Concept about Prevention – This book covers the entire syllabus of “Community Health Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate latest information and topics.
This book is examination friendly setup according to the teachers’ lectures and examination’s questions. At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourished. The unique way of presentation may make your reading of the book a pleasurable experience.
Concept about Prevention
Concepts
Nurses’ contributions in community- oriented nursing focus on 4 main areas: health promotion, disease prevention and control, health maintenance, and health restoration. Health promotion includes all efforts that seek to move people closer to optimal well-being or higher level of wellness.
Disease prevention and control involves all the measures designed to prevent or reduce as much as the possible the incidence, prevalence and consequences of disease. Health maintenance is the combination of promotion and prevention and health restoration is to help prevent complication and to ensure optimal recovery.
Promotion of health is recognized as one of the most important components of public health and community health practice. Health promotion includes all efforts that seek to move people closer to optimal well-being or higher level of wellness. Nursing in particularly has a social mandate engaging in health promotion.
Prevention
Prevention means-
- To promote the health
- To preserve the health.
- To restore the health, when it is impaired.
- To minimize suffering and diseases.
So, prevention includes all steps that stop the progress of disease at any stage of its course.
Or
Prevention/Disease prevention, understood as specific, population-based and individual-based interventions for primary and secondary (early detection) prevention, aiming to minimize the burden of diseases and associated risk factors.
Different types of prevention/intervention at different level
Types of prevention:
- Primordial prevention
- Primary prevention
- Secondary prevention
- Tertiary prevention
1. Primordial prevention:
It is a new concept in the prevention of chronic disease where these micro-organisms have yet not be discovered. The main intervention in Primordial prevention in through individual & education.
Example:
- Hypertension.
- Diabetes mellitus.
- Ischemic heart disease
- Cancer.
- Atherosclerosis
If we can prevent the development of risk factor for the chronic diseases by taking measures in the early childhood, then the disease can be prevented later stage.
Example: In childhood we can give health education to parents regarding the habits and life style are properly
- developed
- Avoidance of smoking
- Eating habit
- Doing exercise
2. Primary prevention:
Primary prevention is the action taken prior to the onset of disease which removes the possibility of occurrence of disease. It signifies intervention in the pre-pathogenesis phase of a diseases or health problems (e.g., LBW)
There are two modes of intervention in the primary level of disease prevention.
a. Health promotion: The measures are-
- Health education.
- Good nutrition
- Good housing
- Personal hygiene
- Marriage and genetic counseling.
- Family planning
- Periodic health screening
- Health legislation
b. Specific protection:
- Immunization
- Food fortification
- Protection against accidents
- Chemoprophylaxis
- Protection from occupational hazards
- Protection from carcinogens
- Avoidance of allergens,
- The control of specific hazards in the general environment. air pollution, noise
3. Secondary prevention:
Secondary prevention is the action, which halts the progress of a disease at its early stage and prevents complications. The specific interventions are:
a. Early diagnosis by:
- Case finding measures individual and mass.
- Screening surveys.
- Surveillance techniques
- Periodic examination
- Selective examination of people at high risk
b. Adequate treatment:
4. Tertiary prevention:
All measures available to reduce or limit impairment and disabilities, minimize suffering caused by disease and to promote the patient’s adjustment to irremediable conditions.
There are two modes of intervention of tertiary level-
a. Disability limitation
b. Rehabilitation;
- Medical rehabilitation
- Vocational rehabilitation
- Social rehabilitation
- sychosocial rehabilitation
Nurse’s contribution in community-oriented nursing on disease prevention and control
The control activities may focus on primary prevention or secondary prevention, most control programs combine the two. The concept of tertiary prevention is comparatively less relevant to control efforts.
Disease control involves all the measures designed to prevent or reduce as much as the possible the incidence, prevalence and consequences of disease.
Broadly these are measures, pending results of epidemiologic investigation-
- The reservoir or source of infection.”
- The routes of transmission.
- The susceptible host (people at risk).
The activities of disease prevention and control are now included in primary health care. It requires – community participation, Political support and inter-sectoral coordination.
1. Controlling the reservoir:
The general measures of reservoir control comprise-
- Early diagnosis
- Notification
- Isolation
- Treatment
- Quarantine
- Surveillance &
- Disinfect ion.
All directed to reduce the quality of the agent available for dissemination.
2 Interruption of transmission:
A major aspect of communicable disease control relate to “breaking the chain of transmission” or interruption of transmission. It includes the clean practices such as-
- Hand washing
- Adequate cooking
- Prorate refrigeration of prepared foods and withdrawal contaminated food will present most food borne illness.
- Provide safe water will prevent water born disease.
1. Vector born control measures should be directed primary at the vector and its breeding places, vector control also includes destruction of stray dog control of cattle, pets and other animals to minimize spread of infection among them and promotion them to man.
2. Personal hygiene & proper handling of secretions & excretions. In short, environmental factor that is to bring about and adjusted equilibrium between host & environment through encouraging some ecological influences and inhibiting others. Also include the early diagnosis & treatment of patients
3. Susceptible host:
The third link in the chain of transmission is the susceptible host or people at risk. They may be protected by one more of the following strategies-
a. Active immunization-
There are some infectious diseases whose control is solely based on active immunization e.g., Polio, tetanus, diphtheria and measles.
b. Passive immunization –
- Normal human immunoglobulin.
- Specific human immunoglobulin,
- Anti-Sera or anti-toxin,
c. Combine passive &active immunization-
E.g., tetanus, diphtheria, rabies, passive immunization is often under or taken in conjunction with inactivated vaccine products to provide both immediate passive immunity and slowly developing active immunity,
d. Chemoprophylaxis –
- Causal prophylaxis.
- Clinical prophylaxis.
1. Health maintenances: Marjorie Gordon (1994), referred to health maintenance as the “umbrella”. The other function, she said, “can be viewed as specific areas of health management. The goal is to identify health strengths, health beliefs, health risks, and health deficits for which improvements are possible to maximize health status”.”
The basic components of health maintenance are: –
a. Health promotion and
b. Disease prevention.
a. Health promotion – Health promotion activities are approach behaviors that seek to expend the potential for health and are often associated with lifestyle choices.
b. Disease prevention – Disease prevention activities are avoidance behaviors that seek to prevent specific diseases or condition.
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