Preventive healthcare

Goal of disease prevention (Latin praevenire, anticipate ',' prevent ' ), usually ( in health ) is reduced even called prevention is the prevention of the occurrence of diseases and thereby reduce their spread and reduce their impact on morbidity and mortality of the population. The key strategy is to push back the trigger factors of diseases or eliminate.

Prevention is justified ethically - normative and economical. Individual suffering should be prevented as far as possible, improves the quality of life and life itself be extended. At the same time reduce the economic burden on then become unnecessary medical treatments prevention.

In particular, in dentistry and cancer medicine is the term prophylaxis (from Greek προφύλαξις prophylaxis, before something established guard outpost, protection ') used as a synonym for disease prevention. See the article prophylaxis ( dentistry) and cancer prevention.

• 3.1 Starting points of preventive measures

Demarcation

Delineate the concept of prevention is the concept of health promotion, which is considerably younger ( Ottawa Charter, WHO, 1986). While it comes to the reduction and prevention of risk factors in prevention, health promotion aims to increase especially the protective factors and the health conditions of life strengthen ( with the economic, cultural, social, educational and hygienic aspects ). The salutogenic model of Antonovsky assumes that there is a continuum whose poles health and disease, the so-called G / K continuum:

Position of the individual                              Health Promotion Prevention     Health < ------------------ X ----------------------------- ------------ X -------------- > Disease Prevention aims that does not shift the position of the individual on the continuum to the right towards disease. Fundamental question: What makes you sick? ( Pathogenesis ). Health promotion is aimed at the position of the individual to the left towards health verschieben.Grundsatzfrage: What keeps you healthy? ( Salutogenesis )

Prevention and health promotion are complementary and share the common goal of improving the health and maintain it.

Distinctions

Disease prevention usually begins before the onset of the disease and differs from the curation or therapy.

Gerald Caplan already differed in 1964 three types of prevention:

• Primary prevention
• Secondary prevention
• Tertiary prevention

These were supplemented in 1986 by Marc Jamoulle around the concept of quaternary prevention.

• Quartärprävention

Primary prevention

Primary prevention begins before the occurrence of the disease and aims to prevent recurrence of disease. Primary prevention is aimed at risk groups, Healthy and persons without disease symptoms. Examples of primary prevention of vaccination of school opportunities for nutrition, exercise, stress management, or prevention of addiction.

From the primary prevention nor the primordial prevention can be differentiated according to Caplan, who still occurs sooner. For her it comes already prevent the occurrence of risk factors.

Secondary prevention

Secondary prevention begins at the early stage of a disease. It is used for early detection of diseases and curb its progression ( progression ) or the chronicity of the disease. Often without a perceptible for those affected disease symptoms has already taken its beginning here of the pathogenetic process. The target group are persons who would participate as healthy or symptom -free at the prevention measure, be the diagnostic measure but to patients. Examples are the mass screening in breast cancer or colon cancer, as well as programs for young people who have had contact with drugs to prevent a dependency or addiction.

Tertiary prevention

Tertiary prevention takes place after an acute treatment or the manifestation of a disease. With it, consequential loss and relapses are to be prevented. It is aimed at patients with chronic impairments and rehabilitation. An example here is the prevention of renal failure in insulin dependent diabetes. The concept of tertiary prevention is broadly in line with the rehabilitation when this is applied to whole populations.

Quartärprävention

In addition to the primary, secondary or tertiary prevention, there is the Quaternary prevention that was preventing unnecessary medicine or prevention of Übermedikalisierung to the target and take into account the principle of " primum non nocere " as a cornerstone of all medicine.

Survey

In a summary table with the dimensions of "personal" (patient, client, seeking advice ) and " professionally " (doctor, therapist, counselor ), the four areas of prevention be represented as follows:

Strategies

When disease prevention, there are both universal strategies that attempt to comprehensively minimize risks ( vaccinations ), and target-group -specific approaches ( with mostly risk-based target group selection).

Starting points of preventive measures

A further distinction is given to the recognition of preventive measures. A distinction is made between behavioral and situational prevention. Here are different approaches to achieve change:

• (also called personal prevention) behavioral prevention influences on individual health behaviors or the individual medical condition. Through education and information, strengthening of the personality, or even sanctions, individuals should be motivated to avoid risk. Example: On is the cigarette: " Smoking damages the health ."
• (also called structural prevention ) the situational prevention, however, has an impact on health and disease by promoting change in the living conditions of people in order to make (work, family, leisure or environmental conditions ) this minimal risk. Example: Smoking in restaurants is prohibited.

Methods of prevention

Substantially all of the prevention methods can be attributed to the following methods:

• Strengthen the motivation and the health literacy of people with the aim to reduce health- damaging behavior and to strengthen health-promoting behavior.
• Legislative measures to enforce by means of laws and regulations, and appropriate sanctions, preventive behavior.
• Economic incentive and penalty systems with which the behavior of individuals and the conditions to be a preventive effect.

Organizations in Germany

In the Federal Republic of Germany public, private and academic organizations provide comprehensive prevention work for the benefit of the population. In this case, the German Cancer Aid with their regularly updated series "Blue Guide " free information to the citizens about available, how they can protect themselves against the widespread disease of cancer. In 2012 she won the first current prevention guidebook " risk factor for cancer Solarium " published. The advice to avoid skin cancer based on the force since 2012 on the protection against harmful effects of artificial ultraviolet radiation ( UVSV ).

Other leading institutions in the field of prevention are:

• Gesundheitsziele.de - forum for the development and implementation of health targets in Germany
• Federal Association for Prevention and Health Promotion Association ( BVPG )
• Federal Centre for Health Education ( BzgA )
• Scientific Institute for Prevention in Health Care ( WIPIG )