Tesser Charles Dalcanale
Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil.
Cad Saude Publica. 2024 Sep 16;40(8):e00068123. doi: 10.1590/0102-311XPT068123. eCollection 2024.
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.
预防受到普遍提倡，尤其是在非传染性疾病方面。然而，鉴于预防性技术的激增，笼统地鼓励医疗保健专业人员和使用者采取预防行为及进行检测似乎站不住脚。在本文中，我们阐述了考虑预防措施的概念、想法和标准，为专业人员（特别是基层医疗保健人员）和管理人员提供一个最低限度的指南。探讨了一级、二级和四级预防的概念，以及减少性和增加性预防、高风险和基于人群的预防策略；循证医学及其当代危机；预防原则；健康促进、一种扩展的、以患者为中心的方法和共同决策。本次讨论旨在提高对预防措施评估的能力，使一级和二级预防的临床和健康决策更加明智，减少医源性伤害。
