1. Definition of clinical preventive service
It means that medical staff in clinical places (including community health service staff in home and community places) evaluate the health risk factors of healthy people and asymptomatic "patients" and implement personalized preventive intervention measures to prevent diseases and promote health. Clinical preventive services are mainly aimed at individual healthy people and asymptomatic "patients"; The service provider is a clinician.
2. The definition of health management
It refers to the process of comprehensively, systematically and pertinently evaluating the health risk factors of the clients and carrying out life-long intervention, so as to reduce the threat of health risk factors, find and treat diseases in time at an early stage, effectively treat diseases and prevent complications, thus economically and effectively avoiding premature death and improving the quality of life. Health management is aimed at both individuals and groups; Service providers are mainly health managers.
3. The content of clinical preventive service
(1) Health consultation for medical practitioners: collect the health risk factors of medical practitioners, work out plans to change unhealthy behaviors with medical practitioners, and urge medical practitioners to implement intervention plans. Urge them to consciously adopt healthy behaviors and lifestyles, eliminate or reduce risk factors affecting health, prevent diseases, promote health and improve quality of life.
(2) Health screening: refers to the use of rapid and simple physical examination or laboratory examination and monitoring and evaluation of risk factors to find unidentified patients or people with health defects in healthy people.
(3) Immunization: It means injecting antigens or antibodies into the body, so that the human body can gain specific resistance to certain diseases, thus protecting susceptible people and preventing infectious diseases.
(4) Chemical prevention: refers to the use of drugs, nutrients (including minerals), biological agents or other natural substances as primary preventive measures for asymptomatic people, in order to improve people's ability to resist diseases and prevent the occurrence of certain diseases.
4. Significance of clinical preventive service
Clinical medical staff account for the majority of the whole health team, and about 78% people see medical staff at least once a year, with an average of three times a year. Medical staff directly contact with "patients" in their special way, and obtain health intervention strategies to control disease risk factors through quantitative evaluation of individual health risks, which can effectively mobilize the enthusiasm and initiative of individuals to improve bad behaviors and lifestyles, and patients have greater compliance with the suggestions of medical staff; Medical staff can learn about patients' health status and behavior changes through follow-up, and put forward targeted preventive health care suggestions in time, which is conducive to managing personal health status, correcting unhealthy behaviors, finding diseases early and treating them in time, improving patients' quality of life and prolonging their lives.
5. Implement the principle of clinical preventive service.
① Pay attention to the collection of risk factors ② Both doctors and patients make the same decision. ③ Health consultation and education-oriented; ④ Choose the content of health screening reasonably ⑤ Carry out targeted clinical preventive services according to the characteristics of different age groups.
(2) Assessment of health risk factors
1. The concept of health risk factor assessment
Health risk assessment refers to collecting all kinds of health-related risk factors information from individual or group health information consultation or investigation, physical examination and laboratory examination, so as to provide basis for further targeted intervention measures.
2. Collection of health risk factors
Risk factors refer to the inducing factors that exist inside and outside the body to increase the occurrence and death of diseases. Such as bad behavior (such as smoking), family history, poor contact with the environment and related occupations, high blood pressure, high serum cholesterol concentration, overweight, abnormal electrocardiogram, past medical history, etc. The collection of health risk factors is the process of collecting these risk factors. Because there are at least hundreds of health risk factors that can increase the risk of future illness, the priority of collecting risk factors should be determined according to the following principles: ① the severity of specific diseases caused by risk factors; ② Whether the risk factors are universal; (3) the degree of risk of risk factors; ④ Whether a certain risk factor can be accurately detected; ⑤ Whether there is evidence that preventive measures can promote health; ⑥ How do these aspects compare with other priority health problems?
3. Risk assessment
It is a quantitative estimation of personal health status and the possibility of future illness and/or death according to the collected health risk factors. Risk factor assessment is the basic starting point to clarify a series of health problems. In clinical preventive services, most customers do not have specific diseases. Medical staff are required to have the thinking mode of linking the risk factors of patients with major health problems that may occur in the future.
(3) formulation and implementation of health maintenance plan
1. Concept of health maintenance and cigarette counting
Health maintenance schedule refers to a series of interventions planned in a specific period according to the patient's age, gender and specific risk factors. Specifically, it includes: what to do, how often to do it, and when to do it.
2. The principle of making health maintenance plan
① According to the risk assessment results, find out the most important risk factors for intervention; ② According to the specific situation of patients, the availability of resources and the feasibility of implementation, select appropriate and specific intervention measures; (3) The plan should be determined in consultation with the "patient" (4) The goal of behavior change should be practical and should start from a small and simple place; ⑤ The two factors that determine the screening frequency are the sensitivity of screening test and the progress of disease, and beauty is not the risk of disease.
3. Implementation of health maintenance plan
The first is to establish a health maintenance flow chart. On this basis, in order to effectively correct the behavioral risk factors of some high-risk groups, it is necessary to work out another set of intervention action plans for health risk factors with "patients". In the process of implementation, there are also health education materials for patients. In the process of implementation, it is necessary to strengthen the follow-up of health maintenance and track the implementation of the plan of "patients" and their feelings and requirements, so as to find neglected problems in time.