Non-Communicable Diseases and Rehabilitation

Prevention and Control of Cardiovascular Diseases
  • heart – 1st leading cause of death ; blood vessels – 2nd
  • Congenital Heart Disease (CHD): Result of the abnormal development of the heart that exhibits septal defect, patent ductus arteriosus, aortic and pulmonary stenosis, and cyanosis; most prevalent in children
    • Causes: environmental factors, maternal diseases or genetic aberrations
  • Rheumatic Fever or Rheumatic Heart Disease: Systematic inflammatory disease that may develop as a delayed reaction to repeated and an inadequately treated infection of the upper respiratory tract by group A beta-hemolytic streptococci.
  • Hypertension: Persistent elevation of the arterial blood pressure.(primary or essential) ;frequent among females but severe, malignat form is more common among males
  • Ischemic Heart Disease/ Atherosclerosis: Condition usually caused by the occlusion of the coronary arteries by thrombus or clot formation.
    • higher among males than females for the latter are protected by estrogen before menopause
    • Predisposing Factor: Hypertension (HPN),Diabetes Mellitus (DM), Smoking
    • Minor Risk Factor: stress, strong family history, obesity
Cardiovascular Disease
 Period of Life  Type of CVD  Prevalence
 At birth to early childhood Congenital Heart Disease  2/ 1000 school children (aged 5-15 yrs. old)
 Early to late childhood Rheumatic Fever/ Rheumatic Heart Disease  1/1000 school children (aged 5-15 yrs. old)
 Early Adulthood Diseases of Heart Muscles Essential Hypertension  10/100 adults
 Middle age to old age Coronary Artery Disease  Cerebrovascular Accident  5/100 adults
Cardiovascular Disease
 Diseases  Causes/ Risk factors
Congenital Heart Disease Maternal Infections, Drug intake, Maternal Disease, Genetic
Rheumatic Fever/Rheumatic Heart Disease Frequent Streptoccocal Sore Throat
Essential Hypertension Heredity, High Salt Intake
Coronary Artery Disease
(Heart Attack)
Smoking, Obesity, Hypertension, Stress Hyperlipidemia, Diabetes Mellitus Sedentary Life Style
Cerebrovascular Accident
Hypertension, Arteriosclerosis
Primary Prevention: CVD
 Disease  Primordial  Specific Protection
Congenital Heart Disease
  • Prevention of viral infection and intake of harmful drugs during pregnancy.
  • Avoidance of marriage between blood relatives
  • Adequate treatment of viral infection during pregnancy.
  • Genetic counseling of blood related married couples.
Rheumatic Heart Disease
  •  Prevention of recurrent sore throat thru adequate environmental sanitation; avoidance of overcrowding; adequate treatment
  • Identification of cases of rheumatic fever
  • Prophylaxis with penicillin or erythromycin
Essential Hypertension
  • From early childhood
    • low salt diet
    • adequate physical exercise
  • Continued low salt diet and adequate exercise
Coronary Heart Disease (Heart Attack)
  • Prevention of development/ acquisition of risk factors
    • cigarette smoking
    • high fat intake
    • high salt intake
  • cessation of smoking
  • control /treatment of diabetes, hypertension
  • weight reduction
  • change to proper diet
  • Adjustment of activities
Cerebrovascular Accident
  •  all measures to prevent hypertension & arteriosclerosis
  • all measures to control hypertension & progression of arteriosclerosis
Primary Prevention thru health education is the main focus of the program:
  1. Maintenance of ideal body wt.
  2. diet – low fat
  3. alcohol/smoking avoidance
  4. exercise
  5. regular BP check up
Cancer Prevention and Early Detection
  • Any malignant tumor arising from the abnormal and uncontrolled division of cells causing the destruction in the surrounding tissues.
  • Common Cancer: Lung cancer, cervical cancer, colon cancer, cancer of the mouth, breast cancer, skin cancer, prostate cancer.
  • 3rd leading cause of illness and death (Phil.)
  • Incidence can only be reduced thru prevention and early detection
Nine Warning Signs of Cancer:
  • Change in blood bowel or bladder habits
  • A sore that does not heal
  • Unusual bleeding or discharge
  • Thickening or lump in breast or elsewhere
  • Indigestion or difficulty in swallowing
  • Obvious change in wart or mole
  • Nagging cough or hoarseness
  • Unexplained anemia
  • Sudden unexplained weight loss
Prevention & Early Detection
 CA type  Prevention  Detection
 Lung No smoking None
 Uterine Monogamy, Safe sex Pap’s smear every 1-3 yrs
 Cervical Monogamy, Safe sex Pap’s smear every 1-3 yrs
 Liver Hep B vaccination, Less   alcohol intake, Avoidance of moldy foods None
 Colon High fiber diet  Regular medical checkup
after 40 yrs of age
 Rectum Low fat intake  Fecal occult blood test DRE Sigmoidoscopy
 Mouth No smoking, betel nut chewing, Oral hygiene Regular dental check-ups
 Breast none Monthly SBE, Yearly exam by doctor, Mammography for 50 yrs old and above females
 Skin No excessive sun exposure Assessment of skin
 Prostate none Digital transrectal exam
Principles of Treatment of Malignant Diseases
  • One third of all cancers are curable if detected early and treated properly.

Three major forms of treatment of cancer:

  1. Surgery
  2. Radiation Therapy
  3. Chemotherapy
Nat’l Diabetes Prevention and Control Program
  • Controlling and assimilating healthy lifestyle in the Filipino culture (2005- 2010) thru IEC
Main Concern:
  • modifiable risk factors ( diet, body wt., smoking, alcohol, stress, sedentary living, birth wt. ,migration
Prevention and Control of Kidney Disease
  1. Acute or Rapidly Progressive Renal Failure : A sudden decline in renal function resulting from the failure of the renal circulation or by glomerular or tubular damage causing the accumulation of substances that is normally eliminated in the urine in the body fluids leading to disruption in homeostatic, endocrine, and metabolic functions.
  2. Acute Nephritis: A severe inflammation of the kidney caused by infection, degenerative disease, or disease of the blood vessels.
  3. Chronic Renal Failure: A progressive deterioration of renal function that ends as uremia and its complications unless dialysis or kidney transplant is performed.
  4. Neprolithiasis: A disorder characterized by the presence of calculi in the kidney.
  5. Nephrotic Syndrome: A clinical disorder of excessive leakage of plasma proteins into the urine because of increased permeability of the glomerular capillary membrane
  6. Urinary Tract Infection: A disease caused by the presence of pathogenic microorganisms in the urinary tract with or without signs and symptoms.
  7. Renal Tubular Defects: An abnormal condition in the reabsorption of selected materials back into the blood and secretion, collection, and conduction of urine.
  8. Urinary Tract Obstruction: A condition wherein the urine flow is blocked or clogged.
Program on Mental Health and Mental Disorders
Mental Health
  • Mental health is not merely the absence of mental illness. According to the World Health Organization (WHO) Manual on Mental Health, a person is in a state of sound mental health when,
    • He feels physically well
    • His thought are organized
    • His feelings are modulated
    • His behaviors are coordinated and appropriate (*note: behaviors considered “normal” may vary according to cultural norms)
  • Any person may develop mental illness regardless of race, nationality, age, sex civil status and socio-economic background may develop mental illness.
Causes of Mental Illness

A Combination or One of These:

  1. Biological factors
    • Like hereditary predisposition, poor nutrition
  2. Physical Factors
    • Physical injuries, intoxication
  3. Psychological Factors
    • Failure to adjust to the difficulties in life.
  4. Socio-economic Factors
    • Unemployment, housing problems

How is Mental Illness Detected?

  1. Interview and assessment by the Clinical Social Worker.
  2. Psychological testing and evaluation.
  3. Psychiatric interview and mental status examination.

Is Mental Illness Curable?

  • Yes. Mental illness is curable if detected early and prompt and adequate treatment is given. Treatment depends on severity of illness and includes:
    • Pharmacotherapy (use of medicines)
    • Various therapies (physical, recreational, occupational, environmental)
    • Psychotherapy and others
Prevention of Mental Illness
  1. Maintain good physical health.
  2. Choose worthwhile activities and develop a hobby
  3. Solve problems as they come and avoid excessive worrying.
  4. Cultivate friendships and choose a friend to confide in.
  5. Strike a happy medium between work and play.
  6. Recognize early signs and symptoms.
Some Early Signs of Symptoms Mental Illness
  • Persistent disturbance in sleep and appetite
  • Over sensitiveness and excessive irritability
  • Loss of interest in activities or responsibilities of previous concern
  • Constant complaint of headaches, weakness of hands and feet and other bodily complaints.
  • Persistent seclusion of oneself from other people.
  • Frequent attacks of palpitations usually expressed as “nerbiyos” & associated with unexplained fears.
  • Frequent attacks of dizziness & fainting.
  • Exaggerated and /or unfounded suspicions
  • Persistent worrying, forgetfulness & absentmindedness.
Program on Drug Dependence/ Substance Abuse
Community-Based Rehabilitation Program
  • A creative application of the primary health care approach in rehabilitation services, which involves measures taken at the community level to use and build on the resources of the community with the community people, including impaired, disabled and handicapped persons as well.
  • To improve the quality of life and increase productivity of disabled, handicapped persons.
  • To reduce the prevalence of disability through prevention, early detection and provision of rehabilitation services at the community level.
Program on the Elderly/Geriatric Nursing Services
Leading causes of illness: elderly
  • Influenza, HPN, diarrhea,
  • bronchitis, TB, diseases. of the heart,
  • pneumonia, malaria,
  • malignant neoplasm, chickenpox
Leading causes of death: elderly
  • Diseases of heart and vascular system
  • Pneumonia, TB, CCOPD
  • Malignant neoplasms
  • Diabetes
  • Nephritis
  • Accidents
Programs on Blindness, Deafness and Osteoporosis
  • Cataract- main causes of blindness
  • VAD- main cause of childhood blindness; most serious eye problem of Filipino children below 6 yrs. old
  • Osteoporosis special problem in women, highest bet. 50—79 yrs. old, MENOPAUSE main cause