Holistic approach to the evaluation of the health status of school children and adolescents

Istraživanje predstavlja studiju preseka na reprezentativnom uzorku od 672 deteta starosti od 7 do 19 godina u Vojvodini. Kao instrument istraživanja korišćeni su upitnici kojima su dobijeni podaci o demografskim i socijalno-ekonomskim karakteristikama, samoproceni zdravlja, zadovoljstvu životom, higijenskim navikama, navikama o ishrani, fizičkoj aktivnosti i slobodnom vremenu, mentalnom zdravlju, zastupljenosti rizika po zdravlje i korišćenju zdravstvene službe. Objektivni nalaz dobijen je merenjem telesne mase i visine, određivanjem indeksa telesne mase i merenjem krvnog pritiska. Osnovni ciljevi ovog rada bili su da se dobije ocena zdravstvenog stanja i utvrde vodeći zdravstveni rizici kao i razlike u odnosu na demografske i socijalne karakteristike, da se utvrde promene u zdravstvenom stanju školske dece i omladine u odnosu na retrospektivni deo istraživanja i da se testira validnost instrumenta. Rezultati su pokazali da 40,2% dece živi u domaćinstvima koja pripadaju grupi siromašnih, imaju jednog brata/sestru, 88% živi sa oba roditelja, a dve trećine ima svoju sobu. Redovne higijenske navike češće imaju devojčice, stariji uzast i deca iz bogatijih domaćinstava. Ishrana je neadekvatna kako sa aspekta redovnosti, tako i unosa pojedinih namirnica, nedovoljan je unos mleka i mlečnih proizvoda, voća i povrća i ribe, a prekomeran unos namirnica koje su izvor tzv. „praznih kalorija“, dok je 17% dece sa prekomernom telesnom masom i gojazno. Slobodno vreme karakterišu sedenterne aktivnosti i nedovoljna fizička aktivnost. Ponašanje u saobraćaju je rizično, većina ne koristi zaštitne mere. Povredu je imalo oko 15% dece, petina je bila izložena nekom obliku fizičkog ili psihičkog nasilja. Većina ocenjuje svoje zdravlje kao dobro, dve trećine svoju telesnu masu kao normalnu a tri četvrtine svoju fizičku aktivnost kao dobru. Higijenu i mogućnost rekreacije u školi petina ocenjuje kao lošu a svako deseto dete bezbesnost u školi kao lošu. Informacije o zdravlju najčešće dobijaju od roditelja. Zdravlje stavljaju na prvo mesto na lestvici životnih vrednosti i imaju visok nivo zadovoljstva životom. Većina ima dobru komunikaciju sa majkom a tri četvrtine sa ocem. Petina oseća napetost, stres i ima emocionalne probleme, lošije vrednosti na skali psihološkog distresa ima svaka šesta a na skali vitalnosti skoro svaka druga mlada osoba. Pušenje i konzumacija alkohola su visoko zastupljeni, a svaka deseta mlada osoba probala je neku od psihoaktivnih supstanci. Korišćenje zdravstvene zaštite je zadovoljavajuće osim u sferi reproduktivnog zdravlja adolescentinja, seksualno ponašanje karakteriše rano stupanje u seksualni odnos i nedovoljna zaštita. U odnosu na retrospektivni deo istraživanja značajne razlike dobijene su u higijenskim navikama, ishrani, fizičkoj aktivnosti i sedenternim aktivnostima, procentu gojaznih, oceni svog zdravlja, zadovoljstvu životom, mentalnom zdravlju, izloženosti duvanskom dimu, konzumaciji alkohola, poznavanju psihoaktivnih supstanci, seksualnom ponašanju, reproduktivnom zdravlju i korišćenju zdravstvene službe.The research represents a cross-sectional study of the representative sample of 672 schoolchildren 7-19 of age in Vojvodina. Instrument was specially constructed questionnaire providing data about demographic and socio-economic characteristics, self assessment of the health, life satisfaction, hygiene, nutrition, physical activity, leisure time, mental health, social support, presence of risk factors, and use of health care. Anthropometric measures included body mass, height, blood pressure measurement and calculating body mass index. The aim of the study was to assess health status of the children, identify health risks and determine demographic and socio-economic differences, as well as to determine differences in relation to the retrospective part of the study, and to determine validity of the instrument. Results showed that 40 percents of children live in households with low level of socio-economic status (SES), 88 percents live with both parents, have 1 sibling, and two thirds have their own room. Good hygiene practice is more likely present in girls, older age and children with better SES. Nutrition habits are inadequate regarding regularity and different food intake, there is low consumption of milk and dairy products, fruits, vegetables and fish, high intake of sweets, snacks and sweet beverages, and there is 17 percents of overweight and obese children. Leisure time is characterized with sedentary activities and lack of physical activity. Road traffic behavior is risky with inadequate safety measures. Injury had 15 percents of children, and the fifth was object of physical and psychological violence. Most of the children assessed their health as good and very good, two thirds their body mass as normal and three quarters their physical activity as good. School hygiene and recreational conditions were poorly rated by fifth of the children, and one in ten assessed school safety as bed. Health information are mostly provided by parents. Health is highly rated among life values and life satisfaction is high. Most of them easy communicate with their mothers and three quoters with their fathers. Every fifth child is having emotional problems, anxiety and stress, lower values on Psychological Distress Scale has every sixth child and on Vitality Scale every second child. Prevalence of smoking and alcohol consumption is high, one in ten adolescents experimented or consumed drugs. Health care use is satisfying except in the sphere of reproductive health of female adolescents. Sexual behavior is characterized with early onset of sexual intercourse and inadequate protection against pregnancy and STD. Differences regarding retrospective part of the study exist in hygiene practice, nutrition, physical activity, sedentary activities, prevalence of overweight and obesity, self assessment of health, life satisfaction, mental health, exposure to tobacco, alcohol consumption, knowledge about drugs, sexual behavior and health care use