Levels of prevention 

Levels of prevention 

Definitions

"Activities designed to protect patients and other members of the public from actual or potential health threats and their harmful consequences."

                                                                                                                                                [According to Mosby's Medical Dictionary 8th edition 2009]

"Prevention is the action aimed at eradicating, eliminating or minimizing the impact of disease and disability (According to A Dictionary of Epidemiology)

Goals-

  • Promotion of health
  • Prevention of illness
  • Preserve health
  • Restoration of health

Levels of Prevention -

  • Primordial Prevention
  • Primary Prevention
  • Secondary Prevention
  • Tertiary Prevention

1. Primordial Prevention

Definition-

"It is the prevention of development of risk factors in population groups in which they have not yet appeared."

  •  Special Attention is Given in preventing Chronic Disease.

Intervention-

Individual and mass education.

Examples-

  • Adult health problem eg.- Obesity, hypertension
  • Lifestyle changes eg. - Smoking, Physical exercise
  • Food and nutrition 

2.  Primary Prevention -

Definition-

Primary Prevention can be defined as "action taken prior to the onset of disease, which removes the possibility that the disease will ever occur."

  •  In this Action are taken before the onset of Disease.
  • It signifies intervention in the pre- pathogenesis phase of a disease or health problem.

Approaches of Primary Prevention -

The WHO has recommended the following approaches for primary prevention-

  • Population (Mass) Strategy
  • High risk strategy

1. Population (Mass) strategy- It is directed at the whole population irrespective of individual risk levels.

  • The population approach is directed towards socio-economic, behavioral and lifestyle changes.

2. High Risk Strategy - It is aim to bring preventive care to individuals at special risk. Examples-Immunization and taking regular exercise.

Intervention-

  • Health promotion
  • Specific protection

A. Health promotion

Definition-"A process of enabling people to increase control the determinants of health and thereby improve their health”.

  • “ Health Promotion is directed towards Strengthening the Host.”
  •  Process of enabling people to increase control over and to improve health

Intervention-There aim can be achieved  by following  intervention-

  • Environmental modification
  • Health Education
  • Life style change
  • Behavioral changes
  • Nutritional intervention

B.  Specific Protection

Definition-Efforts directed toward protection against specific diseases."

  •  “ The provision of Conditions for normal Mental & Physical Functioning of the Human beings & in Group.it includes the Promotion of Health , Prevention of Sickness , & Care of Individuals .”

Intervention-

  • Immunization (BCG, DPT, MMR Vaccines) and seroprophylaxis
  • Chemoprophylaxis(tetracycline for Cholera, dapsone for Leprosy, Chloroquine for malaria,etc.,) 
  • Protection against accidents
  • Use of specific nutrients or supplementations (vitamin A for Children, iron folic acid tablets for Pregnant mothers)
  • Safety of drugs and foods
  • Protection against occupational hazards e.g. - Use of helmet, Seat belt etc.
  • Control of environmental hazards e.g. - Air pollution
  •  Avoidance of allergens.

3. Secondary Prevention-

Definition- "The action which halts the progress of a disease at its incipient stage and prevents complications."

Intervention-

  • Early diagnosis(e.g. screening tests, breast self examination, pap smear test, radiographic examinations etc.)
  • Adequate treatment

Objectives-

  • To prevent the spreads of disease.
  • To prevent the complications.
  • Complete cure of disease.
  • To shorten the period of disability.

Examples- Include screening for high blood pressure and breast self examination.

4. Tertiary Prevention-

Definition-

"It is defined as "all the measures available to reduce or limit impairments and disabilities, and to promote the patients adjustment to irremediable conditions"

  • It is used when the disease process has advanced beyond its early stages.

Modes of Intervention-

  • Disability limitation
  • Rehabilitation

a.  Disability limitation-

  • To prevent or halt the transition of disease process from Impairment & Handicap.
  • Impairment- any loss or abnormality of psychological, physiological or anatomic structure or function.
  • Disability- any restriction or lack of ability to perform an activity in the manner considered normal for a human being.
  • Handicap- disadvantage for a given individual, resulting from impairment or disability, that limits or prevents the fulfillment of a role that is normal for that individual.

b. Rehabilitation-

  • 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.”
  • Requires cooperation from different sections of society.
  • Rehabilitation Medical rehabilitation Vocational rehabilitation Social rehabilitation Psychological rehabilitation

Types of Rehabilitation

  • Medical Rehabilitation - Restoration of body function.
  • Vocational Rehabilitation - Restoration of the capacity to earn a livelihood.
  •  Social Rehabilitation - Restoration of family and social relationship.
  • Psychological Rehabilitation - Restoration of personal dignity and confidence.

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