3rd degree of health. The most common health group in children. The body's resistance to external infections and factors
When a child undergoes medical examination, his medical carda mark is put down about assigning him a certain health group. Usually it is determined as soon as the baby is born, but over time, under the influence of various factors, the child’s health status may change, and accordingly, the health group also changes.
In general, “health group” is a concept rather conventional and is used to assess the health of children under seventeen years of age as a result of a comprehensive examination, without taking into account previous diseases that did not leave significant traces in the child’s body or did not become chronic.
Among the factors that are taken into account when making such an assessment are the main ones:
- are there any chronic diseases;
- how they function various organs and body systems;
- how the body resists diseases, how often does a child suffer from seasonal diseases;
- general level of development, both neuropsychic and physiological.
Many parents, seeing such a mark, cannot understand its meaning and begin to panic. After all, there are five health groups, and it is necessary to understand what each one means.
Group I is characterized by normal development child and absence of chronic diseases. In principle, these are healthy children.
III group. This children-chronicles in a state of remission, or with disabilities resulting from injuries and operations, they may have weight problems. But these children have no restrictions in life. Neuropsychically they are normal.
IV group. Happens often exacerbation chronic illness , such children need constant health maintenance with the help of drug treatment. They may have learning disabilities and find it difficult to adapt to society.
Group V is characterized by Availability serious illnesses, dysfunctions of organs and organ systems. These are disabled people.
We will talk about group II in more detail and try to figure out why the child is assigned to it. It's worth knowing that almost 60% of children belong to health group II. In general, such children are healthy, but there is a possibility of acquiring chronic diseases. Usually, in order to ensure ease of medical observation and rapid response, they are divided into two subgroups.
2-a – present hereditary factor, or the conditions in which the baby lives can contribute to the development of illness, both physical and mental. Such children are mobile, active and physically develop without deviations.
And the availability allergic reactions, minor disturbances in the functioning of organs do not interfere with their full life. These children can engage in physical education without restrictions, in accordance with age programs, they are recommended to attend additional sports sections.
2-b – Children have some deviations from the norm, for example they are susceptible to respiratory diseases, they have a weakened immune system, or have minor developmental abnormalities. It happens that there is a slight lag behind peers in development.
They are recommended special classes that facilitate physical training, taking into account all risk factors, that is, according to special programs. It is undesirable to overwork and undergo serious physical activity.
Thus, we can distinguish a number of factors allowing the child to be classified into group II:
- if he was born ahead of schedule, or, on the contrary, later;
- if the mother was pregnant with several babies;
- the central nervous system was affected during pregnancy;
- immediately after birth the child suffered from an infectious disease;
- the baby weighed little at birth;
- rickets or its consequences are present;
- excess body weight;
- diathesis is present;
- there is cardiac arrhythmia or a heart murmur is heard;
- often suffers from acute respiratory infections and acute respiratory viral infections (more than 4 times annually);
- low level of hemoglobin in the blood;
- there is abdominal pain, lack of appetite;
- the Mantoux reaction fluctuates between positive and negative;
- the child has suffered from Botkin’s disease or pneumonia;
- surgical procedures were postponed.
These kids need in the attention of the medical staff, it is very important to monitor their condition on a regular basis - these should be medical examinations with in-depth examination and, if necessary, application drug therapy, or periodic spa treatment.
Over time, a child can move from one health group to another, depending on whether his condition gets better or worse.
And in order for him not to move into the next group in terms of severity of illness, but, on the contrary, to rise up the conventional steps higher, it is necessary to constantly monitor his health status, carry out preventive actions and adhere to the recommendations of your attending physicians in everything.
According to the Constitution Russian Federation, the state is obliged to promote in every possible way the preservation of the health of its citizens. For this purpose, there is state medicine, social insurance, and regular medical examinations of the population are carried out. Correctly assess the condition of the human body and provide him with the optimal package medical services allow adult health groups and children. Official medicine identifies three main health groups for the elderly middle-aged people and citizens.
Health groups in adults. Group No. 1
The first health group includes people who do not have any chronic diseases. Their health is quite good; they rarely get colds. Arterial pressure normal or has slight deviations that are not significant for normal social life and fulfilling work and family responsibilities.
Usually people with the first group of health are actively involved in sports, try to lead healthy image life. Do not have bad habits, drugs or alcohol addiction. They are very attentive to the condition of their own body: they eat rationally, strictly observe all hygiene standards, and do not forget about exercise. When the first signs of the disease appear, immediately consult a doctor.
Standard monitoring is carried out among people belonging to the first health group, no more than once a year. This is quite enough to prevent the development of chronic diseases.
Health groups in adults. Group No. 2
The second group includes people who are fully able to work, but have some chronic diseases. Most often, these diseases occur without any exacerbations, sharp deterioration condition.
People with the second health group maintain a moderate level physical activity, do not always eat rationally. Dont Have drug addiction, but may have bad habits(for example, smoking). Monitoring of the body's condition is carried out among the second group more often, about twice a year. If necessary, treatment is prescribed.
Health groups in adults. Group No. 3
The most typical purpose of the third health groups for pensioners and people who have been disabled since childhood. The ability to work can be lost completely or partially; exacerbations of chronic diseases regularly occur, which significantly prevent a person from maintaining a normal level of social and physical activity.
Preventive examinations of people belonging to the third health group are carried out especially often, about 3–4 times a year. If necessary, hospitalization is prescribed. A person with a third health group has the right to treatment in dispensaries and sanatoriums.
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 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 general educational institutions, but 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 or physical therapy classes. Thus, for children of the first health group, educational, labor and sports activity 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. It is necessary to carry out special hardening activities with them, exercise therapy, and 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, membership in each of which determines the physical education regimen that best suits their health status. The correct distribution of children into medical groups for physical education is important part 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 groups physical culture.
To the main medical group include schoolchildren without deviations in health status, 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, and their transition to a chronic form.
To a special medical group include schoolchildren with deviations in health status of a permanent or temporary nature, requiring limited physical activity or certain contraindications in the used means of physical culture. 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 engage in a 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 deformation of the spine of I – II degrees.
For schoolchildren in preparatory and special medical groups, a limitation is provided on the amount of physical activity, 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 group physical therapy 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 program of physical education in full, the passing of certain standards is provided, classes are allowed in sports sections and participation in competitions. 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. The final grade, unlike for schoolchildren in the main group, is primarily determined by the physical education teacher in accordance with the standards established for this stage training based on individual criteria.
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. Transition from a special medical group to a preparatory group is possible subject to positive dynamics of treatment results and success in physical education.
Health groups.
Very often, when parents study their child’s chart, they find an entry in it - health group one (or second, third...). But not all parents know what kind of group this is and on what basis it is nominated. Although in fact, this is just a record for a doctor or teacher. Reporting on the characteristics of the baby’s health, allowing you to rationally draw up an action plan for his improvement or education.
What are health groups?
Health groups are a specific scale that takes into account the health and development of the child, it also includes all the risk factors that influenced or are influencing him, and a forecast for the future is made. The health group is set by a local pediatrician or medical worker preschool, this is based on 6 established criteria.
The first criterion evaluates heredity. At the same time, it is necessary to note whether there are diseases in the family that are passed on from generation to generation, and to determine the baby’s predisposition to them. After questioning the parents in detail, the doctor will make a conclusion and determine whether the child is at risk of getting sick or not. In addition, it is important to evaluate the course of pregnancy, the birth itself and, of course, the first month of the child’s life. Complications of pregnancy, childbirth and the baby’s first illnesses are very important for the correct determination of the health group.
The second criterion is, this includes height, weight, head circumference, chest circumference and other parameters. In addition, the child’s neuropsychic development is assessed - this is the third criterion. The child’s skills, speech development, and communication are assessed. To help the doctor, there are tables that reflect the baby’s skills by month and year, but deviations in one direction or another are not considered a pathology; in order to determine whether it is a pathology or not, it is necessary to evaluate the entire range of skills. Afterwards, the child’s behavior is assessed, taking into account the child’s communication with others, how he eats, his emotionality, and bad habits. Last but very important criterion are chronic diseases in the child or defects and developmental anomalies. Particular attention is paid to those vices that affect the life and existence of the baby. A health group is not a static indicator. It can change throughout the child’s life, but, alas, most often in the direction of worsening - from the first to the second, and more often from the second to the third.
Children's health status.
Having collected all the data and assessed, the doctor sets the health group to this moment time. The health of the children's population is characterized by both the presence or absence of diseases, and harmonious and age-appropriate physical and mental development, normal level all functions of the body, lack of tendency to diseases. Health assessment criteria have been developed:
The presence of any diseases at the time of examination (that is, they came to the appointment sick or healthy);
- level of functional state of all body systems (how correctly all organs and systems work);
- compliance of physical and mental development age (how the child grows and what he can do);
- the degree of resistance of the body to adverse effects (how often and for how long it gets sick).
Based on the results medical examination children are divided into five groups.
Group I- healthy children, physically and mentally developing normally, without functional deviations. Children in this group may rarely get sick during the observation period, but at the time of the examination they should be healthy, the body's resistance should be high. In fact, the first health group combines absolutely healthy babies, but children with this health group are very rare, literally a few. Over my years of practice, I have only exhibited this health group a couple of times.
Group II- healthy children, but with functional and some morphological abnormalities, with reduced resistance to diseases. Such children should not have chronic diseases, but can suffer acute diseases more than 4 times a year.
The second group has several subgroups, and the entire group includes healthy children, but with some nuances. Group “A” includes healthy babies, but either there is a family history, or the mother’s pregnancy and childbirth were complicated. Group “B” includes children who are often ill, with some functional abnormalities with possible risk development of chronic diseases.
The remaining groups include sick children with various diseases by its severity. Such children must undergo medical examination by specific specialists. Special health and treatment programs are being developed for them. So, the third group includes children with developmental defects in the compensation stage; if the defects are in the subcompensation stage, then such children already belong to the fourth health group, and the decompensation stage is the fifth health group.
III group- children with chronic diseases in a state of compensation (that is, in a state without exacerbation, not manifesting themselves in any way). This group unites children with congenital pathology or chronic diseases, in which there may be rare and mild exacerbations of the underlying disease. The body's resistance in such children is somewhat reduced. Diseases for which group 3 is assigned include: chronic gastritis or duodenitis, HDVP, Chronical bronchitis, pyelonephritis, anemia, obesity, stuttering, flat feet and adenoids.
IV group- children with chronic diseases in a state of subcompensation. This group includes children with congenital pathology or chronic diseases in which, after an exacerbation of the underlying disease, the general state and well-being. The body's resistance in children is sharply reduced. This is epilepsy hypertonic disease, thyrotoxicosis, progressive scoliosis.
Group V- children with chronic diseases in a state of decompensation. These are children with severe disabilities who cannot walk, cancer patients and others severe conditions. Children in this group have severe developmental defects or chronic diseases with significantly reduced functional capabilities. Such children usually do not attend general child and adolescent institutions and often have disabilities.
Depending on the diagnosis itself, children with the third and fourth health groups may be recommended to reduce their loads or even home schooling.
How can you tell if the group is the right one?
When determining a health group, it is necessary to take into account all criteria characterizing health of this child. Comprehensive assessment health status is carried out at the time of the medical examination. Functional status body systems are revealed clinical methods, by using functional tests. The correspondence of the physical and mental development of the child’s body according to biological age is carried out. The body's resistance is judged by the number of acute diseases and exacerbations of chronic diseases. last year. When examining children and adolescents, we must not forget about functional deviations in health, which can occur at a certain age and are not a true pathology, but reflect age-related physiological changes occurring in the body.
So there is a pattern of occurrence of functional deviations in the health of children:
- V infancy abnormalities in the composition of the blood (anemia), allergic manifestations appear,
- V early age digestive disorders appear (especially if the child is not fed correctly);
- in to school age dysfunctions of the nervous, respiratory and urinary systems, musculoskeletal system and ENT organs appear;
- at school age, disorders of cardiovascular activity and functions of the visual organs appear.
The most frequently asked questions.
If a child belongs not to the first health group, but to the second, is this dangerous?
Not really, but this child requires attention from both the doctor and the parents, even more from the parents. The fact is that this health group indicates that the baby’s body is working at the limit of its strength. To maintain your health, or that it is affected by too much harmful factors, Negative influence which may not be detected immediately - for example, severe hypoxia during childbirth can make itself felt only at 2-3 years, when development has cooled down. The second group is a signal for observation and active activities with the child through hardening, massage, gymnastics - but this is not a sick child. Previously, there was an opinion that children with the second health group should be limited in physical activity in kindergarten and school as a kind of “blow away specks of dust,” but this is an unjustified recommendation. You just need to monitor the tolerance and gradualness of the loads, but not limit them.
The third health group is children with chronic pathology and this is forever?
No, the third health group, if there have been no exacerbations of the disease for a long time, and its terms have passed dispensary observation, are transferred to the second group, that is, the child is considered healthy, with the caveats that he was once sick. This happens with allergy sufferers, children under three years old - as they say, they “outgrow”, with children with pyelonephritis, children with anemia who have been cured and hemoglobin is at stable levels.
Children with the third health group do not go to physical education?
No, they go - but usually to preparatory or special group, it all depends on the disease. They are shown courses in physical therapy and gymnastics.
In medicine, there is such a thing as a children’s health group, which means health assessment from birth to almost adulthood.
Specialists using comprehensive surveys, tests and individual consultations assess health status and provide recommendations.
All this helps in the future more clearly and competently make diagnoses, help in creating individual treatment.
The chief physician who determines the health group is pediatrician, it is based on test results, observations of other specialists, and helps to create a program for improving performance.
Most often, health groups are necessary for a child to enter kindergarten or school without problems; sometimes it is necessary to change educational institutions so that the child receives information in a high-quality manner, and specialists regularly observe him and correct disadvantages in development.
Today we can safely say that parents often accept the verdict of specialists as discrimination because sometimes restrictions on physical activity are required or special diet according to which the child should eat.
Of course, this makes him stand out from the rest, which is why parents begin to worry. The system is currently structured in such a way that not all teachers and parents take into account doctors’ recommendations, because they do not consider it important, although timely correction helps to avoid problems in the future.
How is the health group determined?
Chronic diseases. This is determined different doctors, each of them specializes in its own area. Pathologies can significantly influence which health group a child will be given. It can also be different congenital diseases or acquired with age.
Quality of work internal organs . This is also a significant factor that affects the general condition of the body. In this case, all organs are examined to determine where help is needed and where everything is functioning at a sufficient level.
Sometimes to determine the quality of the heart, kidneys, lungs, etc. Computer diagnostics is sufficient, but sometimes several tests may be necessary.
Immunity. Children often get colds and viral diseases, and this directly depends on how strong their immunity is. In order to understand which health group a child belongs to, it is important to analyze how often he gets sick and what diseases.
Sometimes his immune system may simply be weakened, which is not critical, but with the right approach, the child’s condition can be significantly improved.
Mental development. Another important factor, which defines the health group. The baby must develop harmoniously and fully communicate with peers. It is also important how well he perceives information and communicates with the world.
There is an indicator of compliance with your age group, so if there are any deviations, you can safely talk about violations. First of all, the child’s behavior is assessed, and only then his level of development.
1 health group in a child - who is included in it?
The first group includes children of any age from birth to adulthood, who do not have any impairments. Their body develops in accordance with age group, organs function normally, and mental health fine.
They have no pathologies, they are absolutely normal according to all criteria. Unfortunately, today according to all-Russian indicators approximately 10% children from birth to adulthood belong to the first health group. All the rest have some kind of disease or developmental problems, so they cannot be called absolutely healthy.
If a child is in the first group, it does not mean that he does not pass regular inspection. Necessary get tested regularly and visit doctors in order to promptly identify any problems with organ functioning and prevent them.
There are standards, according to which children should constantly undergo preventive measures, this will help them stay healthy longer and not put their health at risk. The health group is determined more than once, so it cannot be said that the child will always belong to a certain one.
Regular examinations and tests help identify problems. It often happens that a child was initially in the first health group, and later some problems appeared, which led to changes in indicators.
The health status of Russian children today is in a critical situation Therefore, parents should regularly monitor the development of diseases or mental disorders in a timely manner.
