Prevention and Control of Disease
The goals of medicine are to promote health, to preserve health, to restore health when it is impaired, and to minimize suffering and distress. These goals are embodied in the word "prevention"
Prevention; Definition and ConceptActions aimed at eradicating, eliminating or minimizing the impact of disease and disability, or if none of these are feasible, retarding the progress of the disease and disability.The concept of prevention is best defined in the context of levels, traditionally called primary, secondary and tertiary prevention. A fourth level, called primordial prevention, was later added.
Determinants of PreventionSuccessful prevention depends upon: a knowledge of causation, dynamics of transmission, identification of risk factors and risk groups, availability of prophylactic or early detection and treatment measures, an organization for applying these measures to appropriate persons or groups, and continuous evaluation of and development of procedures applied
Preventable Causes of DiseaseBEINGS Biological factors and Behavioral FactorsEnvironmental factorsImmunologic factorsNutritional factorsGenetic factorsServices, Social factors, and Spiritual factors
[JF Jekel, Epidemiology, Biostatistics, and Preventive Medicine, 1996]
Leavells Levels of Prevention
Levels of preventionPrimordial preventionPrimary preventionSecondary preventionTertiary prevention
Primordial preventionPrimordial prevention consists of actions and measures that inhibit the emergence of risk factors in the form of environmental, economic, social, and behavioral conditions and cultural patterns of living etc.
Primary preventionPrimary prevention can be defined as the action taken prior to the onset of disease, which removes the possibility that the disease will ever occur.It signifies intervention in the pre-pathogenesis phase of a disease or health problem.Primary prevention may be accomplished by measures of Health promotion and specific protection
Primary prevention (cont.)It includes the concept of "positive health", a concept that encourages achievement and maintenance of "an acceptable level of health that will enable every individual to lead a socially and economically productive life". Primary prevention may be accomplished by measures designed to promote general health and well-being, and quality of life of people or by specific protective measures.
Health promotionHealth promotion is the process of enabling people to increase control over the determinants of health and thereby improve their health.
Secondary prevention Secondary prevention attempts to arrest the disease process, restore health by seeking out unrecognized disease and treating it before irreversible pathological changes take place, and reverse communicability of infectious diseases.
It thus protects others from in the community from acquiring the infection and thus provide at once secondary prevention for the infected ones and primary prevention for their potential contacts.
Early diagnosis and treatmentWHO Expert Committee in 1973 defined early detection of health disorders as the detection of disturbances of homoeostatic and compensatory mechanism while biochemical, morphological and functional changes are still reversible.
The earlier the disease is diagnosed, and treated the better it is for prognosis of the case and in the prevention of the occurrence of other secondary cases.
Tertiary preventionIt is used when the disease process has advanced beyond its early stages.
It is defined as all the measures available to reduce or limit impairments and disabilities, and to promote the patients adjustment to irreversible conditions.
Intervention of tertiary prevention are disability limitation, and rehabilitation.
ImpairmentImpairment is any loss or abnormality of psychological, physiological or anatomical structure or function.
DisabilityDisability is "aphysicalormentalimpairment whichhasaadverseeffectontheir abilitytoperformnormalday-to-dayactivities"
HandicapHandicap is termed as an any physical or mental defect, congenital or acquired, preventing or restricting a person from participating in normal life
Rehabilitation is the combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability.
ControlThe term disease control describes ongoing operations aimed at reducing:The incidence of diseaseThe duration of disease and its risk of transmission The effects of infection, including both the physical and psychosocial complicationsThe financial burden to the community.
Control activities focus on primary prevention or secondary prevention, but most programs combine both.
The term "elimination" is used to describe interruption of transmission of disease, as for example, elimination of measles, polio and diphtheria from large geographic regions or areas
Disease EradicationEradication literally means to "tear out by roots".
It is the process of Termination of all transmission of infection by extermination of the infectious agent through surveillance and control.
To-date, only one disease has been eradicated, that is smallpox.
MonitoringMonitoring is "the performance and analysis of routine measurements aimed at detecting changes in the environment or health status of population.
It also refers to on -going measurement of performance of a health service.
Surveillance surveillance means to watch over with great attention and often with suspicion According to another, surveillance is defined as "the continuous inspection of the factors that determine the occurrence and distribution of disease and other conditions of ill-health"
Nursing Role in Health Promotion
Nurses have played key roles in prevention in such areas as prenatal care, immunization programs, occupational health and safety, cardiac rehabilitation and education, and public health care and early intervention.
Nurses in all settings can meet health promotion needs of patients, whether their practice is in a hospital, clinic, patient's home, health maintenance organization, private office, or community setting.
Nursing Role in Health PromotionHealth promotion is primarily accomplished through patient education, an independent function of nursing.
Health promotion should occur through the life cycle, with topics focused on infancy, childhood, adolescence, adulthood, and older adults.
Nursing Role in Health PromotionFor infancy, teach parents about the importance of prenatal care, basic care of infants, breast-feeding, nutrition, and infant safety.
For childhood, tell the importance of immunizations; proper nutrition to enhance growth and development; and safety practices such as fire prevention, and poison proofing the home
Nursing Role in Health PromotionFor adolescence, focus on motor vehicle safety; avoidance of drug, alcohol, and tobacco use; sexual decision making and contraception; and prevention of suicide.
For adulthood, teach patients about nutrition, exercise, and stress management to help them feel better; also teach cancer-screening techniques, such as breast and testicular self-examination, and risk factor reduction for the leading causes of death from heart disease, stroke, cancer, and chronic lung disease.
Nursing Role in Health PromotionFor older adults, tell the topics of nutrition and exercise to help people live longer and stay fit, safety measures to help them compensate for decreasing mobility and sensory function, and ways to stay active and independent
Nursing Role in Preventive Health Through health education, nurses can implement a larger group of people to promote in healthy lifestyles and longer lives. Regular exercise: Nurses promote regular activity (30 minutes of exercise at least five days a week) to improve heart conditions, control high blood pressure and other diseases such as stroke, diabetes and arthritis.
Nursing Role in Preventive HealthWeight management: Exercise also encourages weight management. Maintaining and controlling weight with exercise and healthy eating habits to prevent diseases such as obesity, cardiovascular disease and osteoarthritis.
Avoidance of smoking and drug abuse: there is the risk of lung cancer, emphysema and other forms of cancer.
Nursing Role in Preventive HealthModerated alcohol use: Education about the effects of alcohol consumption, alcohol use lead to liver disease, stroke or high blood pressure, increase the chances of illness.
Control of existing diseases: Nurses involved with work to identify existing conditions in the early stages.