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by: Zelda McCullough


Zelda McCullough
GPA 3.63

D. Dailey

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D. Dailey
Class Notes
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This 8 page Class Notes was uploaded by Zelda McCullough on Tuesday October 13, 2015. The Class Notes belongs to KIN 3605 at Louisiana State University taught by D. Dailey in Fall. Since its upload, it has received 19 views. For similar materials see /class/222594/kin-3605-louisiana-state-university in Kinesiology at Louisiana State University.

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Date Created: 10/13/15
Chapter 12 Health Prevention and Promotion Types of Prevention Primary prevention practicing good health habits and getting vaccinated to prevent an illness Secondary prevention engaging in particular health screenings to detect disease at an early treatable stage Tertiary prevention properly caring for an already established disease to stay as well as possible minimize its negative effects and prevent complications Prevention any activity that reduces the incidence and severity of disease disability and premature death Brushing teeth eating healthy exercise getting u shot etc May be initiated by a professional prescribing a screening test May be done by a health organization to reach a broader audience public service ads Prevention can be community based classes The Healthy People Initiative Provides health specific objectives and outlines ways to meet those objectives in a format that diverse groups working together can use 0 Scientifically based Concept of healthy people initiative was developed upon the release of Healthy People the Surgeon General 5 report on health promotion and disease prevention 0 Set goals for different age groups 0 Healthy People 2000 9 Healthy People 20109 Healthy People 2020 Best known set ofprevention activities is set by USPFTF Primarv P 39 Vaccines and Pills In uenza a debilitating but usually self limiting viral infection that causes incapacitating weakness fever pills and body aches 0 May be life threatening in elders especially the chronically ill 0 Majority of deaths attributed to in uenza happen to those over age 65 0 Those affected are at a higher risk for developing pneumonia Pneumococcal pneumonia in ammation of the lungs caused by the pneumococcus bacteria 0 Significant cause ofillness death and hospitalization of those 54 and older Shingles painful blistering skin rash caused by chicken pox Tetanus rare in US but when it does occur it is most common in those 50 or older Vaccines o In uenza vaccine reformulated each year by CDCP I Works best in healthy elders I Available in a shot or nasal spray I Medicare covers u shot for those 65 and older 0 Pneumococcal pneumonia reduces risk of contracting disease in all ages but most effective in healthy adults I Vaccine lasts about 5 years 0 Shingles CDCP recommends shingles vaccine regardless of having shingles or chicken pox I Reduces severity and duration of the disease I Only covered w Medicare part D coverage 0 Tetanus mixed w vaccine for Td and is often given during ch dhood Daily aspirin therapy can reduce the risk of heart disease healthy people at risk should take a low dose daily 0 Aspirin reduces stickiness of blood platelets which reduces blood clots o Undesirable side effects are stomach upset GI bleeding and hemmorghic stroke 1 Prpvtanfinn39 Screening Screening is targeted at populations at risk for the condition 0 Colon cancer screening done on those over age 50 0 Diagnostic test9 performed on those w symptoms of the illness Screening is done on healthy people to find disease early when it can be treated o Specialists tend to recommend more tests 0 Preventive care often recommends opposite mammogram for those age 20 and older 0 Professionals vary in their biases Screenings include health interviews family history height weight and blood pressure as well as laboratory tests xrays etc 0 Certain characteristics must be met before screenings are done on a wide scale I The test must be able to detect the illness before any signs or symptoms of the disease are evident to the patient or the healthcare provider I The test must be accurate w a minimum of false positives or false negatives I Screening and early treatment of the disease should improve the health of the patient 0 Early detection is not always great diseases that are almost always fatal have individuals living with diagnosis knowing their fate I Screening should result in a longer life as evidenced by well conducted research Gold standard on determining which screenings save lives is randomized controlled trials Screening tests often not recommended for elders w life threatening chronic diseases Relevant Screening Tests for elders Breast Cancer 0 O O Randomized controlled studies have shown a reduction in mortality in those over 50 who have gone through screenings Mammograms X ray on breast tissue used to detect changes in women who have no symptoms or signs ofbreast cancer I Detect small deposits of calcium or tumors I Should be conducted yearly for women over 50 Breastself examinations should also be conducted Colorectal cancer 0 O O O 0 Screening can find precancerous polyps and cancer at the early stage I Polyps can be easily removed Fecal occult blood test or digital rectal exam should be conducted yearly from 4050 to about age 75 Fecal Occult blood test I Can be done at home or in physician s office I Smears of stool placed on cards and sent to lab for testing Digital Rectal exam I Gloved finger is stuck into patient s rectum to feel for abnormalities After 50 barium enema colonoscopy or sigmoidoscopy every 37 years I Barium enema mixture ofbarium and water is pumped into rectum and xrays are taken I Colonoscopy and sigmoidoscopy procedures when a lighted tube is inserted into rectum and physician looks at lighting ofbowel for possible cancer 0 Colonoscopy allows visual of entire colon o Sigmoidoscopy allows visual of only lower 13 0 Virtual colonoscopy using CT or MRI is also an option Prostate Cancer most common cancer in mean and second to lung cancer in death rates 0 Can be screened w digital rectal exam or prostate specific antigen blood test PSA I When PSA levels rise it may be an indication of cancer 0 Screen is controversial I Bc it is slow growing and may not effect life expectancy I Unclear whether early detection always improves quality of life 0 Most recommend screening after age 50 but must discuss the pros and cons ofscreening I Frequent false positive results unnecessary anXiety and biopsies Heart Disease 0 1 Screen for CD risk factors 2 Determine which asymptomatic patients have CD through tests 0 Could start w lifestyle screening smoking sedentary lifestyle hypertension 0 Medical tests include medical EKG I Measures electrical activity of the heart I Not a good test for heart disease 0 Medical tests aren t recommended on a routine basis I Screening for risk factors is more important Hypertension leading risk factor for heart disease stroke and other illnesses in US 0 Lowering blood pressure reduces death rates 0 Screen w a blood pressure cuff 0 May need to be screened 12 years but with high pressure monitoring is essential I Many people in US do not know they have hypertension bc they have never been screened 0 Goal of treatment is to reduce blood pressure to lower than 12080 High Cholesterol 0 High cholesterol can be safely treated so screening is recommended I There are safe medications to help control abnormal lipids thus reducing risk of heart disease 0 Women over 45 and men over 35 should be screened w blood tests about every 5 years o Lipid levels are likely to increase after 65 I Age to stop screening hasn39t been established Osteoporosis o DEXA is most accurate test I Painless and quickly asses bone density 0 Routine screenings are recommended for women over age 65 0 Men and black women may not benefit from screenings I Black women have a higher bone mineral density than white women Vision 0 Use of Snellen eye charts for vision loss is widely recommended lines of letters I Frequency has not been determined 0 Glaucoma slowly progressive loss ofvision that increases w age can be screened for and early treatment may help I Medication can slow or stop glaucoma process 0 Large scale tests are underway to determine if screening and treatment can prevent blindness from glaucoma Hearing 0 Although routine screenings have not been proven effective treating hearingimpaired adults can improve the quality of their lives I Hearing loss can be caused by multiple factors noise medications illness and prebycusis Counseling and interviews may be the best type of screening Audiometric testing could be done every 10 years for those w hearing loss 00 Problem drinking 0 The risk of alcoholism declines w age 0 Screening should include specific question regarding the quantity frequency and degree ofintoxication All people who drink should be counseled on the dangers of excessive drinking 0 Questionnaires and screenings should be relayed to physicians O Tertiary Prevention Occurs after the diagnosis ofillness Tertiary prevention attempts to prevent further disability complications or death including testing treatments and rehab Disease specific educationpatient education the act of teaching an individual about his or her disease giving him or her the best control over the course of the illness May include education giving someone more control over the course of the illness 0 Examples I Teaching diabetics to check their blood sugar and mange their illness I Teaching someone with prostate disease to insert a cathedra I Teaching those w heart failure to weigh themselves and manage their uid intake I Flexibility exercises for those w arthritis I Proper diet for those w hypertension or heart disease Preventative Services Diseases like COPD which the US spends most of its money on can be prevented Medicare private insurances doctors and patients do not focus on preventive care 0 It s easier to take a pill 0 Medicare does not reimburse many important screenings or other preventative services Originally Medicare specifically excluded preventive care 0 Now helps cover many screenings and immunizations change is slow bc congress must authorize these changes 0 Medicare does not pay for some important screenings but sometimes pays for screenings w no proven benefit Medicare covers some screenings not recommended by the USPSTF but misses some that the USPSTF highly recommends Only half of nation s elders receive recommended preventive health care serv1ces Health Promotion quotTalking is more important than testing The vast majority of diseases that plague Americans is related to lifestyle 0 Last 20 years have shown decrease in heart disease largely due to health promotion Health promotion includes activities on an individual community legislative laws requiring seatbelts etc and nationwide basis 0 Effectiveness is on a case by case basis It is unknown what efforts are most effective w which topics and populations Health promotion activities should be a collaboration between doctor and patient 0 Patient must initiate and sustain health behavior change Changing Health Behaviors There are 5 stages in changing health behaviors o Precontemplation no intentions to change in foreseeable future individuals often unaware of their problems 0 Contemplation people are aware a problem exists and are thinking about overcoming it but have not yet made a commitment o Preparation9 combines intention w previous failed attempts individuals are indenting to take action in the next month and have made failed attempts in the past 0 Action individuals modify their behavior experiences or environment in order to overcome their problems 0 Maintenance 9 people work to prevent relapse and consolidate gains Counselors need to determine where their patients are and tailor the counseling to the correct stage Know your audience Health Behavior Change Theory Transtheoretical model proposes that health promotion approaches be individualized o Asses openness of each client to behavior change Specific Health Promotion Interventions Smoking Cessation o 20 of all deaths are linked to smoking cigarettes o 10 of elders still smoke about 1 in 5 of all Americans smoke 0 510 years after you quit smoking cancer risk drops 0 Doctors need to screen for tobacco use and encourage quitting Physical Activity Counseling 0 A11 age groups should engage in physical activities that are tailored towards each person s capabilities 0 Physician counseling has NOT shown to be effective I Perhaps bc exercise is a difficult habit to get into and office counseling is quick and nonspecific Dietary Counseling 0 For those w diet related chronic diseases intensive behavioral counseling is recommended 0 Take a dietary history address potential barriers to change offer specific guidance and recommend follow up Motor Vehicle injury prevention 0 Fewer elders drive and they drive less I Low rate of motor vehicle accidents 0 Still elders should be cautioned against drunk driving encouraged to wear seatbelts and educated about their medications while driving Fall prevention 0 Falls are a leading cause of unintentional injury and death among elders Providing education about falls is not enough Instead exercise safety behaviors environmental hazard reduction and medication review is recommended 00 The Educated Health Consumer Self care any individual effort to maintain or improve wellness The Internet provides much information that can help in selfcare but how do you know which information is good 0 Using org edu or gov as a guide 0 There is a wealth of information from the AARP Medline Plus that is trust worthy Public Policy Change to Promote Health Changing laws bring about large scale health changes in some situations 0 Seatbelt laws airbagantilock breaks clean water speed limits Regulations can help in the type of care we receive 0 Preventative care nursing homes It helps if the policy and regulations are being funded by the government enacting the change


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