Disease prevention is aimed at avoiding problems or minimizing problems once they occur.
Primary prevention is the total prevention of a condition.
Secondary prevention is the early recognition of a condition and the measures taken to speed recovery.
Tertiary prevention is the care given to minimize the effects of the condition and prevent long-term complications.
Preventive care should involve assessment for people at risk for specific disorders.
Evidence Base
Health promotion goes beyond prevention to help people manage their health and live longer and feel better.
Health promotion has become a priority since the U.S. Department of Health and Human Services (DHHS) initiated its Healthy People 2000 campaign in 1990.
For the Healthy People 2010 campaign, launched in 2000, 23% of the campaign’s stated objectives were reached or exceeded, whereas 48% of the stated objectives were approached. The two major goals of Healthy People 2010 were to enhance life expectancy while improving quality of life and to reduce health disparities due to gender, race and ethnicity, income and education, disabilities, and other factors.
Healthy People 2020 consists of four overreaching goals with 42 topic areas (see Box 3-1, page 22):
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
Achieve health equity and eliminate disparities.
Create social and physical environments that promote good health for all.
Promote quality of life, healthy development, and healthy behaviors across all life stages.
For more information, see www.healthypeople.gov.
The Millennium Development Goals (MDGs) were approved by the United Nations in 2000 to address the most pressing needs of the poor worldwide, including some health needs.
Goals to be achieved by 2015 focus on the following areas:
Eradicating extreme hunger and poverty.
Achieving universal primary education.
Promoting gender equality.
Reducing child mortality.
Improving maternal health.
Combating human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome, malaria, and other diseases.
Ensuring environmental sustainability.
Developing a global partnership for development.
Nurses are at the forefront of health care throughout the world and can make tremendous strides in reaching these goals by caring for families and communities and advocating for vulnerable populations.
Review progress of the MDGs at www.un.org/millenniumgoals.
Access to quality health services
Adolescent health
Arthritis, osteoporosis, and chronic back conditions
Blood disorders and blood safety
Cancer
Chronic kidney disease
Dementias, including Alzheimer’s disease
Diabetes
Disability and secondary conditions
Early and middle childhood
Educational and community-based programs
Environmental health
Family planning
Food safety
Genomics
Global health
Health communication
Health care-associated infections
Health-related quality of life and well-being
Hearing and other sensory or communication disorders
Heart disease and stroke
Human immunodeficiency virus
Immunization and infectious disease
Injury and violence prevention
Lesbian, gay, bisexual, and transgender health
Maternal, infant, and child health
Medical product safety
Mental health and mental disorders
Nutrition and weight control
Occupational safety and health
Older adults
Oral health
Physical activity and fitness
Preparedness
Public health infrastructure
Respiratory disorders
Sexually transmitted diseases
Sleep health
Social determinants of health
Substance abuse
Tobacco use
Vision
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.
Health 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. Specific preventive services are evidence-based and recommended by the United States Preventive Services Task Force (www.ahrq.gov/clinic/prevenix. htm), the Canadian Task Force on Preventive Health Care (www.canadiantaskforce.ca/index.html), the National Institute for Health and Clinical Excellence (www.nice.org.uk) in the United Kingdom, as well as other agencies (see Table 3-1).
For infancy, teach parents about the importance of prenatal care, basic care of infants, breastfeeding, nutrition, and infant safety (see Chapter 42).
For childhood, stress the importance of immunizations; proper nutrition to enhance growth and development; and safety practices, such as use of car seats and seat belts, fire prevention, and poison-proofing the home (see Chapter 42).
For 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—heart disease, stroke, cancer, and chronic lung disease.
For older adults, stress 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 (see Chapter 9).
the patient. Nurses should understand the concepts and processes related to behavior change in order to help direct interventions for successful outcomes in individual patients or groups.
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