The criteria for assessing the health of children and adolescents, presented below, have been developed and applied.
- The presence or absence of chronic diseases at the time of examination.
- Level of functional state of the main body systems.
- The degree of resistance of the body to adverse effects.
- The level of development achieved and the degree of its harmony.
Based on the specified criteria, health groups are identified, presented in Table 12.
Table 12
Classification of the disease
According to the severity of the disease, myopia is usually divided into:
- Weak degree (up to 3.0 D);
- Middle steppe (up to 6.0 D);
- High degree (over 6.0 D).
Mild myopia does not cause any particular discomfort to the patient and does not require constant wearing of optical lenses. Moderate myopia requires certain treatment and constant wearing of corrective glasses. A severe form of the disease often leads to the need for surgical treatment.
In addition to the degree of myopia, the disease varies in its course. This is how it happens:
- Progressive;
- Not progressive.
With a non-progressive form of myopia, the pathology can be easily corrected and treated, manifested by decreased distance vision. In the progressive form of the disease, which is also manifested by decreased distance vision, vision decreases so rapidly that it requires an increase in optical correction by 1 D almost every 12 months. Various complications often arise against its background, which sometimes require surgical intervention. Typically, a similar form of the disease is observed with a high degree of myopia.
There are often cases when myopia is combined with astigmatism. This refractive error is caused by a change in the shape of the cornea, focusing parallel rays of light at several points simultaneously. During an ophthalmological examination, astigmatism is not always detected. Suspicions of its presence arise due to the impossibility of vision correction even with long-term selection of optical lenses. Indeed, in this case, corrective lenses should be aimed not only at increasing visual acuity, but also at eliminating astigmatism.
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ORDER of the Ministry of Health of the Russian Federation dated December 30, 2003 N 621 “ON COMPREHENSIVE ASSESSMENT OF CHILDREN’S HEALTH”
In order to improve the organization of medical care for children and develop measures to preserve and strengthen the health of children of different age and social groups, I order:
1.1. Instructions for (Appendix No. 1).
1.2. An algorithm for determining health groups in children aged 3 to 17 years inclusive based on the results of preventive medical examinations (Appendix No. 2).
2. Entrust control over the implementation of this order to the Deputy Minister of Health of the Russian Federation O.V. Sharapova.
APPROVED
by order of the Ministry of Health of Russia dated December 30, 2003 N 621
The system of comprehensive assessment of health status is based on 4 basic criteria:
— presence or absence of functional disorders and/or chronic diseases (taking into account the clinical variant and phase of the pathological process);
— level of functional state of the main body systems;
- the degree of resistance of the body to adverse external influences;
- the level of development achieved and the degree of its harmony.
The main method for obtaining characteristics on the basis of which a comprehensive assessment of health status is given is a preventive medical examination.
A comprehensive assessment of the health status of each child or adolescent with the formalization of the result in the form of assignment to one of the “health groups” is given with mandatory consideration of all the listed criteria.
Depending on their health status, children can be classified into the following groups:
- to health group I
include healthy children with normal physical and mental development, without anatomical defects, functional and morphofunctional abnormalities;
- to health group II
include children who do not have chronic diseases, but have some functional and morphofunctional disorders, convalescents, especially those who have suffered severe and moderate infectious diseases;
children with general delay in physical development without endocrine pathology (short stature, retardation in the level of biological development), children with underweight (weight less than M-1 ) or overweight (weight more than M+2), children often and/or for a long time those suffering from acute respiratory diseases;
children with physical disabilities, consequences of injuries or operations, while maintaining the corresponding functions; - to health group III
include children suffering from chronic diseases in the stage of clinical remission, with rare exacerbations, with preserved or compensated functionality, in the absence of complications of the underlying disease; children with physical disabilities, consequences of injuries and operations, subject to compensation for the corresponding functions, the degree of compensation should not limit the child’s ability to study or work, including adolescence;
- to IV health group
include children suffering from chronic diseases in the active stage and the stage of unstable clinical remission with frequent exacerbations, with preserved or compensated functional capabilities or incomplete compensation of functional capabilities; with chronic diseases in remission, but with limited functionality, complications of the underlying disease are possible, the underlying disease requires maintenance therapy; children with physical disabilities, consequences of injuries and operations with incomplete compensation of the corresponding functions, which, to a certain extent, limits the child’s ability to study or work;
- to health group V
include children suffering from severe chronic diseases, with rare clinical remissions, with frequent exacerbations, continuously relapsing course, with severe decompensation of the functional capabilities of the body, the presence of complications of the underlying disease, requiring constant therapy; disabled children; children with physical disabilities, consequences of injuries and operations with a pronounced impairment of compensation of relevant functions and significant limitations in the ability to study or work.
The classification of a sick child or teenager into health groups II, III, IV or V is carried out by a doctor, taking into account all the given criteria and signs. A specialist doctor, based on the analysis of data contained in the history of the child’s development, the child’s medical record for educational institutions, the results of his own examination, as well as instrumental and laboratory studies, makes (in his specialty) a complete clinical diagnosis indicating the underlying disease (functional disorder), its stage, variant of the course, degree of preservation of functions, presence of complications, concomitant diseases or the conclusion “healthy”.
A comprehensive assessment of the child’s health status based on the conclusions of specialists and the results of his own examination is given by a pediatrician who heads the work of the medical team conducting a preventive examination.
Children with diseases or functional disorders suspected for the first time at the time of examination, as well as with suspicion of a changed nature of the course of the disease, level of functionality, the appearance of complications, etc., based on the results of a preventive medical examination, a comprehensive assessment of their health status is not given. In such cases, a full diagnostic examination is necessary. After receiving the examination results, an updated diagnosis is made and a comprehensive assessment of the health status is given.
All children, regardless of which health group they are assigned to, undergo an annual screening examination, the results of which determine the need for further pediatric examination.
Children assigned to health group I undergo preventive medical examinations in full within the time limits determined by the current regulatory and methodological documents.
Children assigned to health groups III-V undergo preventive medical examinations at appropriate age periods. In addition, monitoring their health status and assessing the effectiveness of treatment and rehabilitation measures is carried out based on the results of dispensary observation.
APPROVED
by order of the Ministry of Health of Russia dated December 30, 2003 N 621
Note: this diagram does not include all functional disorders and chronic diseases that occur in childhood (including adolescence). This list includes the most commonly diagnosed health and developmental disorders.
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Signs of myopia
The main symptom of myopia is decreased distance visual acuity and blurred images. Trying to restore clear vision, a person begins to squint, which causes:
- Fatigue and pain in the eyes resulting from prolonged tension in the muscles of the eyes and face.
- Headache.
When the disease occurs with existing astigmatism, which causes changes in the shape of the eyeball, stretching of the choroid and retina occurs, which often causes trophic disorders. Such disorders, for example, include the myopic cone, which occurs at the optic nerve head.
A myopic cone is a crescent-shaped formation that develops in the fundus of the eye, in close proximity to the border of the optic nerve. When it occurs, a disruption of the metabolic process in the eye muscles occurs, which causes a decrease in their motor activity. The progression of myopia provokes an increase in this formation and its transformation into a false posterior staphyloma.
As a result of this, the sclera near the optic nerve becomes thinner and the myopic cone begins to protrude to a limited extent. In this case, it is possible to develop hemorrhages in the retina and vitreous glass, and the appearance of a rough pigment focus in the macular zone.
Such changes often lead to retinal ruptures and detachment. They become the cause of a complicated form of cataract and vitreous opacification.
Children's health groups and their characteristics
Those children for whom there are suspicions of illness or functional impairment are not given a comprehensive health assessment. In this option, it is necessary to carry out a full range of analyzes and studies to determine the group correctly. After the tests are received, it is necessary to clarify and make a diagnosis, then recommendations can be given and treatment prescribed.
The first group is completely healthy children who do not have any defects or problems. Their mental and physical health corresponds to standard measurements; they do not have any malformations, defects or other disorders in the organization and functioning of organs.
Vision health group
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Groups of children with disabilities
Assignment: Give a description of each option for the educational environment based on the picture________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
– support for children with disabilities (CHD) – activities of teachers and specialists (psychologists and social educators) aimed at creating socio-pedagogical and psychological conditions conducive to the successful learning and development of every child with disabilities in the school environment.
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Children's health groups
Upon admission to school, it is expected, among other documents, to provide a medical certificate of the future student about his state of health, which indicates the medical group to which he belongs. Typically, in general educational institutions, children with appropriate health status, physical development, and level of physical fitness are divided into 3 medical health groups : 1) basic , 2) preparatory and 3) special .
In order to improve health, promote the harmonious development and hardening of the student’s body, it is necessary to provide each student with a complete, comprehensive (in qualitative and quantitative terms) motor regime . The solution to this problem depends on the correct choice of a medical group for a particular student, and the active use of all means of physical education for the purpose of improving the health of young people.
