchildren who do not suffer from chronic diseases, but have some functional and morphological abnormalities, as well as schoolchildren who are often (four or more times a year) or for a long time (more than 25 days for one disease). This group has rather vague criteria, so assigning a particular schoolchild to it is often the competence (or incompetence) of the doctor.
Group 3 – patients in a compensated state: having chronic diseases or congenital pathology in a state of compensation with rare and mild exacerbations of a chronic disease without a pronounced disturbance in the general condition and well-being.
Group 4 – patients in a subcompensated state: having chronic diseases or congenital pathology in a state of subcompensation with disturbances in general condition and well-being after an exacerbation, with a protracted nature of convalescence after acute diseases.
Group 5 – patients in a decompensated state: with severe chronic diseases in a state of decompensation and with significantly reduced functional capabilities; as a rule, they do not attend educational institutions general profile, and are trained either in specialized schools or at home and are observed according to individual schemes.
A comprehensive assessment of health status and distribution into health groups is provided by a pediatrician.
Children and adolescents assigned to different groups require a differentiated approach in organizing physical education classes or physical therapy. Thus, for children of the first health group, educational, work and sports activities are organized without any restrictions in accordance with state physical education programs for the corresponding age category. Children of the second health group as a risk group need increased attention from doctors. They need to be dealt with special events hardening, physical therapy, diet therapy; They need to organize a rational lifestyle in accordance with their state of health. Children with the third, fourth and fifth health groups should be under constant medical supervision, their motor mode is limited by certain contraindications (but should be an obligatory part of their lifestyle), and the duration of rest and sleep is extended for them.
After being distributed into health groups, children recognized as fit to study in a general education school are divided into medical groups, belonging to each of which determines the mode of study. physical culture, which best suits their health status. The correct distribution of children into medical groups for physical education is an important part of the work of a pediatrician and physical education teacher.
Distribution of schoolchildren by medical group carried out by a pediatrician on the basis of the “Regulations on medical control over the physical education of the population of the USSR. Order No. 826 dated November 9, 1966.”
Based on data on the state of health, physical development and physical fitness of children, all students enrolled in state programs are divided into four groups: basic, preparatory, special and therapeutic physical education group.
To the main medical group include schoolchildren without deviations in health, as well as those with minor deviations with sufficient physical development.
For the preparatory group include children without deviations in health with insufficient physical development, as well as with minor deviations in health. The group with health problems includes students with chronic diseases. The largest population of this group consists of schoolchildren with focal infections of the oral cavity, nasopharynx, paranasal sinuses nose, etc. Particularly common are chronic tonsillitis (20–40% of students), dental caries (almost 90%), etc. It is known that chronic foci of inflammation in the nasopharynx and oral cavity change the overall reactivity of the body, reduce its protective functions and natural resistance to infections . Such children often get sick during the period of acute respiratory viral infections (ARVI) and influenza; they often have exacerbations of chronic tonsillitis, otitis, and sinusitis. The source of infection in the nasopharynx can provoke bronchitis, pneumonia, their transition to chronic form.
To a special medical group include schoolchildren with health conditions of a permanent or temporary nature, requiring limited physical activity or certain contraindications in the means of physical education used. The special medical group also includes schoolchildren suffering from other diseases due to which at this time it is necessary to significantly limit physical activity (after tuberculosis, with a significant lag in physical development and physical training, with acute gastrointestinal diseases with symptoms of exhaustion, five to six months after hepatocholecystitis, as well as viral hepatitis).
The contingent of a special medical group also includes schoolchildren for whom physical activity does not pose a danger, but they cannot exercise general program due to defects of the musculoskeletal system: ankylosis, contractures, severe muscle atrophy, after traumatic injuries, chronic infectious polyarthritis, accompanied by limited mobility of joints, with residual effects of poliomyelitis, as well as severe spinal deformity of I - II degrees.
For schoolchildren of the preparatory and special medical groups, a limitation on the amount of physical activity is provided, the degree of which depends on the health status of the student, his illness and other criteria for the state of the body. Thus, special medical groups are composed of students for whom physical activity received in physical education lessons is contraindicated or requires significant limitation. Therefore, physical education of schoolchildren of a special medical group is carried out according to a specially developed program that corresponds to the characteristics of the contingent involved in this medical group.
To the physical therapy group include children (most often belonging to the fourth and fifth health groups) who have certain severe health problems and are exempt from physical education at school. Such groups should work directly with medical institutions under the supervision of an appropriate specialist.
Thus, no child attending a general education institution should be completely exempt from physical education. If such a situation occurs, the doctor who made such a decision must bear responsibility for it.
In accordance with the above-mentioned Order of the Minister of Health of the USSR No. 826 dated November 9, 1966, to date, the distribution of schoolchildren into medical groups is carried out according to Table 13 below.
Table 13
Approximate indications for determining the medical group for certain health conditions in children and adolescents
It should be noted that the table below confirms once again: with rare exceptions, usually associated with acute conditions, there cannot be children who are completely exempt from physical education! This fully applies to those cases where when a child starts school after suffering an acute disease or condition (cold-infectious, injury, etc.). At the same time, the following are recommended for his release from physical education in the medical group in which he is constantly engaged (Table 14).
Table 14
Approximate timing for resuming physical activity after illness
The given periods relate only to physical education classes at school, but during these periods the student must engage in physical exercises according to physical therapy schemes directly under the supervision of an appropriate specialist and the attending physician.
Thus, in accordance with the results of medical examinations or (in acute conditions and after them) the conclusion of the attending physician, students are distributed into medical groups for physical education directly at school.
Physical education in medical groups. Physical education classes in medical groups directly in educational institutions are conducted according to appropriate programs.
Main group. Here, classes are conducted according to the state physical education program in full, certain standards are required, classes in sports sections and participation in competitions are allowed. The result of successful completion of the program is an assessment determined by the relevant criteria.
Preparatory group. Classes are conducted according to the general physical education program, subject to a more gradual completion with a delay in passing control tests (standards) and standards for up to one year. Directly during classes, schoolchildren in this group need more careful monitoring by the physical education teacher and the medical worker of the educational institution. In addition to compulsory physical education lessons, classes in the general physical training section are recommended for such students. Final grade, unlike schoolchildren of the main group, is mainly determined by the physical education teacher in accordance with the individual criteria established for this stage of education.
Special medical group. Classes are conducted according to a special program or certain species state program, the preparation period is extended, and the standards are replaced by the implementation of individual tasks. The main form and means of work of a special medical group are physical therapy classes.
Transfer from one group to another is made during the annual medical examination of schoolchildren. The transition from a special medical group to a preparatory group is possible subject to positive dynamics of treatment results and success in physical education.
Reading time: 11 minutes
The physical component of health determines the mental and social well-being of the child, his harmonious development, success in adult life. Developmental defects, presence of chronic diseases, congenital anomalies require adjustment of physical activity and constant medical monitoring. Comprehensive medical examinations make it possible to assess the state of the physiological systems of the body, the dynamics of pathology, in order to determine the health group of children for the organization of general strengthening activities and rehabilitation measures.
What is a children's health group?
IN pediatric practice the concept of “health group in children” – symbol, which doctors use to assess the general condition of the body. The conclusion is made on the basis of a comprehensive examination by specialists and a local pediatrician. The conclusion is issued at the current moment, so the health group may change. It depends on the dynamics of the state.
Assess and determine the health group of children of different age categories necessary in order to further provide timely medical care or organize observation by narrow specialists. Its definition is very important for children who attend educational institutions. When diagnosing chronic diseases or the presence of developmental anomalies, a special group is assigned in which the requirements are reduced and physical activity is reduced.
How to determine a child's health group
Only qualified doctors determine the health groups of children and adolescents. Subject specialists who are members of the medical commission draw conclusions after examination and additional research. All data is provided to the pediatrician, who, based on the findings of the commission, laboratory tests, criteria for a comprehensive health assessment, own observations gives a conclusion. The health group for children is determined taking into account data on the course of pregnancy and early development.
Referral for annual medical examination
There is an opinion among parents that annual medical examinations are a whim of doctors and a waste of time. Parents sometimes do not notice how and when their child began to develop a chronic disease. His whims, complaints of fatigue, poor health are attributed to laziness or bad character. Walkthrough medical examination once a year is necessary and justified. Statistics indicate a small percentage of absolutely healthy children.
Legalized by the state compulsory passage medical examination at 1 year of age, upon registration as a child preschool, before entering the 1st grade of school, annually school age. Parents need to understand that undergoing a medical examination cannot be treated formally. A comprehensive health assessment is not carried out to obtain a certificate of ability to attend kindergarten or school, and for timely detection diseases, developmental disorders.
At the annual examination, the doctor analyzes anthropometric data, laboratory tests, dynamics of morbidity. IN medical report indicates whether it is possible to visit childcare facility, belonging to a physical education group. It will help parents adjust their daily routine, nutrition, mental and physical activity. When pathological conditions are identified, a dispensary record is registered and observation by a specialist.
Comprehensive assessment of children's health status
Clinical examination involves examination by specialized specialists. The local pediatrician, based on their findings and his own observations, makes a comprehensive assessment of the patient’s physiological condition. The medical commission includes:
- surgeon (identification possible violations posture);
- ophthalmologist (determining visual acuity and its correction);
- ENT (identification of structural features of the nasopharynx, tendency to diseases of the throat, nose, ear);
- cardiologist (monitoring the functioning of the cardiovascular system);
- neuropathologist (identification of features nervous system);
- dentist (checking the condition of teeth).
What to do if a child is diagnosed with functional impairment or a chronic disease
The purpose of the annual preventive examination is to determine possible functional disorders and chronic diseases. When they are detected, a comprehensive health assessment is not done. Conducted additional research, the diagnosis is being clarified. Only after this the pediatrician gives a comprehensive assessment. This is the algorithm of actions of the medical commission in the initial detection of pathologies.
Classification of criteria
There are developed criteria for children's health, their classification is varied. In pediatric practice, 5 basic principles are popular by which the health group of children is determined:
- Heredity. When examining a newborn, the doctor determines the presence hereditary diseases, which are recorded in a number of generations of the family. If there are genetic pathologies, laboratory tests will help determine the likelihood of such a disease. The genealogical criterion takes into account the peculiarities of pregnancy, childbirth itself, and the development of the newborn in the first month.
- Physical development. This is based on basic anthropometric data: height, weight, head circumference, chest circumference, limb length and others. There is a special table in which digital indicators of normal physical development are recorded.
- Development of organ systems. In parallel with the increase in body weight and height, the formation of internal organs and their systems. You can control this process using additional tests and hardware techniques (for example, ultrasound). Doctors pay special attention to the development of organs that provide basic life processes - the heart, stomach, kidneys, lungs.
- Degree of immune protection. Healthy body reliably withstands factors environment, less susceptible to infections. Reason weak immunity In frequently ill patients, it is necessary to find out through additional examination and diagnosis.
- The relationship between mental and physical health. A neurologist, psychologist and pediatrician jointly determine the course of the body’s nervous reactions and the level of development mental processes, physical health and correlate the data with special tables of standards.
Children's health groups and their characteristics
A comprehensive assessment of health status is carried out from 3 to 17 years of age according to specially developed criteria. The health group in children is indicated by Roman numerals. Belonging to it is determined not so much by an established diagnosis as by physical capabilities, so patients with the same diseases can be in different groups Oh.
Parents express concern when their children's health group does not meet normal standards. The doctor's conclusion on its assignment is not a diagnosis. Medical gradation of this type provides a comprehensive assessment of physical development and the ability to correct it in the future, taking into account various factors, which actively influence him.
I health group
Absence of anatomical defects and functional pathologies. Patients are practically healthy and rarely get sick. The identified functional abnormalities in the body do not affect the overall physiological state and do not require special medical correction. At the time of examination, they are practically healthy, with isolated deviations in neuropsychic development.
Group II
Small deviations are recorded, reduced immune defense. There are no chronic diseases, functional disorders are diagnosed. There is a general delay in physical development: excess or deficiency of body weight, impaired vision, anemia, flat feet and other dysfunctions. Health group 2 in a child means that he often suffers from acute respiratory infections (more than 4 times a year). There is a high risk of developing pathological conditions and their transition to a chronic disease. Subgroup 2a includes patients with risk factors for the development of diseases:
- genetic (hereditary diseases);
- biological (difficult pregnancy and difficult childbirth);
- social (smoking, alcoholism, parents working in hazardous industries, late pregnancy, venereal diseases, threat premature birth or miscarriage).
Subgroup 2b is characterized by the presence of morphological abnormalities and functional disorders. Newborn babies are characterized by diseases that they suffered in the first minutes and hours of life. After discharge from maternity hospital pathologies persist, the risk group is indicated. The pediatrician draws up an observation plan, conducts systematic examinations and preventive measures, if necessary, prescribes treatment. These kids get sick often. They require constant monitoring at home.
III group
Chronic diseases that are characterized by long periods of remission. Rarely do exacerbations of the condition occur that pass without complications of the underlying disease. Young patients have normal physical development, but anthropometric indicators (height, body weight) are below normal. Health group 3 in a child is an indicator of mental retardation.
IV group
Several chronic diseases are present. One or more diseases are in the stage of subcompensation, severe defects are present, pathological conditions. This includes patients who are in remission with ongoing maintenance treatment. This includes patients with physical disabilities due to traumas suffered and operations.
Group V
Severe chronic disease, physical defects, disruption of the functionality of vital internal organs. These include the most severely ill patients, who often experience deterioration and seizures, followed by complications. The underlying disease requires constant treatment measures. This includes children with disabilities.
Newborn health groups
In pediatrics, there is a special health assessment for newborns. Membership in a specific group is determined upon discharge from the maternity hospital. This is the basis for drawing up a plan for working with your baby. A set of measures is carried out by the local pediatrician. The criteria by which the health group of a newborn is determined are given in the table:
| Criteria | |
| 1 | The baby and his mother are healthy. The course of the first half of pregnancy must be taken into account |
| 2a | The mother of the newborn has narrow pelvis. The baby exhibits physiological immaturity (prematurity or postmaturity of the 1st degree), and initial degree edematous syndrome manifests itself |
| 2b | The woman in labor has chronic diseases, she does not have enough milk, she suffered C-section or multiple pregnancy. The child has respiratory distress (mild asphyxia) |
| 3 | The newborn has moderate or severe asphyxia, stage 3 postmaturity, birth trauma, he was infected in utero |
| 4, 5 | Severe congenital defects, anomalies present, impaired physiological processes, which the newborn’s body cannot restore on its own (severe decompensation) |
What is the Apgar score
A quick universal assessment of the newborn's health is determined by the Apgar score. This system was created in 1952, developed by American anesthesiologist Virginia Apgar. Using a scale, the doctor quickly assesses vital signs important signs baby. It includes 5 criteria, which are determined at 1 and 5 minutes of life. Each criterion is assessed with points, they are summed up, and the condition of the newborn is assessed using this number.
There is a special table that shows the rating scale (from 0 to 2 points) for each of the criteria:
- breath;
- heart rate;
- muscle tone;
- reflexes;
- skin color.
It’s great if each criterion is assessed by the doctor as 2 points, but a newborn cannot receive 10 points in the first minute of life (the feet and hands are bluish). A score of 9 is given to an absolutely healthy baby who can breathe independently, his pulse is more than 100 beats per minute, his arms and legs are bent at the joints. He screams loudly, sneezes, responds to manipulation with movements, his skin has healthy pink. A score of 7 or more is considered the norm - the physiological condition of the newborn is good and does not require special care.
Resuscitation measures are carried out for babies who have received 4-6 points on the Apgar scale. His condition is monitored every 5 minutes, at 10, 15, 20 minutes. Positive dynamics during observation indicate the correctness of the medical measures taken. A score below 4 requires immediate medical action to save the newborn's life.
An Apgar score of 3-4 implies average deviations from normal indicators. With constant monitoring medical personnel the condition of the newborn is classified as satisfactory. Indicators 0-2 are assessed as critical, urgent is required resuscitation actions, in the future additional examinations and observations from specialists.
Expert recommendations for different health groups
The development of a child occurs in society, his physical and social activities requires correction depending on membership in a certain health group. For this purpose, doctors have developed methodological recommendations:
- Educational and physical activities of the first health group are carried out according to existing general education programs. When directly organizing activities, take into account age characteristics. Taking them into account, without restrictions, you can comply with standards, participate in a variety of events, and attend additional educational and sports institutions.
- Contraindications for active exercises of the second group are not radical. Hardening is carried out, organized proper nutrition To correct weight, feasible physical exercise is required. Participation in general physical training sections is recommended. Walking and playing games are beneficial fresh air. Physician approval is required only for participation in high impact activities.
- The third group requires correction of physical activity; any activity is organized according to specially developed programs. The doctor gives recommendations and sets restrictions. Special attention requires recovery after stress using special complex breathing exercises. During physical activity that occurs at a low and slow pace, heart rate must be monitored. Permission to participate in sports events is given by a doctor.
- Education in the fourth group takes place according to special programs in relevant institutions. Motor activity limited, a large amount of time in the daily routine is allocated for rest. Regular sports activities contraindicated, he attends a physical therapy group.
- An individual approach is taken to drawing up programs for organizing activities in the fifth group, they are approved by the attending physician. Motor activity is significantly limited. Large quantity time is allotted for rest. Physical therapy classes are conducted individually by a qualified specialist.
Video
IN medical card Each child is marked with a health number. What does this number mean? The children's health group, the table of which requires the availability of certain data, is a conditional indicator that involves assessing the health of minors from birth to the age of 17. The assessment is made according to information about the presence of diseases (both congenital and acquired), functionality immune system And general condition baby.
Criteria for assessing
As a rule, the health group of children and adolescents is determined during the first examination by a local pediatrician after the baby is born, but many parents learn about it only after the child reaches 1.5-3 years of age. It is at this time that the baby is sent to a nursery or kindergarten. That’s when the question arises about what the number in the medical record means.
To determine a particular group, the doctor assesses the child’s condition. An assessment is given that includes a complex vital signs. As a rule, the assessment is given at the time of inspection.
In this case, only current pathologies are taken into account. All acute diseases that have not become chronic remain a thing of the past. This, in turn, suggests that the assessment of the condition may vary over time.
The assessment is based on the following indicators:
- The absence or presence of diagnosed chronic diseases, including congenital pathologies.
- Level of functionality of the main systems and organs (lungs, liver, kidneys, heart, stomach, etc.). Diagnostic and analytical methods are used to determine the condition.
- The body's ability to resist infectious agents and adverse effects. Frequency of occurrence is taken into account acute infections and the development of relapses of existing pathologies.
- Correspondence of psychological, physical and neuropsychological development to age. Indicators such as height, weight, head and body circumference of the child are taken into account, which are compared with accepted standards of physical development and special tables. The child’s current physical development is assessed by comparison with the average indicators for each specific age group.
Definition of each group
The formation of children is carried out on the basis of the Instructions for a comprehensive health assessment and the Rules for conducting assessments approved by the Ministry of Health.
Today there are 5 groups, designated by Roman numerals from I to V.
As a rule, the countdown begins with health group I in children. This includes exclusively healthy children and adolescents who do not have any developmental defects or disorders of the internal organs. Minors belonging to this category undergo medical examinations within the time limits determined by medical standards.
The second group includes virtually healthy children and adolescents who have reduced body resistance to infectious agents and minor health problems. Typically, minors included in the second group are distinguished by normal or mild retardation of mental and neuropsychological development.
The main criteria for determining children to health group II:
- The absence of chronic pathologies against the background of minor morpho- and functional problems. For infants this may be a burdened medical history of the mother during pregnancy (pathologies, toxicoses, difficult birth etc.).
- Convalescence, or recovery after pathologies that have infectious nature with moderate or high severity.
- Retardation in physical development not associated with endocrine disorders(short height, puberty, underweight) or too much weight.
- Increased incidence of acute respiratory diseases or their long course.
- Physical deficiencies, consequences of injuries or organ-preserving operations.
Finding a child in this category requires more careful monitoring by pediatricians. As a rule, the condition is monitored through annual preventive examinations.
Subsequent groups
Group III of child health involves the inclusion of minors:
- with pathologies of a chronic nature, differing long-term remissions and rare exacerbations;
- having physical disabilities due to injuries and surgical interventions, subject to full compensation for impaired functionality of systems and organs and without restrictions in training and work;
- with normal neuropsychological development or with a slight delay;
- With physical indicators, corresponding to the generally accepted ones, with deficiency/excess weight of 1 and 2 degrees or with short stature.
Children with chronic diseases active phase or different frequent relapses included in group IV. This also includes minors with full or incomplete compensation for organ function due to injuries and surgical interventions. Health group 4 involves regular supportive treatment and monitoring of children.
Child health group V includes minors with the most pronounced pathologies chronic type, accompanied by rare remissions and frequent relapses, with severe organ damage and the presence of serious complications. In addition, this group includes disabled children with physical disabilities, consequences of injuries and surgical interventions that are incompatible with normal training and labor.
Minors included in groups III to IV require regular medical supervision. Depending on the dynamics of the state of the group, it can change both upward and downward.
Health group 2 is the most common. To her, by general assessments, include more than 50% of all minors of the age in question. Besides, this group has several subgroups (Table 1).
Some parents are worried that the child belongs not to the first, but to the second group. Such an assessment does not indicate the baby’s physical abnormalities, but only shows that he needs close attention and care.
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