BOLIVARIAN REPUBLIC OF VENEZUELA

MINISTRY OF PEOPLE'S POWER FOR HIGHER EDUCATION

SAN SEBASTIÁN UNIVERSITY VILLAGE EDO-ARAGUA
CECIILIO ACOSTA UNIVERSITY COLLEGE
NATIONAL NURSING TRAINING PROGRAM

PARTICIPANTES:
Liudmeli Padrón
Tavera Astrid
Laura Utrera
Valera Yennifer

Prof. Lic Luis Aliaga

July, 2013
 INTRODUCTION
Despite advances in the diagnosis and treatment of diseases,
Prevention actions are the most active to achieve a healthy and dignified life.
In recent years, given the health situation of the population, which is
unsatisfactory, the health system has undergone important modifications aimed at
strengthening of Comprehensive Health Care, based on the need for
strengthen the primary level of care, which is located
near the population, which came to change the objective of health care in
that level, shifting the priority of attention to the promotion of health and to
disease prevention.
In the provision of first level healthcare services, the
actions aimed at prevention (which also include those of promotion)
of health) must occupy a prominent place, as they allow for an increase in
health levels of the population, to prevent them from getting sick, at a lower cost, in
comparison to the high costs generated by restorative healthcare.
The prevention of disease is one of the five basic functions of the
Public Health, which together constitute the stages of the Care process
of Health.
Theoretically, this can be prevented in any of its phases, depending on:
of what is known about its history. Thus, in the pre-pathogenic period, one can
prevent through general health promotion and specific protection against
the causal agent. This is what Leavell and Clark have called primary prevention. The
Secondary prevention refers to the action taken during the early phases of
pathogenic period, and it can be achieved through early diagnosis and a
appropriate treatment. Tertiary prevention includes the mechanisms aimed at
reduce the incapacity and correct the defects
 PRIMARY HEALTH CARE

Primary Care ofHealth(acronym:APoAPS), according to the given definition

in the Alma-Ata Declaration, approved by the International Conference on
Primary Health Care of Alma-Ata of1978called by theOrganization
World Health(OMS) is as follows:
It is essential healthcare based on methods and technologies
practical, scientifically founded and socially acceptable, put to
reach of all individuals and families in the community through their
full participation and at a cost that the community and the country can bear,
in each and every stage of its development with a spirit of
self-responsibility and self-determination. Primary care is part of
member of the national health system, of which it constitutes the function
central and the main core, as well as the global social and economic development
of the community.

This definition encompasses a series of actions ofpublic healththey are from

diagnosis, prevention, healing, and rehabilitation that must be carried out from a
primary and local level for the benefit of the community. In addition, being the basic level and
member of anythe health system.

Objectives of Primary Care

Primary care must offer services based on need and respond accordingly.
at its level to the majority of the problems. A versatile Primary Care and
resolutive, competent to respond to complex patients and to consider the
joint health, and that it cooperates with other social and health services, and extra-
sanitary facilities

Characteristics of Primary Care

The basic attributes of primary care are theaccessibilitythe

coordinationtheintegrityylongitudinality;are the ones that mark their quality and
efficiency.
 The accessibility of the efficient provision of sanitary services in relation to
organizational, economic, cultural, and emotional barriers.
The coordination is the sum of the actions and efforts of the services
primary care.
The integrals the ability to solve most health problems
of the population served (in primary care it is around 90%).
The longitudinalities are the monitoring of the different health problems of a
patient by the same healthcare professionals, doctor and nurse

Primary care includes

1. Healthcare on demand, scheduled, and urgent both in the consultation

as in the home of the sick.
2. The indication or prescription and the execution, where applicable, of procedures.
diagnósticos y terapéuticos.
3. Activities in the field of prevention, health promotion, care
family and community care.
4. Information and monitoring activities in health protection.
5. Basic rehabilitation.
6. The care and specific services related to women, childhood, the
adolescence, adults, the elderly, at-risk groups, and the sick
chronic.
Palliative care for terminally ill patients.
8. Attention to mental health, in coordination with care services
specialized.
9. Oral health care.

Organization of Primary Care

Structure (what exists): physical and human
2. Process (what is done or ordered to be done)
3. Resultado (lo que se consigue)
 LEVELS OF ATTENTION OF LEVELL AND CLARK

Prevention was also described in 1945 by Henry Sigerist as one of

the four functions of Medicine, along with the repair or treatment of damage and
rehabilitation: later on, the Americans referred to them as functions
of Public Health.
From the perspective of the involved subjects, Prevention encompasses
specific individuals and social groups, which by their characteristics are
susceptible to acquiring specific diseases. Implement the measures
Prevention, being precise, specific, and timely, generates lower costs and the
results are given in the short and medium term, different from what happens in the Promotion
as a process that requires creating favorable conditions for health and life,
therefore, their results are long-term.
When talking about prevention, it is necessary to revisit the natural history.
of the disease according to the scheme of Leavell and E. G. Clark.
According to Leavell and Clark (1965), preventive medicine is the science
and the art of preventing diseases, prolonging life, promoting health and
physical and mental efficiency, exercised with the aim of intercepting diseases in
any phase of its evolution at the three levels of preventive action that
they describe. (p.20)
The Levels of Prevention were proposed by Leavell and Clark in the
the 1960s. In each of them, specific actions are generated that
they contribute to the control of the disease and its sequelae at different stages of the
natural history of the disease. The earlier the measure is applied
preventive, will be more effective in its goal to stop the course of the disease, or
prevent it from developing in the individual; therefore, emphasis should be placed on the
primary prevention before the disease appears, in order to contribute to the
well-being of the population in general
The levels of prevention by Leavell and Clark suggest that they do not
should be considered in the strict sense of pure prevention. Every disease
it has its own way of evolving when left to its own course,
this is known as: Current History of the Disease. The intervention with
the interposition of barriers in its evolutionary cycle or disease progression is called
Prevention Levels.
In this sense, three (03) proposed categories are considered in prevention.
by: Leavel and Clark, (1965). Primary, Secondary and Tertiary.

Primary Prevention
In primary prevention takes place during the pre-pathogenic phase of the
natural history of the disease, that is, before the interaction of the agents or
risk factors with the host related to the production of the provoking stimulus
the disease.
 Primary prevention is the set of health activities that are carried out
both by the community and the governments as well as by the healthcare personnel before that
a certain disease appears. It includes:
1. Health promotion, which is the encouragement and defense of health.
population through actions that impact the individuals of a community,
such as anti-tobacco campaigns to prevent lung cancer and others
diseases associated with tobacco.
2. The protection of health such as environmental health and the
food hygiene. The activities of promoting and protecting health that
Incidents related to the environment are not carried out by the doctor or the nurse, but by others.

public health professionals, while vaccination is indeed carried out by the doctor
and nurse.
3. Chemoprophylaxis, which consists of the administration of drugs for
prevent diseases such as the administration of estrogens in women
menopausal women to prevent osteoporosis.
According to the WHO, one of the instruments for health promotion and
preventive action is health education, which addresses not only the transmission
of information, the promotion of motivation, personal skills and the
self-esteem, necessary to take measures to improve health. The
educación para la salud incluye no sólo la información relativa a las condiciones
underlying social, economic, and environmental factors that influence health, but
also that which refers to risk factors and behaviors, in addition to the use
of the health care system.

Objective:

Health promotion and disease prevention

ACTIONS:

A. EDUCATION: Procedure for transmitting all that is known about the

health at the individual and collective level. It has three steps: Information, Motivation (
To interest), proper education (To take action)
 ADVANTAGES:

It favors the changes

Better Individual and Group Results

Exchange of Opinions

OBSTACLES
Little interest from the people

Fear of Illness

Cultural prejudices

FIELD OF ACTION OF EDUCATION

Improve the standard of living (Influence the modification of the conditions
existing)

Medical Activities (Specific Prevention, advantages of procedures,

curative medicine, rehabilitation procedures

REQUIREMENTS

To be in accordance with age, sociocultural condition, type of ailment

It can be done in different places.

Interest on the part of the doctor

TYPE OF EDUCATION

Individual (Personal interview)

Collective (Planning, advertising, awareness, use of media)

audiovisuals

B. SPECIFIC PREVENTION: application of measures aimed at avoiding

especially one or a group of diseases. Examples: Immunization
Administration of vitamin A and D, Addition of iodine to salt, Application of fluoride.

a. DISEASE DETECTION

Intentional search for ailments before they occur.

corresponding symptoms. Generally, it is carried out in large groups.
 It is advisable to repeat periodically.

It is necessary to consider false positive or false negative results.

Use simple and inexpensive tests

They must be followed by a Diagnosis

It can be carried out by auxiliary staff.

Example: Serology for Syphilis (VDRL) Tuberculin Test (Mantoux)

Glucometer (peripheral blood sugar levels, cytological examination
(Papanicolaou), Blood pressure measurement.

Secondary prevention
In secondary prevention, stopping the progression of processes
pathological conditions through early diagnosis and timely treatment
It is also called early diagnosis, screening. A detection program
precoz is a systematic or universal epidemiological program, for
detectar en una población determinada y asintomático, una enfermedad grave en
initial or early stadium, with the aim of reducing the associated mortality rate
through an effective or curative treatment.
His actions directed at the patient to prevent the progression of diseases and
limitation of disability.
Actions.
Correct diagnosis, adequate treatment.
It is the responsibility of the doctor, based on the clinical examination, interpretation of

diagnostic aids, iatrogenesis should be avoided

Understand:
EARLY DIAGNOSIS AND IMMEDIATE TREATMENT: Its objectives
to prevent the spread to inhabitants if the disease is transmissible, to treat
to cure or stop the process of the disease to prevent complications or
sequelae, prevent disability.
 LIMITATION OF INCAPACITY: Its purpose is to prevent all
possible complication and sequel, maximizing the residual capacity and avoiding
death. Correct treatment.

Tertiary Prevention
In tertiary prevention, trying to limit the sequelae or rehabilitate the
people who have suffered from illness. That is to say, they are actions aimed at the sick,
to prevent the progression of diseases and limitation of disability.

Actions. Correct diagnosis, appropriate treatment.

It is the doctor's responsibility, based on the clinical examination, interpretation of
diagnostic aids, iatrogenesis should be avoided

Understand:

The recovery from the clinically manifest disease through its

diagnosis and treatment.
Physical, psycho-social, and labor rehabilitation seeking to reduce the degree of
the sequelae, the degree of disability, and the frequency of premature deaths.
Rehabilitation is a set of physical, mental, and social measures,
vocational and economic factors that tend to make a deficient individual, using
all its remaining capacity, may reestablish itself in society and provide for its
own subsistence.
Its goal is to develop the remaining capacities to the fullest, to prevent
possible secondary mental illness and reduce the socioeconomic effects of
invalidity.
Steps of rehabilitation:
Recovery: Regain what was previously held, with the aim of restoring to
maximum the physical and functional part diminished or lost temporarily or definitively,
treatment that the doctor will perform on the patient.
Reeducation: To re-teach the use through movements and maneuvers
lost or addicted. Treatment that the physiotherapist will carry out.
 Readaptation: It is the adjustment to what is different in relation to the adaptation that must be

to have the patient of their new condition, from a psychological point of view.
Relocation: Reintegration that the patient will have to undergo in their environment

familiar, social and work.

 CONCLUSIONS

According to the Leavell and Clark model, the natural history of all
diseases are divided into two periods: the prepathogenic, in which it occurs the
stimulation of the disease as a consequence of the reciprocal action between agent,
host and environment, and the pathogenic period, which begins with the reaction of the
host to the stimulus of the disease, which conditions a clinical horizon
characterized by an early pathogenesis, early discernible lesions,
advanced illness and convalescence or death.
For each of the stages, Leavell and Clark propose specific levels of
prevention of the disease, which is directly related to the moment
What is the morbid event about? In the pre-pathogenic period, it is proposed
carry out two types of primary prevention actions: health promotion and
specific protection. Secondary prevention includes diagnostic actions
early and timely treatment and actions aimed at limiting the
inability. Finally, tertiary prevention refers to rehabilitation actions
According to Leavell and Clark (1958), Primary Prevention refers to the set of
health activities carried out both by the community and by governments as
by healthcare personnel before a certain disease appears, and it comes
given through health promotion and specific protection. And Prevention
Secondary school aims to enable the early discovery of your problem.
of health and make it cease or modify the severity or scope of the disease.
Tertiary prevention is considered when the characteristics of a
certain illness lead to sequelae or disability. This level is based on the
physical or mental rehabilitation for which adequate facilities must be provided
for the rehabilitation of the disabled with the aim of recovering their qualities
remaining and reintegrating it into their usual activities
 BIBLIOGRAPHIC REFERENCES

Pender, NOLA J.. "Theory of Health Promotion. Neither Theories nor Models of
Nursing. 1994. p. 5/2.
FRANCO, Saúl. Human vital process - Health disease process: A new
Perspectives. EN: Memories of Ethics, University, and Health. Santafé de Bogotá:
1994 pgs. 67 - 68.
Preventive Medicine for the Doctor in his community. An Epidemiologic approach.
Leavell H.R., Clark E.G., 2nd Edition, Mac Graw-Hill, 1958.