Non-Communicable Diseases Prevention and Care of Ageing Population PDF

Summary

This document details non-communicable disease prevention and care of ageing populations presented by Alma Cecelia R. Malazarte. It covers different types of NCDs, risk factors for each NCD and prevention/screening methods for cardiovascular diseases, cancer, chronic respiratory illnesses and diabetes.

Full Transcript

## Non-Communicable Diseases Prevention and Care of Ageing Population - Presented by: Alma Cecelia R. Malazarte ### Non-Communicable Disease - Non-transmissible, non-infectious - Most often referred to as “chronic diseases”, “lifestyle-related diseases” ### Main Types of NCD: - Cardiovascular...

## Non-Communicable Diseases Prevention and Care of Ageing Population - Presented by: Alma Cecelia R. Malazarte ### Non-Communicable Disease - Non-transmissible, non-infectious - Most often referred to as “chronic diseases”, “lifestyle-related diseases” ### Main Types of NCD: - Cardiovascular Diseases (heart attacks and stroke) - Cancers - Chronic Respiratory Diseases (chronic obstructive pulmonary disease and asthma) - Diabetes ### 4 Major LRDs and the 4 Common Shared Risk Factors | | Tobacco use | Unhealthy diet | Physical inactivity | Harmful use of alcohol | |---|---|---|---|---| | Cardiovascular diseases | ✓ | ✓ | ✓ | ✓ | | Diabetes Mellitus | ✓ | ✓ | ✓ | ✓ | | Cancer | ✓ | ✓ | ✓ | ✓ | | Chronic respiratory diseases | ✓ | ✓ | ✓ | ✓ | ### Cardiovascular and Cerebrovascular Diseases - Cardiovascular Deaths: most common cause of NCD mortality worldwide - CVD ( heart disease) general term used to refer to diseases of that involve the heart or blood vessels (arteries, capillaries, and veins) - Cerebrovascular Disease (stroke): group of brain dysfunction related to disease of the blood vessels supplying the brain - ATHEROSCLEROSIS & HYPERTENSION: most common causes of these 2 diseases ### Cardiovascular and Cerebrovascular Diseases - Prevention - Prevention: Screening - A medical test or procedure that checks for diseases or health conditions in people who don't have any symptoms to identify diseases early, when they may be easier to treat or cure - Mammograms: For breast cancer - Colonoscopies: For colorectal cancer - Pap tests and HPV tests: For cervical cancer - Blood tests: For cholesterol ### Screening: HPN - BP monitoring thru reliable aneroid devices that are calibrated every 6 months - BP recorded BID (AM and PM) for several days before a Dx can be made ### Ambulatory Blood Pressure Monitoring - At home, 24-hour monitoring as you go about your daily life. - Records readings every 60 mins - Records readings every 15-30 min - Heart rate - Blood pressure ### Classification of Blood Pressure for Adults | Blood pressure classification | Systolic BP | Diastolic BP | |---|---|---| | Normal | less than 120 | and less than 80 | | Prehypertension/Elevated | 120-129 | and less than 80 | | Stage 1 Hypertension | 130-139 | or 80-89 | | Stage 2 Hypertension | 140 or higher | or 90 or higher | | Hypertensive Crisis | Higher than 180 | and/or higher than 120 | - Source: 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines ### Screening: Elevated Cholesterol - Blood samples to determine total serum cholesterol, LDL, and HDL - Fasting for at least 9-12 hours - Elevated LDL: major cause of CVD - Total cholesterol: - Sum total of LDL and HDL and other cholesterol at a given time ### Table 2: ATP III Classification of LDL, Total, and HDL Cholesterol (mg/dL) | LDL Cholesterol | | |---|---| | <100 | Optimal | | 100-129 | Near optimal/above optimal | | 130-159 | Borderline high | | 160-189 | High | | $\ge$190 | Very high | | Total Cholesterol | | | <200 | Desirable | | 200-239 | Borderline high | | $\ge$240 | High | | HDL Cholesterol | | | <40 | Low | | $\ge$60 | High | ### Cancer - 2nd most common cause of death worldwide ### "CAUTION" - **C**hange in bowel or bladder habits - A common sign of colorectal cancer. - **A** sore that does not heal - If located on the skin or in the mouth, skin cancer or oral cancer could be the cause. - **U**nusual bleeding or discharge - Any bleeding from the bladder, vagina, or rectum could mean prostate, cervical, or colorectal cancer. - **T**hickening or lump in breast or elsewhere - A lump on the breast can be a sign of cancer. A lump on a testicle can mean testicular cancer - **I**ndigestion or dysphagia - Can be a symptom of stomach, throat, esophagus, or mouth cancer. - **O**bvious change in wart or mole - Most common sign of skin cancer. - **N**agging cough or hoarseness - A cough that lasts for four weeks or longer can be a symptom of lung and/or throat cancer - **U**nexplained anemia - **S**udden weight loss ### Cancer in the Philippines - Estimated number of new cases in 2020, Asia, worldwide, Philippines, both sexes, all ages (excl. NMSC) - Other cancers: 11 483 782 (41%) - Lung: 1 541 087 (12.2%) - Breast: 1 314 753 (17.6%) - Colorectum: 2 954 154 (10.7%) - Stomach: 1 912 428 (5.9%) - Oesophagus: 1 086 706 (3.9%) - Liver: 1 573 263 (5.7%) - Prostate: 1 723 725 (5.5%) - **Total: 27 664 189** ### COPD - Condition affecting the lungs in which the airways narrow overtime - Chronic bronchitis, chronic asthma, and emphysema. - Strong risk factor: ### Diabetes Mellitus - Chronic metabolic disease characterized by high levels of blood sugar due to the inability of the pancreas to produce enough insulin, or inability of the body to effectively use the insulin it produces - Risk factors: ### Risk Factors for NCD - Tobacco use - Alcohol use - Unhealthy diet - Physical inactivity - Air pollution ### Prevention of NCD - Friendly social network - Self-limitations - Reduce the noise - Exercise - Stress management skills - Meditation - Time management - Sleep habit ### Strategies for the Control and Prevention of NCDs 1. Promote physical activity and exercise - Physical activity: Body movement that results in expenditure of energy (occupational, leisure time, routine, daily activities) - Exercise: Planned, structured, repetitive aimed at improving or maintaining physical fitness (performed with vigor and alertness without undue fatigue) Moderate intensity for 30 minutes for 5 days 2. Promote proper nutrition (ABC) - Aim for physical fitness (ideal body weight) - Build healthy nutrition-related practices - Choose foods sensibly ### The Food Pyramid - **Not needed for good health.** - Foods and drinks high in fat, sugar and salt - **Needed for good health. Enjoy a variety every day.** - Fats, spreads and oils - Meat, poultry, fish, eggs, beans and nuts - Milk, yogurt and cheese - Wholemeal cereals and breads, potatoes, pasta and rice. - Vegetables, salad and fruit - **For adults, teenagers and children aged five and over** - Most people consume snacks high in fat, sugar and salt and sugar sweetened drinks up to 6 times a day. (Healthier Wales survey 2016) There are no recommended servings for Top Shelf foods and drinks because they are not needed for good health. - **In very small amounts:** Use as little as possible. Olive oil or polyunsaturated spreads. Choose rapeseed, olive, canola, sunflower or corn oils. Limit mayonnaise, coleslaw and salad dressings as they also contain oil. Always cook with as little fat or oil as possible - grilling oven-baking, steaming boiling or stir-frying. - **2 Servings a day:** Choose lean meat, poultry (without skin) and fish. Eat oily fish up to twice a week. Choose eggs, beans and nuts. Limit processed salty meats such as sausages, bacon and ham - **3 Servings a day:** Choose reduced fat or low-fat varieties. Choose low-fat milk and yogurt more often than cheese. Enjoy cheese in small amounts. Women who are pregnant or breastfeeding need 3 servings a day - **3-5 Servings a day:** Wholemeal and wholegrain cereals are best. Enjoy at each meal. The number of servings depends on age, size, if you are a man or a woman and on activity levels. Watch your serving size and use the Daily Servings Guide below. - **5-7 Servings a day:** Base your meals on these and enjoy a variety of colours. More is better. Limit fruit juice to unsweetened, once a day. 3. Promote smoke-free environment - 5 As to quit smoking - Ask Smoking status - Advice: To stop smoking, can cause death - Assess: Willingness to quit - Assist: Quitting - Arrange follow-up: Monitor progress - RA 10352: Excise tax on alcohol and tobacco for 5 years for the Universal Health Care program of the government 4. Stress management techniques - Spirituality - Stress debriefing - Smile - Self-awareness - Scheduling activities - Siesta - Sensation techniques - Sports - Socials - Sounds and songs - Speak to me - Stress debriefing - Smile ### PEN - Package of Essential Non-Communicable Disease Interventions - Set of cost-effective interventions that can be delivered to an acceptable quality of care even in resource-poor settings ### PEN Objectives - **Vision**: Effective and equitable prevention and care for people with NCDs - **Goals**: Closing the gap between what is needed and what is currently available to reduce the burden, health-care costs and human suffering due to major NCDs by achieving higher coverage of essential interventions in LMIC - **Objectives**: - Improve equity and efficiency of care of major NCDs - Improve the quality of care of major NCD - Have a beneficial impact on health ### Primary Health Care Center Staff Team and Roles - **Physician** - Receives NCD referrals from nurse - Physically examines pt - Prescribes meds & promotes adherence - **Nurse** - Conduct risk assessment & screening - Measure ht & wt, take VS - Perform UA and blood sugars, if needed - Healthy lifestyle counseling - **Others** - Dietitian - Smoking cessation specialist - Health educator - **World Health Organization, NCD Management | March 2014 | 24 | WPR** ### Mental Health - **RA 11036: Mental Health Act** - An act establishing a National Mental Health policy for the purpose of enhancing the delivery of integrated mental health services, promoting and protecting the rights of persons utilizing psychosocial health services. - June 21, 2018 - The State shall comply strictly with its obligations under the United Nations Declaration of Human Rights - The applicability of Republic act No. 7277, as amended, otherwise known as the “Magna Carta for Disabled Persons" ### 4 Facets of Mental Health Problems as a Public Health Problem - **Defined Burden:** Burden of currently affecting persons with mental disorders - Quality of life indicators, Disability adjusted life years (DALY) - **Undefined Burden:** Portion of the burden relating to impact of mental health problems to person other than the affected individual directly affected - Felt by families and relatives of mentally ill - **Hidden Burden:** Stigma and violations of human rights - Rejection, shame: Suffered by mentally ill - **Future Burden:** Burden in the future resulting from the aging of the population, increasing social problems and unrest inherited from the existing burden ### Mental Health Services at a Community Level 1. Basic mental health services at all LGUs down to the barangay 2. Community resilience and psychosocial wellbeing training in all barangays, including the availability of mental health and psychosocial support services during and after natural disasters and other calamities 3. Training and capacity-building programs for local mental health workers in coordination with mental health facilities and departments of psychiatry in general or university hospitals 4. Support services for families and co-workers of mental health services 5. Dissemination of mental health information and promotion of mental health awareness among the general population ### National Prevention of Blindness Program - **Background:** - **Vision 2020**: The right to sight - Is a global initiative to eliminate avoidable blindness by the year 2020. - **Aim**: To develop sustainable comprehensive health care system to ensure the best possible vision for all people and thereby improve quality of life - **5 Priority Preventable/Treatable Conditions:** - Cataract - Refractive Errors and Low Vision - Trachoma - Onchocerciasis (African River Blindness) - Childhood Blindness - **Vision**: All Filipinos enjoy the right to sight by year 2020 - **Mission**: - Strengthen partnership among and with stakeholders to eliminate avoidable blindness in the Philippines - Empower communities to take proactive roles in the promotion of eye health and prevention of blindness - Provide access to quality eye care services for all ### Violence Against Women and Children (VAWC) - RA 9262 - Anti-violence Against Women and Their Children - Women and child are one of the vulnerable group of populations - Women are common victims of violence - As nurses, we provide immediate treatment and assess signs if violence - Follow up: Social worker - RA 9231: Special Protection of Children against Child Abuse, Exploitation, and Discrimination Act ### Older Adults in the Philippines - Article XV, section 4 of the 1986 Philippine Constitution which states “The family has the duty to care for its elderly - Expanded Senior Citizen Act, Senior Citizens Center were also established - The Expanded Senior Citizens Act of 2010: Republic Act No. 9994 ### Comparison of Benefits | RA 7432 | RA 9257 | RA 9994 | |---|---|---| | Exemption from ITR - Annual Taxable does not exceed P60k or such amount determined by NEDA | Exemption from ITR - Annual Taxable does not exceed the poverty level as determined by NEDA | a. Exemption from Income - Tax who are considered to be minimum wage earners under RA 9504. b. 20% discount and exemption from VAT | | 20% discount on transportation services, hotels and similar lodging establishments, restaurant, recreation centers, and purchases of medicine anywhere in the country | 20% discount from all establishments on services of hotels and similar lodging establishments, purchase of medicines for the exclusive use and enjoyment of SC, and funeral and burial services | | ### Ano ang Social Pension? - “Nakapaloob sa Republic Act 9994 o Expanded Senior Citizens Act of 2010 na ang mga indigent senior citizens, edad 60 at pataas, ay makatatanggap ng social pension na nagkakahalaga ng PhP 500 kada buwan.” - “Ito ay para makatulong sa pang-araw-araw nilang gastusin at pangangailangang medikal. Ito ay ipinapatupad ng Department of Social Welfare and Development (DSWD) katuwang ang Office of Senior Citizens Affairs (OSCA), City/Municipal Social Welfare and Development Office (C/MSWDO) at Senior Citizens Organizations.” ### Did You Know? - “RA 7277 - Magna Carta for Disabled Persons" is an act providing for rehabilitation, self-Development and self-reliance of disabled persons and their integration into the mainstream of society and for other purposes. - The rights and privileges of disabled persons: - Equal opportunity for employment - Access to quality education - National Health Program - Telecommunications - Accessibility (barrier-free environment) - Political and civil rights - Source: https://ots.gov.ph

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