[A conceptual framework for good preventive practices (or for quaternary prevention)].

IF 1.9 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Cadernos de saude publica Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI:10.1590/0102-311XPT068123

Charles Dalcanale Tesser

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引用次数: 0

Abstract

Prevention is universally advocated, especially in the case of noncommunicable diseases. However, given the proliferation of preventive technologies, it does not seem defensible to generically encourage preventive behaviors and tests for healthcare professionals and users. In this essay, we articulate concepts, ideas and criteria for considering preventive measures, providing a minimum guide to be used by professionals (especially in primary healthcare) and managers. The concepts of primary, secondary and quaternary prevention are explored, as well as those of reductive and additive prevention, high-risk and population-based preventive strategies; evidence-based medicine and its contemporary crisis; the precautionary principle; health promotion, an expanded, person-centered approach and shared decision-making. This discussion was designed to improve competence in the evaluation of preventive measures, making clinical and health decisions more judicious and less iatrogenic regarding primary and secondary prevention.

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[良好预防做法（或四级预防）的概念框架]。

人们普遍提倡预防，尤其是非传染性疾病的预防。然而，鉴于预防技术的激增，一概鼓励医疗保健专业人员和用户采取预防行为和进行预防检测似乎站不住脚。在本文中，我们阐述了考虑预防措施的概念、观点和标准，为专业人员（尤其是初级医疗保健人员）和管理人员提供了最低限度的指南。文中探讨了一级预防、二级预防和四级预防的概念，以及还原性预防和附加性预防、高风险预防和以人群为基础的预防策略、循证医学及其当代危机、预防原则、健康促进、以人为本的扩展方法和共同决策等概念。讨论旨在提高评估预防措施的能力，使临床和健康决策在一级和二级预防方面更加明智，减少人为因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cadernos de saude publica 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.30

自引率

7.10%

发文量

356

审稿时长

3-6 weeks

期刊介绍： Cadernos de Saúde Pública/Reports in Public Health (CSP) is a monthly journal published by the Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation (ENSP/FIOCRUZ). The journal is devoted to the publication of scientific articles focusing on the production of knowledge in Public Health. CSP also aims to foster critical reflection and debate on current themes related to public policies and factors that impact populations'' living conditions and health care. All articles submitted to CSP are judiciously evaluated by the Editorial Board, composed of the Editors-in-Chief and Associate Editors, respecting the diversity of approaches, objects, and methods of the different disciplines characterizing the field of Public Health. Originality, relevance, and methodological rigor are the principal characteristics considered in the editorial evaluation. The article evaluation system practiced by CSP consists of two stages.