Development Of Physical Examination Standards For Elementary And Middle School Students

Objectives Based on evidence-based analysis and empirical research, our study aims to investigate the preventive physical examination status for students in different areas in China, and to investigate the student physical examination records in different countries and areas, so as to compare with Chinese student physical examination record and to provide evidence for government to establish standard of student's health examination. Our ultimate purpose was to develop classified physical examination standards for elementary and middle school students in China, this will suitable for developed, general and undeveloped provinces, respectively. Meanwhile, our study aims to develop operation requirements for evidence-based practice, so as to promote health for students.Methods Seventy-five professional staffs of health examination units were selected from 3 different economic levels in China, then who they asked about the items of physical examination, feedback of results, and fees of examination. Meanwhile, 50 foreign student physical examination records were searched by Google, then the contents of those foreign records were classified and analyzed. Furthermore, our study was based on a broad review of articles, reports, electronic resources and foreign students'physical examination forms. We conducted expert consultation and empirical research, and then we proposed the physical examination standards for elementary and middle school students in first step. Taking into account both economy and health resources in China, according to the classified principles, we try to develop standards for 3 economic levels. An empirical research was performed in Eastern, Central and Western China, which aimed to examine the relationship of BMI, WC, WHR with metabolic syndromes (MS). Secondary sexual characteristics as well as mental health level were assessed in students from primary and secondary schools. Impact of mental health on puberty timing were then analyzed. Finally, to regularize the physical examination among students, we should also develop the operational requirements.Results The health examination items of three economic levels in China were different from each other, the feedback of results were not definite, and professional staff from 53.5% of units for students'preventive health examination were not qualified. Foreign student physical examination records are mainly composed of the following 5 parts: student information, medical history, immunization record, physical exam and physician assessment. The physical exam including morphological, medical, surgical, ophthalmology and otorhinolaryngology, and accessory examinations. BMI is calculated in the physical examination forms, the accessory examinations including tuberculin test, blood lead and routine urinalysis. Some physical examination forms including secondary sex characteristic and genitals examination. Empirical research results showed, relationships of BMI, WC, WHR with metabolic syndromes were observed to be statistically significant. Students with WHtR≥0.5 and WC≥P90 were more susceptible to MS than those with WHR≥P90, while BMI was found to be a protective factor of MS. It was 17.7% girls had stage 2 breast development at the age of 8. Prevalence of depression was significantly higher in boys with pre-dated testis development compared with those with normal and delayed development at the age of 11y, prevalence of depression was significantly higher in boys with delayed development compared with those normal and pr-dated development at the age of 17y (P<0.01 for all). And the prevalence was significantly higher in boys with delayed genitalia development compared with those with normal and pre-dated development at the age of 13y (P<0.01). Classified physical examination standards were developed for elementary and middle school students in China, that is Standards I for developed provinces, Standards II for general provinces and Standard III for undeveloped provinces. The items for three kind standards including ask and check, morphological and physiological function, medical, surgical, ophthalmology and otorhinolaryngology, and accessory examinations. We also developed physical examination technical regulation for elementary and middle school students, which was suitable for elementary and middle school students, vocational high school students, technical school students in 3 economic levels in China, universities and colleges of general education can also refer to this technical regulation.Conclusions Student physical examination record in China has a lot differences according areas, and foreign records have significant referential value for us. Classified physical examination standards for elementary and middle school students enable areas of 3 economic levels conduct physical examination adjust measures to local conditions, whearas, empirical research is needed. Physical examination technical regulation presents operation requirements for physical examination, which make sure the evidence-based practice and may evaluate students'health status, screen health promblems and promote health for students.