Medical-Social Characteristics of Student Adolescents, New Approaches to Improving the Organization of Medical Care

The dissertation research by Vaganova Lyudmila Ivanovna is devoted to a comprehensive medico-social study of the health status of student adolescents studying in higher educational institutions. The research analyzes the lifestyle, social-hygienic characteristics, and psychological status of this category of student youth, as well as the dynamics of morbidity based on healthcare utilization data and preventive examinations. The interrelationships between social-hygienic factors, lifestyle, and the morbidity of student adolescents are investigated, and forecasts of medico-demographic indicators are developed.

On the basis of the conducted analysis, scientifically grounded recommendations were formulated for improving the organization of preventive examinations, sanitary-hygienic education, and upbringing of students of adolescent age. New technologies in the organization of medical care were proposed in the work, including applied software for preventive service provision, as well as programs for health strengthening and the prevention of negative phenomena in the student adolescent environment.

The contemporary period of healthcare development is characterized by complexity and contradictions. There is a breakdown of longstanding, decade-old concepts regarding the activities of healthcare, its principles, and the pathways for ensuring the population's health needs. The aim of the ongoing healthcare reform is to enhance its medical, social, and economic efficiency (Lisitsyn Yu.P. et al., 1999; Shchepin O.P. et al., 1999; Shevchenko Yu.L., 2000, et al.). The specific situation that has arisen in the country with regard to medico-demographic processes and the health status of adolescents, social stratification of society, the decline in quality of life, and numerous unresolved medical-social problems of the younger generation pose new tasks for healthcare authorities and institutions.

The protection of adolescent health has traditionally been regarded as one of the most important social tasks of society. Student adolescent youth will, in the near future, address the pressing problems of humanity and determine the development strategy of the state. The successful training of highly qualified cadres is closely linked to the strengthening and protection of health, as well as the enhancement of the work capacity of this social group (Grinina O.V., Kicha D.I., 1995; Agadzhanyan A.A., 1999; Rosenfel'd L.G., Kruglyakova I.P., 2000, et al.).

Student adolescent youth is sensitive to the impact of adverse environmental factors. The first years of study at universities coincide for them with the period of age-related and physiological restructuring of the organism, the transition from the status of a child to the status of an adult with all corresponding rights and obligations. Adolescents find it difficult to adapt to new living conditions: a new collective, living away from relatives, changes in the rhythm of life, the nature and regimen of nutrition, and new for them methods of teaching and academic assessment. All of this negatively affects their health. Moreover, the economic downturn in production in Russia and the financial crisis of 1998 led to difficulties in providing quality medical care to adolescents.

The problem of preserving and strengthening the health of student adolescent youth is a complex issue linked to the socio-economic development of society, the implementation in practice of measures aimed at improving conditions of study, daily life, nutrition, and rest, together with the improvement and assurance of the accessibility of medical services.

The deterioration of student health, including that of adolescents, and the spread of negative trends in their lifestyle have been noted by many authors engaged in the study of the health of the student contingent (Agadzhanyan A.A. et al., 1995; Rusanova E.I., 1998; Kruglyakova I.P., 2000, et al.).

Scientists and practitioners of healthcare have accumulated a certain experience in addressing questions related to the strengthening of health in this group of student youth. However, the problem of the health status of student adolescents is complex and multifaceted. Under contemporary conditions, in connection with the changed economic situation, it requires a new approach to its resolution, setting before domestic healthcare the task of guaranteed provision of quality medical care to student adolescent youth, the search for new forms of its organization, including the development of effective methods of mass preventive examinations, hygienic education, and upbringing.

The introduction of new technologies in the organization of medical care for student adolescents will make it possible to raise an active, capable, and healthy generation.

THE AIM OF THE RESEARCH is to study, on the basis of a comprehensive medico-social investigation, the health status in dynamics, to compile a morbidity forecast, and to develop scientifically grounded recommendations for improving the organization of medical care, hygienic education, and upbringing of students of adolescent age.

In accordance with the stated aim, the following tasks were determined:

1. To analyze the state of the problem based on the data of domestic and foreign authors, and to develop a plan and program of the research.

2. To study the lifestyle, social-hygienic characteristics, and psychological status of students of adolescent age.

3. To analyze the health status of university adolescents on the basis of morbidity indicators by healthcare utilization, data from preventive examinations, subjective assessment, and to carry out morbidity forecasting.

4. To determine the interrelationships between social-hygienic factors, lifestyle, and the health of adolescents.

5. To study the organization of sanitary-hygienic education and upbringing of student adolescents.

6. To develop scientifically grounded recommendations for improving the organization of preventive examinations, sanitary-hygienic education, and upbringing.

THE SCIENTIFIC NOVELTY of the research consists in the fact that, for the first time, a comprehensive medico-social investigation of students of adolescent age studying in higher educational institutions of a million-city was conducted; an analysis of morbidity, social-hygienic characteristics, and lifestyle was carried out; a morbidity forecast for adolescents was compiled; and new forms of the organization of preventive examinations, sanitary-hygienic education, and upbringing were developed.

THE SCIENTIFIC-PRACTICAL SIGNIFICANCE of the work is determined by the fact that the medico-social and psychological characteristics of students of adolescent age, the identified features of their lifestyle and risk factors, made it possible to develop a system of measures aimed at the restoration, maintenance, and preservation of their health.

The theoretically substantiated and, with the direct participation of the author, introduced system of the organization of preventive examinations, sanitary-hygienic education, and upbringing of adolescents represents an original contemporary organizational technology that makes it possible to expand and improve the quality of medical, medico-social, and preventive care for students, and to make efficient use of medical personnel.

On the basis of the obtained material, an informational and methodological letter, approved by the Chief Administration of Healthcare of the region, was prepared on the organization of medical care, sanitary-hygienic education, and upbringing of student adolescents.

IMPLEMENTATION IN PRACTICE. The materials of the research were used in the development of the regulation on the conduct of preventive examinations, sanitary-hygienic education, and upbringing of students.

A program for the strengthening of health and the enhancement of the work capacity of student adolescents living in dormitories, aimed at preventing the spread of drug addiction in the student adolescent environment, was developed. Recommendations on the organization of sanitary-hygienic education and upbringing of student adolescent youth were implemented in universities in the city of Chelyabinsk.

Applied software enabling the organization of preventive medical care for this contingent at a higher and more economical level was created and recommended for implementation in all medical institutions of the city of Chelyabinsk and the region.

The obtained data are used in the educational process at the departments of public health and healthcare of the Chelyabinsk State Medical Academy, social physiology of the Chelyabinsk State University, fundamentals of medical knowledge of the South Ural State University, and the Institute of Health and Human Ecology of the Chelyabinsk State Pedagogical University.

THE MAIN PROVISIONS TO BE DEFENDED: the features of the health status of students of adolescent age in dynamics; the lifestyle, social-hygienic characteristics, and psychological status of student adolescents, the main risk factors and their interrelationship with morbidity; new technologies in the organization of preventive examinations, hygienic education, and upbringing of student youth.

PUBLIC PRESENTATION OF THE RESEARCH. Based on the results of the research, 20 scientific works were published, including 1 at the international level, 7 at the all-Russian level, and 12 at the regional level. The main provisions of the research were reported at the First All-Russian Scientific Conference "Lifestyle and Student Health" (Moscow, 1995), the Sixth Scientific-Practical Conference "Development of the System for Ensuring the Quality of Medical Care in Contemporary Conditions and Problems of Optimizing the Structure of Healthcare" (Moscow, 2001), the Third International Scientific-Practical Conference "Health and Education in the XXI Century" (Moscow, 2002), and the International Scientific-Practical Conference "Health Technologies of the XXI Century" (Chelyabinsk, 2002). In addition, the results of this research were reported at regional and oblast meetings.

The materials of the dissertation research were reported at a joint session of the relevant problem commission, the staff of the department of public health and healthcare, and representatives of practical healthcare.

VOLUME AND STRUCTURE OF THE WORK. The dissertation research is presented across 140 pages of typed text and consists of an introduction, five chapters, a conclusion, conclusions and proposals, a list of references, and appendices and documents confirming the implementation or practical use of the scientific results. The structure of the research is determined by the set tasks; the work is illustrated by 25 tables, 26 figures, and 5 schemes, and the reference list contains 257 sources, including 38 foreign ones.