The challenge is to be able to transit between reason and intuition, knowing how to view knowledge in a relative light without ignoring its importance, while broadening the possibility of solving concrete problems. It is precisely here that the radical - and at the same time very small - difference between prevention and promotion in health stands out. It is radical because it entails far-reaching change in the way knowledge is interlinked and used in formulating and operationalizing health practices, and this can only truly occur by way of a transformed world view, as discussed above.
It is very small because the practices of promotion, just like those of prevention, use scientific knowledge. Health promotion projects also rely on the classic concepts - disease, transmission, risk - that guide the production of specific knowledge in health and whose rationality is the same as that of prevention discourse.
This can lead to confusion and a lack of differentiation between the practices, mainly because the radical difference between prevention and promotion is not always clearly affirmed or exercised. The idea of promotion involves strengthening individual and collective capacity to deal with the multiplicity of factors that condition health.
Promotion goes beyond applying techniques and norms, recognizing that it is not enough to know how diseases function and to find mechanisms to control them.
It has to do with strengthening health by building a capacity for choice, using knowledge to discern differences between and singularities in events.
In the context of change in traditional public health approaches, the approach by Castellanos to the concept of health status allows us to broaden our understanding of health promotion as an idea. Health status is defined according to the options of the social actors involved in the process. It cannot be understood " apart from the intentionality of the subject that analyzes and interprets it " Castellanos, Under the health status concept, health needs are differentiated from health problems.
Needs are formulated by objective analyses and procedures. Problems require a more complex approach, shaped by choosing priorities involving the actors' individual and collective subjectivity in their day-to-day activities Castellanos, In the context of change in scientific discourse that surfaced in collective health some ten years ago, there emerged a recognition of values like subjectivity, autonomy, and difference.
As discussions advanced within the field, it became clearer that reflecting on health in a complex manner does not mean incorporating a new discourse that migrates from the pole of objectivity to the pole of subjectivity, from the universal to the singular, from the quantitative to the qualitative, etc. It is not simply a question of opting for values that were suppressed during the development of modern scientific rationality, and now to suppress those that formerly were hegemonic.
It is thus not an issue of constructing new perspectives that continue to reproduce old oppositions, but to learn how to transit between these different levels and ways of understanding and apprehending reality, taking as a reference not systems of thought, but the events that mobilize us to elaborate and intervene. To properly understand how promotion differs from prevention is precisely to be aware that the uncertainty of scientific knowledge is not simply a technical limitation which can be successively overcome.
Achieving health is a question not only of survival but of qualifying existence Santos, It refers one to the social, existential, and ethical dimension, to a path of its own that refers to concrete situations, to an engagement and active commitment by subjects who devote their uniqueness to placing what is known at the service of what is not known in the search for the truth that emerges in lived experience Badiou, Therefore, thinking in terms of health promotion is knowing that changes in behavior are oriented simultaneously by what is known of deterministic conditions and by the clear realization that not all of them are known, nor will they ever be Atlan, Practical awareness of the limits of knowledge means laying no claim to a new scientific theory that can formulate a discourse capable of unifying all the dimensions involved in health.
Promoting health involves choice, and this is not really the sphere of knowledge, but of value. It is linked to processes that are not expressed by way of precise, easily measured concepts. These "quasi-concepts" not only permit transdisciplinary approaches by linking with concepts from other areas, but they are open to the multiple meanings emerging from the consideration of difference, subjectivity, and singularity in individual and collective health occurrences.
However, this openness continues to take the concepts that shape the specificity of the public health field as a reference for dialogue. This dialogue is not achieved without gaps and gray areas. One example in this respect is the important link between health promotion projects and knowledge developed through epidemiological risk studies.
This link occurs in studies that articulate with other multiple approaches for example, studies on vulnerability to AIDS , which integrate the dimensions of personal behavior, social context, and organization of institutional programs Mann et al.
Many projects that define themselves as promotion also point to occupational and environmental exposure as origins of disease. They propose encouraging such behavioral changes as exercise, use of seat belts, and stopping smoking and use of alcohol and other drugs. The integration of epidemiology and health promotion lies in the problematic field analyzed in this article.
What has been said about the difference and similarity between prevention and promotion also has to do with the use of epidemiological concepts, which are the basis of preventive public health discourse. It is not an issue of "accusing" the reductive aspect of these concepts as a limit to understanding the complexity of health and disease processes in populations or to shaping public health practices.
Rather, it is a matter of being clearer about the limits of these concepts, fostering direct attempts to improve methods and to construct new concepts and use them in a more integrated and appropriate way for the interests and needs of structuring health policies for promotion. Epidemiological knowledge plays an undeniably central role in shaping public health practices. The traditional discourse of prevention suffered from the theoretical poverty and hegemony of mechanistic, linear logic in the conceptual development of epidemiology.
Such problems have been revealed by existing critiques of the epidemiological concept of risk Goldberg, ; Almeida-Filho, ; Castiel, ; Ayres, What values are produced by representations formed through this concept? What meanings are generated socially when habits and behaviors are identified as risks to health? Nonetheless, despite proposing to measure individual or collective risks, what the risk model's mathematical method estimates is the "average causal effect" - a reduction from both the individual and collective point of view.
Such reductions - logical transitions that are necessary and inevitable if the method is to be workable - construct representations divorced from the complexity of the processes. The problem is that transformations produced through risk studies tend to be used without considering the shifts in logical levels they produce.
This "deletion" is not value-free. On the contrary, cultural meanings proliferate in it. The options involved in the process by which something is both revealed and concealed correspond to interests, values, and needs. The development of risk analysis was linked to a cultural process that constructed an individualist Man, faced with the need to deal with the disaggregating forces of nature and society through a logic of order and protection and who invested little in improving relations with others by strengthening his own autonomy Czeresnia, Considering that one of the main aspects in the notion of health promotion is to stimulate autonomy, the challenge that arises involves far-reaching transformations in how one deals with such representations.
There can be no proposing "objective, quickly executable recommendations" that will form a capacity to appropriate information without the "risk" of values being incorporated uncritically. Clarity as to the values contained in the different promotion projects is one of the main problematic points in the proposal. Any practice in health promotion presents points of view as to what is "good health".
The general idea of promoting health conceals deep-rooted theoretical and philosophical tensions Seedhouse, Health promotion proposals are even open to the possibility of broadening practices to incorporate alternative rationalities complementary to the ones characteristic of traditional public health discourse. Diversity is salutary to the extent that its theoretical foundations are made explicit. It is with this care that one should consider proposals such as that of evidence-based medicine, which use essentially epidemiological criteria and methods to systematize the results of applied research, clinical experiments, and public health Jenicek, How is a "best evidence" finding, formulated through clinical epidemiological knowledge, to be related to clinical experience and public health?
What are the mediations between operational criteria and practical decisions? How are technical "good recommendations" to be translated into action Jenicek, ? No technical protocol can solve the implementation of "good practice", which does not disqualify the relevancy of constructing protocols that optimize information on procedures quite the contrary.
There can be no working properly and practically on constructing the idea of health promotion without facing two fundamental, connected issues: the need for philosophical thinking and the consequent reconfiguration of education communication in health practices. Philosophical discussion is considered crudely as "dilettante", hovering above life and the real world. However, without it there is no way to deal with the gray areas that emerge as we seek to dialogue and flow between the different dimensions in the complexity of health.
Without reflection, there is no way to meet the challenge of translating information generated by the production of scientific knowledge into actions that can effectively promote social and environmental change, as well as changes in "unhealthy" behavior by subjects. The emerging challenges are not resolved simply by applying new models; the question of education is not solved merely with information and technical capacity-building. Abrir menu Brasil. Abrir menu. Dina Czeresnia About the author.
Prevention; Health Promotion; Complexity; Epidemiology. Secondary prevention includes those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury.
This should limit disability, impairment or dependency and prevent more severe health problems developing in the future. Tertiary prevention includes those preventive measures aimed at rehabilitation following significant illness. At this level health educators work to retrain, re-educate and rehabilitate the individual who has already had an impairment or disability. Summary Primary prevention includes those measures that prevent the onset of illness before the disease process begins.
Immunization against infectious disease is a good example. Secondary prevention includes those measures that lead to early diagnosis and prompt treatment of a disease. Breast self-examination is a good example of secondary prevention. Tertiary prevention involves the rehabilitation of people who have already been affected by a disease, or activities to prevent an established disease from becoming worse. Click on various risk factors, demographics, diseases and conditions to see graphic comparisons.
What are some of the most common conditions, and how are they related to one another? What can we do to improve our health? Licenses and Attributions. Patients who are making major lifestyle changes to improve their health and reduce risk of disease often need continued support.
Without a support system in place, patients may redevelop poor health habits or put themselves at risk for developing diseases or worsening existing health conditions. As health promotion and disease prevention through healthy living and lifestyle changes continue to occupy an important place in medical care, nurses can expect to take more active roles in promoting behaviors that will help patients across the age continuum to improve their health.
The responsibility to live a healthier lifestyle ultimately lies in the hands of individuals, but nurses can help to educate, inform, and support those who are willing to take the next steps toward achieving healthier lifestyles for themselves. If you are working toward advancing your education in nursing, understanding your role in health promotion and disease prevention is critical.
With an online Master of Science in Nursing MSN degree , you might consider becoming a nurse leader, which means you may not only be focused on disease prevention among your patients, but also on the mentorship and education of other nurses in this area. Clearly, whether you strive to become a nurse practitioner or other leader, health promotion is an important area of study.
Registered Nursing. Nursing In Practice. Skip to main content. Apply Program Guide. Teaching about the Dangers of Alcohol, Tobacco, and Drug Use Addictions to alcohol, tobacco, or illegal drugs are ever-present concerns. Promoting Regular Health Checkups Regular health assessments are key elements of health promotion and disease prevention. Offering Follow Up and Support Patients who are making major lifestyle changes to improve their health and reduce risk of disease often need continued support.
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