The preventive direction in pediatrics includes a set of measures that ensure the development and education of a healthy child, the prevention of diseases and disability of children.
Distinguish between primary, secondary and tertiary disease prevention.
Primary prevention consists in preventing diseases by eliminating or neutralizing causal and predisposing factors. It includes a set of social, economic, hygienic, medical and educational measures that must be carried out not only by healthcare institutions, but also by state and public organizations. Primary disease prevention is not only a medical, but also a social problem. — mental health northbrook
The main directions of primary prevention:
- Dispensary observation for children of all age groups.
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Carrying out non-specific and specific immunoprophylaxis.
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Improving the quality of life, the formation of a healthy lifestyle.
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Preparing children for admission to preschool and school.
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Psychological assistance to children at risk.
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Family planning.
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Systematic monitoring of a woman during the prenatal period of pregnancy and the postnatal period.
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Organization of a balanced diet.
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Hygienic food quality control.
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Improving the level of health education.
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Prevention of childhood injuries.
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Prevention of alcoholism and drug addiction among children and adolescents.
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Epidemiological control.
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Monitoring the environmental situation.
Secondary prevention involves active early detection of diseases and functional disorders, preventing their progression and possible complications. Secondary prophylaxis is ensured by the optimal organization of medical and health-improving work, dispensary observation and anti-relapse treatment of diseases.
The main directions of secondary prevention:
- Identification of predisposition or early signs of the disease.
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Formation of risk groups.
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Dynamic monitoring of risk groups.
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Monitoring of physical and mental development, sensory system, etc.
The main goal of primary and secondary prevention is the formation in the family of medical and hygienic skills for a healthy lifestyle.
Tertiary prevention involves the dynamic monitoring of patients with chronic diseases.
The main directions of tertiary prevention:
- Rehabilitation of patients with chronic diseases and disabled children.
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Psychological support for a sick child and his family.
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Medical and social adaptation of patients with chronic diseases and disabled children to work.
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Orthopedic correction.
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Organization of public organizations to support patients with chronic diseases, etc.
ORGANIZATION OF DISPERSONIZATION IN THE SYSTEM OF THERAPEUTIC AND PREVENTIVE CARE
Clinical examination is an active method of dynamic monitoring of children’s health, which is a system of scientifically based, socio-economic, sanitary, therapeutic, preventive and anti-epidemic measures aimed at preserving, quickly restoring health, reducing morbidity and rehabilitation.
Dispensary observation should cover both healthy and sick children.
The main tasks of the clinical examination:
Ø preservation, strengthening and restoration of health,
Ø Improving the physical development of children of various age groups.
The goals of the medical examination of healthy children:
Ø preservation and further strengthening of health,
Ø improvement of physical development,
Ø ensuring psychosocial adaptation and harmonious development.
The goal of the medical examination of children with risk factors, borderline health, reduced body resistance to disease is to ensure health as a “state of complete socio-biological and mental well-being”.
The purpose of the medical examination of sick children is to reduce the incidence of disease, maintain health and prevent disability, medical and social adaptation to work.
Clinical examination includes the following activities:
- Preventive medical examinations and active early detection of diseases and risk factors for diseases.
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Dispensary registration and systematic monitoring of the health status of children of all age groups: studying living conditions, identifying factors that adversely affect health, assessing the physical and mental development of the child, developing measures aimed at improving it.
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Organization and implementation of a set of planned preventive and therapeutic measures, including laboratory and instrumental methods of examination, rehabilitation and anti-relapse treatment, rehabilitation of the oral cavity and chronic foci of infection.
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Advocacy of medical and hygienic knowledge and skills of a healthy lifestyle, hygienic education, active fight against unhealthy habits, especially in children with an increased risk of developing diseases.
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A systematic analysis of the quality and effectiveness of the clinical examination based on the results of preventive examinations, the state of health and physical development, the development and implementation of measures to increase the effectiveness of the medical examination.
For differentiated treatment and health-improving work, three groups of dispensary observation are distinguished:
The first group (D-1) — children whose examination did not reveal functional disorders from individual organs or they are insignificant, or there are deviations in lifestyle.
This group includes the following categories of children:
Ø healthy children, in whom all physiological parameters and test results are within a stable norm, and functional reserves correspond to average indicators for a given age and gender;
Ø children with minor deviations from the norm in some physiological characteristics, which does not affect the functional activity of the body;
Ø children with unstable indicators, having risk factors or deviations in lifestyle.
This group of dispensary observation is examined at the annual preventive examinations, performing the prescribed minimum of laboratory and instrumental examination. The planned medical and social measures are aimed at eliminating risk factors, mobilizing functional reserves, that is, at the primary prevention of the disease.
The second group (D-2) consists of practically healthy children with borderline conditions, whose functional indicators periodically deviate from the norm, physiological reserves are reduced, but there is no obvious clinic of the disease.
For the timely detection of a possible transition of the borderline state into an organic disease, examination of children in this group should be carried out at least 2 times a year. It is advisable to use the methods of functional diagnostics with the performance of stress tests as widely as possible.
The third group (D-3) includes sick children:
• at the stage of complete compensation, as a rule, in the initial period of a chronic disease with minimal functional impairment, with rare exacerbations and the possibility of achieving persistent long-term remission. Inspection is carried out 2-4 times a year, depending on the nosological form and nature of the course of the disease, according to the results of the examination, a contradictory treatment is prescribed;
• in the stage of subcompensation of a chronic disease;
• at the stage of decompensation of a chronic disease with frequent or prolonged exacerbations, a sharp decrease in the functional reserves of the body, requiring periodic in-patient treatment and constant supportive drug therapy. All therapeutic measures are aimed at stabilizing the pathological process.
For a comprehensive assessment of the characteristics of the child’s health status and the effectiveness of medical and health work, the following criteria are taken into account:
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The presence or absence of a chronic disease.
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The level of the functional state of the basic systems of the body.
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The degree of body resistance to adverse influences.
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The level of physical, mental and harmonious development of personality.