The role of a nurse in the prevention of postural defects in children

● JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE ● No.2/2016 ●
● JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE ● No. 2/2016 (15-18)
●
The role of a nurse in the prevention
of postural defects in children
(Rola pielęgniarki w profilaktyce wad postawy u dzieci)
M Wojciechowska 1,B,D, H Makowska 2,A,D, I Łopacińska3,C,E,F
Abstract – Introduction. Relatively frequent postural defects are a
considerable problem of contemporary children and youth. Parents and nurses in the education and upbringing setting can play a
significant role in the early diagnosis of these defects.
The aim of the study. The aim of the study was to establish to
what degree parents are prepared to educate their children in the
field of postural defects prevention.
Materials and Methods. A study by means of a diagnostic survey
with the use of the survey technique involved 100 parents (81
women and 19 men) of children aged 6 attending zero-grade classes at Primary School in Rawa Mazowiecka.
Results and conclusions. By partaking in screening tests which
diagnose developmental disorders of motor system as well as by
carrying out regular checks of the pupils' health status, nurses in
the education and upbringing settings have the opportunity to
reduce the prevalence of postural defects in children and youth.
Parents declare that they undertake preventive actions but a vast
majority of the surveyed persons have insufficient knowledge
about the causes of the defects.
wana większość ankietowanych ma niewystarczającą wiedzę na
temat przyczyn powstawania wad.
Słowa kluczowe - wady postawy, profilaktyka, edukacja.
Author Affiliations:
1. Józef Piłsudski University of Physical Education in Warsaw
2. Collegium Masoviense – College of Health Sciences
3. University of Humanities and Economics in Łódź
Authors’ contributions to the article:
A. The idea and the planning of the study
B. Gathering and listing data
C. The data analysis and interpretation
D. Writing the article
E. Critical review of the article
F. Final approval of the article
Key words - postural defects, prevention, education.
Streszczenie – Wstęp. Dużym współczesnym problemem dzieci i
młodzieży są stosunkowo często występujące wady podstawy. We
wczesnym ich wykryciu szczególną rolę mogą odgrywać rodzice
dzieci oraz pielęgniarka środowiska nauczania i wychowania.
Cel pracy. Celem badań było określenie stopnia przygotowania
rodziców do roli edukatora dzieci w zakresie profilaktyki wad
postawy.
Materiał i metody. Badaniem metodą sondażu diagnostycznego z
zastosowaniem techniki ankiety objęto 100 ( 81 kobiet i 19 mężczyzn) rodziców dzieci w wieku 6 lat z klas zerowych ze Szkoły
Podstawowej w Rawie Mazowieckiej.
Wyniki i wnioski . Pielęgniarki środowiska nauczania i wychowania uczestnicząc w badaniach przesiewowych diagnozujących
zaburzenia rozwojowe aparatu ruchu oraz regularnie prowadząc
kontrolę stan zdrowia ucznia mają możliwość zmniejszenia częstości występowania wad postawy u dzieci i młodzieży. Rodzice
deklarują podejmowanie działań profilaktycznych ale zdecydo-
Correspondence to:
Małgorzata Wojciechowska MD PhD, Gorkiego 26/65 Str., PL92-524 Łódź, Poland, e-mail: [email protected]
Accepted for publication: March 18, 2016.
I.
INTRODUCTION
ostural defects are at the top of the list of civilisation
diseases. They pose a medical, social and economic
problem. The defects can be congenital or acquired.
They occur most frequently at the school age and include
spine, feet and chest defects [1,2].
P
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● JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE ● No.2/2016 ●
Downplaying even the smallest disorders of the osteoarticular system in children can result in numerous diseases
and systemic dysfunctions [2-5].
It is stressed that the prevention of postural defects
should be commenced at as an early age as possible. Parents and guardians should ensure conditions optimal for the
development of correct body shape and posture from the
very first days of the child's life [2].
Screening tests carried out by nurses in the education and
upbringing setting as well as inspections at routine health
checks are of great significance and allow one to diagnose
postural defects. The most dangerous postural defects occur
during the so-called growth spurts when the development
of muscular system anticipates the growth of the skeletal
one. At the age of puberty, the child's body develops rapidly, which requires optimum adjustment of physical activity
to harmonious development of the muscles that are responsible for correct posture [1,6,7].
Postural defects prevention is a component of health
promotion. At the preschool age, it is carried out in the
form of general development games and activities, and at
school – in the form of physical education classes adjusted
to the developmental age [1,5,8]. The prevention of postural defects should involve the parents' care for harmonious
development of their child. Physical activity, appropriate
diet, participation in physical education classes as well as
aqua-gymnastics have a stimulating and strengthening effect on the development of the osteoarticular system
[5,9,10]. A school nurse is one of the actors undertaking
preventive measures in the education and upbringing setting. Her scope of activity includes carrying out screening
tests of physical development, with particular attention to
the locomotor, visual and aural system, and qualifying children with positive screening test results for corrective classes. The nurse, in cooperation with other figures in the field
of postural defect prevention (physical education teachers),
carries out health education of pupils and parents [1].
The aim of the study was to establish to what degree parents are prepared to educate their children in the field of
postural defects prevention.
II.
MATERIALS AND METHODS
The study was carried out in February 2014 among parents of zero-grade pupils at Primary School No. 1 in Rawa
Mazowiecka. The participation was voluntary and the study
took place during a meeting with the class teacher, upon the
consent of the school administration. 100 parents of chil-
dren aged 6 took part in the study – 81% women and 19%
men.
In order to achieve the aims of the study, the diagnostic
survey method was used with the survey technique and the
research tool comprised a survey questionnaire developed
by the authors.
III. RESULTS
The analysis of the study enabled to formulate the following results.
70% of the surveyed parents said that their child's postural defect had been diagnosed by a school nurse during
screening tests, 27% indicated a general practitioner (paediatrician) and 3% – a therapist.
67% of the surveyed parents knew which developmental
periods are most susceptible to the occurrence of postural
defects and had knowledge about particular threats related
to the child's development.
Almost all of the surveyed persons (99%) believed that it
is necessary to correct postural defect from an early age,
while only 1% found it unnecessary.
The Internet is the source of knowledge about the prevention of postural defects for 30% of the respondents.
21% of the respondents rely on their own experience or the
experience of friends and relatives, and only 20% of the
surveyed persons obtain information on postural defects
prevention from a nurse or a doctor.
What poses a problem is the lack of contact of the surveyed parents with a physical education teacher, since only
4% of the respondents undertake such consultations.
19% of the respondents seek advice at a paediatrician if
their children suffer from osteoarticular conditions. Only
2% consult a physiotherapist or an orthopaedist, whereas
4% of the surveyed persons obtain knowledge they find
necessary from medical publications.
97% of the parents attend screening tests and routine
health checks on time, while 3% of the respondents do not
observe the appointed dates.
97% of the parents remind their children about the necessity to maintain correct posture during doing their
homework, keep appropriate distance from the screen/text
when working on computer/reading and to check their eyesight regularly; 3% of the parents, however, do not pay
special attention to these recommendations. 91% of the
parents ensure that their child has appropriate workplace
for doing homework.
According to 97% of the parents, their children spend
free time outdoors in an active way.
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94% of the surveyed persons pay considerable attention
to appropriate eating habits of their children, ensuring that
their diet is balanced, rich in calcium, vitamins and minerals, they mind their children's body weight and educate
them in terms of healthy diet.
87% of the respondents make sure that their children
sleep for enough time on a surface of appropriate hardness;
however, 13% of the parents do not control passive rest of
their children.
IV. DISCUSSION
Screening tests of children at school age are carried out
by a school school in accordance with guidelines and they
are the easiest and cheapest manual method for the diagnosis of developmental defects in children. A nurse in the
education and upbringing setting performs and interprets
screening tests (including posture check and eyesight
check), thus identifying the defects. The age of 6-7 and 1113 are periods in which one should pay particular attention
to children's posture [1,2,7]. In order to strengthen muscles,
improve blood pressure and the efficiency of the respiratory system, one should remember to administer exercises
during classes as well as to ensure the influx of fresh air,
which provides rest for one's mind and spine. Other task
aimed at counteracting postural defects is to adjust the writing desk and the chair to the child's height. Unfortunately,
not all of the surveyed parents are aware of these seemingly
obvious recommendations.
The author's own research indicates that only 67% of the
surveyed parents are aware of the threats resulting from not
observing correct posture and know the dangers posed by
loading the spine with heavy rucksacks as well as the consequences of sitting at school desk for a few hours. However, almost all of the respondents (99%) notice the need to
correct postural defects from an early age, naming kindergarten and school as the institutions which should develop
in children the need and skills to take care of their osteoarticular system, particularly during physical education classes, exercises during lessons as well as compensatory and
corrective activities [1,2].
It is stressed that aqua-gymnastics is one of the most effective forms of therapy for the correction of a postural
defect at all stages of its development. Swimming reduces
load on joints and strengthens muscular and skeletal system
and relieves spine load. To compensate a motor dysfunction other forms of therapy are also required, such as corrective and compensatory gymnastics, daily exercises under
parental supervision and other compensatory exercises.
Any form of therapy is effective, provided that it is patientspecific [9,10].
Preventive activities administered by parents to their
children are of various character. Nevertheless, the authors
believe that their selection can give rise to many doubts, as
the surveyed persons most frequently obtain necessary information from the Internet and only a small share of these
activities is based on information obtained from a nurse.
When a postural defect is diagnosed in a child, the nurse
cooperates closely with the parents on compensatory instruction addressing locomotor system disorders [7]. In
order to make the corrective process effective, parents
should have knowledge on the causes, effects and prevention of postural defects in children.
The authors' study indicates that the respondents exercise
control over the activity of their children, in particular the
outdoor activity after school. At the same time, the authors
would like to draw attention to an opinion that is somewhat
common nowadays that children usually spend too much
time on school classes and extracurricular activities and
therefore they do not have much time for active and passive
rest [1,2,10].
One of the priorities for correct development and health
of a child involves maintaining appropriate body statics.
For this reason, parents' knowledge on the causes of defects
and the effects of their development is indispensable. Every
parent wishes to bring up an entirely fit child who has no
restrictions concerning the choice of future occupation.
Although most of the studied parents undertake preventive
activities so as to avoid the occurrence of postural defects,
27% of their children have been diagnosed with one and
require professional, mainly physiotherapeutic help.
This situation indicates the need to intensify the activity
of nurses in the education and upbringing setting, mainly in
the field of the prevention of postural defects in children.
V. CONCLUSIONS
 By partaking in screening tests which diagnose developmental disorder of motor system as well as
by carrying out regular checks of the pupils'
health status, nurses in the education and upbringing settings have the opportunity to reduce
the prevalence of postural defects in children
and youth.
 Parents declare that they undertake preventive actions but a vast majority of the surveyed persons
have insufficient knowledge about the causes of
the defects.
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VI.
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