Community Health Advocacy
Three levels of prevention
The three levels of prevention, primary secondary and tertiary represent the different stages of disease, which they target. The primary prevention level is used to prevent the person from getting the disease. As argued by Ureda and Yates (2005), this is the true preventive strategy since it aims at preventing the occurrence of the disease. Primary prevention strategies reduce the incidence and prevalence of the disease by encouraging people to protect themselves from exposure to disease risk factors. A quintessential example given by Green (1971) is using sunscreen to protect from the ultraviolet rays of the sun as a prevention mechanism against skin cancer. Other forms of primary prevention include immunization, public health education through health promotion activities, chlorination of water, and legislative activities such as speed limits to prevent road accidents.
For a community health nurse, the first level of prevention, primary prevention, is of extreme importance since it includes getting involved with activities such as health promotion, immunizing the population against communicable diseases and providing health advise against risky activities such as smoking. Primary prevention as a community health nurse also involves improving host resistance through proper nutrition and promoting healthy behaviors and fostering safe and clean environments to reduce the disease risk.
The second level of prevention, secondary prevention is where the disease has already occurred by happens before the person notices there is anything wrong. As stated by Flaskerud (1992), secondary prevention is aimed at detecting diseases and responding to the treatment needs as soon as possible. For certain diseases whose progression is slow, it is effective at reducing the impact of the disease on individuals and communities. One approach to secondary prevention that is common is screening. This is essentially the use of different test to detect early signs of disease. Such as computerized tests that are noninvasive aiming at detecting early signs of heart disease. This test, which uses computerized tomography scans, looks for arterial calcium deposits that are early signs of heart disease. Other forms of secondary prevention include eye tests to check for glaucoma, pap smears for cervical cancer, mammography for breast cancer, and PSA (prostate-specific-antigen) test for prostate cancer.
In community health nursing, the second level of prevention is important because it involves being involved in activities such as screening procedures such as routine blood sugar tests for patients above 40 years of age, and other activities especially at nurse-patient level. Public health screening activities in programs are also essential in ensuring this level of prevention is ensured. A good example is organized screening programs targeted at the community.
The third level of prevention, tertiary prevention, involves bother rehabilitative and therapeutic measures once the person already has the symptoms and signs of the disease. Tertiary prevention has several goals, which include preventing damage and pain that may arise from the disease, slowing down the progression of the disease, preventing the disease from causing complications, giving optimum care to people with signs of the disease, and helping those with the disease to live healthy lives afterwards. A quintessential example of tertiary preventive activities includes treating diabetics to prevent complications that occur as a result of the disease such as liver and kidney failure. Other examples are management of patients with chronic heart disease with therapy and medication, physical and occupational therapy as rehabilitation for patients who suffered from accidents and stroke. Counseling of patients is also a form of tertiary prevention since it is aimed at offering high quality and appropriate psychological care.
The tertiary level of prevention in community health nursing involves modifying the risk factors of a disease to assist the patient lose weight, make modifications to their environment to make it clean and safe. This is done through health promotion activities, rehabilitation, and counseling of patients to prevent possible adverse outcomes of their disease. For a community health nurse, tertiary prevention is aimed at enhancing the quality of life of the patient (Baker, 1992). This can be done by conducting follow-up examples of the patient to identify potential risk factors and disease progression rates, implementing health service organization changes to improve access to better quality of care, referral of patient to specialist clinics and ensuring control of high-risk sites including tattoo parlors that may be sites for contracting diseases.
Baker, J.E.L. (1992). Primary, Secondary, and Tertiary Prevention in Reducing Pesticide-Related Illness in Farmers. Journal of Community Health Nursing, 9(4), 245-254. doi: 10.2307/3427201
Flaskerud, J.H. (1992). HIV Disease and Levels of Prevention. Journal of Community Health Nursing, 9(3), 137-150. doi: 10.2307/3427251
Green, M.M. (1971). The Expanded Role of the Public Health Nurse. Canadian Journal of Public Health / Revue Canadienne de Sante’e Publique, 62(2), 147-152. doi: 10.2307/41984635
Ureda, J., & Yates, S. (2005). A SYSTEMS VIEW of HEALTH PROMOTION. Journal of Health and Human Services Administration, 28(1), 5-38. doi: 10.2307/41288055
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