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HEALTH AND SOCIAL PROBLEMS
OF SCHOOL-AGE CHILDREN AND QUALITY OF THE AWARENESS OF STUDENTS OF HEALTHY LIFESTYLE
Tarpomanova Tsvetelina Hristova, Filkova Silviya Ivanova, Medical College, Medical University of Varna, Bulgaria
E-mail: dr_tarpomanova@abv. bg
Abstract. Some of the main medico-social problems of school age are associated with poor diet and decreased physical ac-tivity, some food-related disorders and adoption of negative behavior models - smoking, abuse of psychoactive substances, etc.
School age is important to promote a healthy lifestyle and avoidance of risky behaviors. The school must provide a safe and healthy en-vironment, appropriate educational programs, facilities supporting physical activity, provision of adequate food and creating habits for healthy eating.
The purpose of this study was, based on the visual medico-social problems to identify and analyze the quality of awareness of a healthy lifestyle of the students of the high school course. The study included students from 8th to 11th class of four schools in the city of Varna. Direct individual poll was used. The results were processed through mathematical statistics methods and graphic analysis.
The survey shows that in general, the students were informed about the main factors contributing to a healthy regime and lifestyle. An average of 20-30% of them have inaccurate or incomplete information regarding the topics related to nutrition, physical activity, use of narcotic substances. About 80% share that no meetings have been ever conducted at school with the parents on these topics.
To be a quality and reliable, the information must be presented by medical professionals and other persons competent in the relevant fields.
Keywords: medico-social problems healthy lifestyle, quality of information, nutrition, physical activity, psychoactive substances.
Introduction
Human health as a state of complete physical, mental and social well-being is a result of the complex influence of ecological, social, economic, medical, psychological
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and emotional factors. Some factors support health, while others are harmful (e.g. contaminated living environment, noise, psychological tension, poor diet, decreased physical activity, alcohol and nicotine abuse) [4]. Quality health education from a very early age is necessary in order for people to acquire the ability to protect themselves from unfavorable factors, and to acknowledge and take optimal advantage of the so called sanogenic (healthy) factors.
Health education is a purposeful process of influence through which the students acquire health knowledge and develop health-related skills and habits. It reflects on the value system and promotes healthy behavior directed towards disease prevention, recuperation and care to increase the health status of the individual and society as a whole [7].
Healthy lifestyle contributes to high vitality of growing children and helps them to fully exploit their potential. According to the Project for National Health Strategy 2014 - 2020 the most important factors that influence citizen health are social and economic (50%), followed by lifestyle (20%). In the structure of the prerequisites for risk of mortality, behavioral factors such as smoking, alcohol abuse, unhealthy and unbalanced diet, and poor physical activity are most significant [8].
Some of the main health and social problems at school age are obesity resulting from poor diet and lack of exercise [11,12], eating disorders and acquisition of negative behavioral models involving smoking, use of psychoactive substances, etc.
School age is important for promoting healthy lifestyle and avoidance of risky behavior. Every school has to provide a safe and healthy environment, including good hygiene, violence prevention, suitable educational programs, exercise equipment, adequate food and means supporting the habits of healthy eating [6].
Diet is important for the growth and development of children. The creation of a healthy diet model early in life is a prerequisite for its maintenance at a later age to decrease future risks of cardiovascular diseases, hypertension, diabetes and some types of cancer. The diet needs to be balanced and appropriate [3, 5].
Eating disorders are pathologies whose most obvious symptom is a change in feeding behavior connected to a negative self-esteem as regards body and weight [1]. Such are anorexia and bulimia. Anorexia is characterized by underweight which is self -induced by starvation or excessive limitation of eating. It is typically observed in girls during or soon after puberty, but does not subside after this period. Bulimia is another serious disorder in eating behavior characterized by frequent consumption of large amounts of food. This eating disorder, similar to anorexia, is observed only in females, mostly within the range of 16 - 40 years of age. Bulimia may be caused by various factors, but the most frequent one is depression [13]. Both eating disorders can lead to serious conditions. It is important to inform students of the nature of these disorders, the reasons for their development and the consequences.
Exercise is another important factor contributing to the maintenance of normal
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body weight which improves physical and mental health [11, 12]. The recommended duration of moderate physical activity is 60 minutes per day, 5 times a week. Insufficient exercise in combination with a poor diet increases the risk of unfavorable consequences for one's health [14].
Other important factors influencing the human organism are smoking, alcohol consumption and use of narcotic substances. They all increase the risk of development of various conditions and lead to serious harm to different organs and systems [10].
It is extremely important to present health information in a reliable, comprehensible manner both in the family and at school [9]. This ensures that the concepts are understood correctly by the children and are integrated in their lifestyle.
The aim of the present study is to identify and analyze the quality of awareness of healthy lifestyle of secondary school student, based on the established health and social problems.
Material and methods
The study includes a total of 160 students from 8th to 11th grade from the city of Varna, distributed as follows:
- 20 students from 10th grade and 20 students from 11th grade at First Language School;
- 20 students from 10th grade and 20 students from 11th grade at Professional School of Economy "Dr. Ivan Bogorov"
- 20 students from 10th grade and 20 students from 11th grade at Professional School of Electrical Engineering;
- 40 students from 8th grade at National School of Humanitarian Sciences and Arts "Konstantin Preslavski"
The study was carried out during the period February 20 - March 31, 2015 using direct individual surveys. The awareness of students was evaluated with respect to the following main topics: physical exercise, diet, smoking, alcohol consumption, drugs, anorexia and bulimia.
The results were processed using mathematical and statistical methods and graphic analysis.
Results and discussion
About 77% of the interviewed students claim that no school-initiated meetings with parents have been carried out with respect to education and/or information on healthy lifestyle. We consider this a significant gap, because the organization of such joint meetings could achieve at least three main goals:
- to standardize and verify the information offered to children;
- to stimulate control on behalf of the family;
- to receive feedback on potential risky and unhealthy behavior of students.
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The meetings can be carried out periodically with the participation of different specialists.
Most of the surveyed students - 72% - think that the main cause of diseases lies in daily lifestyle. The remaining 28% consider external factors, genetic burden and level of medical care as underlying causes (fig.1).
6% 10% 1 ■ Genetic burden (heredity) Lifestyle ■ External factors
72% ■ Level of medical care
Fig. 1 Answers to the question: "Which reason do you consider most important
for the development of disease?"
Half of the surveyed students think that the lack of exercise is the main cause of obesity. Another 40% consider that the leading cause is consumption of pastry, sugar confectionary and fatty foods. The remaining 10% presume that the main reason for overweight lies in heredity.
About 80% of the students claim to know the norm for physical exercise for their age. When asked a supplementary question about what the norm is, they answered that between 30 and 60 minutes of exercise per day are required.
The answer to the question: "Do you exercise? If yes, how often?" is optimistic. Most students do exercise. 80% of the participants in the survey practice sports. The frequency is different. The share of students exercising 2 - 3 times a week is highest (41%). However one should not underestimate the fact that 20% of the students do not exercise at all (fig.2).
The activities of students during their leisure time are important for their socialization. The encouragement of exercise should be a priority to society. Physical activity, interaction with the environment, and mental and physiological development are important factors for the overall advancement of personality during this dynamic period of growth. Good student health is also important. It is defined by lack of disease and trauma in combination with adequate physical development, vitality, and mental and social well-being [2].
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20% 2-3 times a week
41% ■ Every day
| 12% H^
■ Once a week
27% ■ I do not exercise
Fig. 2 Do you exercise? If yes, how often?
The obtained data show that still a significant percentage of the students do not know what is the optimal, healthy physical activity for their age and do not exercise.
The questions on the importance and use of some psychoactive substances yielded the following distribution of the answers: 85% of the surveyed students are convinced that smoking and alcohol consumption are harmful for one's health. More than 75% think that marijuana smoking is unhealthy, leads to addiction and represents a transition to the use of "hard" drugs. The remaining 25% claim that it is absolutely harmless.
The answers to the question on the nature of anorexia and bulimia show that the students are not very familiar with these disorders. The topics are specific and it is advisable that information on them is presented by specialists - psychiatrists of psychologists (fig.3).
■ Result from a poor diet
17%
Result from psychological
37% problems
The conditions require
treatment
42%
■ The conditions subside after
puberty
Fig. 3 Definition of anorexia and bulimia
Regardless of the subjective estimate of the students that they are sufficiently informed, there are gaps in their knowledge regarding healthy lifestyle. This is a clear sign that the quality of the presented information should be improved. At educational institutions the persons presenting such information are mostly class teachers and less frequently school psychologists. The importance of the involvement of medical and
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other specialist in order to improve health knowledge among secondary school students is underestimated. No educational or interactive meetings with parents are carried out to verify the presented information on healthy child lifestyle and to help students assimilate it. All of these activities are easy to achieve and can be planned during the school year by the administration of the respective educational institution.
The scarcity of educational information on the role of the discussed risk factors for student health is alarming. Health specialists maintain remain mostly passive regarding the matter.
The share of other informational sources is low.
Conclusion
Any drop in the levels of health risk factors among students, i.e. poor diet, lack of exercise, smoking, alcohol consumption, etc., decreases the probability of development of chronic non-infectious diseases at an older age. Limitation of these risk factors can be achieved through activities aimed at promoting health and disease prophylaxis in the framework of programs with the participation of all public structures and organizations and, most importantly, children and their families.
The survey shows that in general the students have been informed of the major factors for a healthy lifestyle. However, in some respects this information is obviously insufficient:
- there is still a significant percentage of students who are not familiar with the optimal, healthy level of physical activity for their age and do not exercise.
- a quarter of the participants in the survey claim that smoking marijuana is absolutely harmless;
- around 15% of the students underestimate the consequences of smoking and excessive alcohol consumption;
- more than 60% are not informed that anorexia and bulimia are conditions that require treatment and do not subside spontaneously.
Schools do not organize meetings with parents.
The achievement and maintenance of a good health status is a continuous process influenced by the evolution of knowledge on healthy lifestyle and practices, personal efforts and medical care. The gaps in the knowledge, skills and habits of students necessitate optimization of the means to present information both to them and to their families. In order for the information to be reliable, it should be presented not only by school psychologists and class teachers, but also by involved medical specialists and external professionals competent in the relevant fields.
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