Prevention is better than cure, so the saying goes. As the population in the developed world ages and there are many more people who have chronic conditions and illnesses many of which are lifestyle related, government policy is changing. Services like the National Health Service were set up to treat illness. Now the emphasis is changing and there is more focus on prevention of illness and on helping people who have chronic conditions to manage their illness. There is a greater emphasis on health and wellbeing.
Occupational Therapists (OTs) have traditionally worked in rehabilitation or recovery settings, but have the skills and in depth knowledge to deliver preventative programmes based on occupation, or peoples’ daily routines that are effective and sustainable.
Last year I heard Dr Sheena Blair speak at the Student Occupational Therapy Links Scotland(SOTLS) conference in Glasgow. Dr Blair concluded that as occupational therapists, our next big challenge and emerging area of practice is in public health and in the prevention of illness. Follow this link to read my post about the conference.http://www.blogger.com/blogger.g?blogID=7020627754640309197#editor/target=post;postID=7331785227788042008
During my recent study visit to the University of Southern California to investigate the Lifestyle Redesign® occupational therapy approach developed there, I learned about it’s use in many different areas f practice, including prevention.
Preventative occupational therapy can be categorised into three areas, primary, secondry and tertiary. The examples given below to illustrate this are from the Lifestyle Redesign® Diabetes Programme developed by Dr Chantelle Rice, but could easily be applied to other situations or conditions.
Primary prevention is defined as education or heath promotion strategies designed to help people avoid the onset of unhealthy conditions, diseases, or injuries.
• Example: Both of an individual’s parents have diabetes and he/she is overweight with high blood pressure and elevated blood sugar levels.
Secondary prevention includes early detection and treatment designed to prevent or disrupt the disease process.
• Example: An individual was just diagnosed with diabetes and according to lab results, their physician believes that he/she has had diabetes for approximately 6 months. He/she does not have any of the chronic conditions associated with diabetes and should focus on healthy eating routines, physical activity and other healthy habits to control blood sugar, lipids and pressure.
Tertiary prevention refers to treatment and services designed to arrest the progression of a condition, prevent further disability, and promote social opportunity.
• Example:An individual has had diabetes for 10 years, has suffered from a stroke, and currently lives with diabetic retinopathy, tingling in their fingers and numbness in their feet. Facilitating the implementation of healthy lifestyle habits to prevent the further development of chronic conditions, or additional conditions, and increase ability and function in activities of daily living.
Brownson, C. (2001). Occupational Therapy in the promotion of healthy and the prevention of disease and disability statement. The American Journ Occupational Therapy, 55 (6), 656-660.