dördüncül koruma ve aşırı medikalizasyon

Year 2023, Volume: 17 Issue: 4 - Turkish Journal of Family Medicine and Primary Care, 572 - 581, 19.12.2023

Uğur Büyükokudan , Kadriye Avcı

https://doi.org/10.21763/tjfmpc.1329929

Abstract

Dördüncül koruma, aşırı tıbbi medikalizasyon riski altındaki kişilerin belirlenmesi ve hastaların gereksiz tıbbi müdahalelere karşı korunmalarını içerir. Günümüzde gelişen teknoloji ve artan sağlık hizmeti kullanımıyla beraber, hastalara gereksiz aşırı teşhis ve aşırı tedavi uygulanabilmektedir. Aşırı medikalizasyon kavramı ise, hastalara sağladığı faydalar açısından doğrulanmamış, potansiyel olarak zararlı ve bu nedenle gereksiz maliyetlere yol açan tıbbi uygulamalar olarak tanımlanmaktadır. Bunlar hastalarda sosyal, psikolojik ve ekonomik yönden olumsuz etkilenme; sağlık sisteminde ise memnuniyetsizlik ve ekonomik yükü arttırmaktadır. İnsanların tüm yaşamları boyunca tıbbi müdahalelerden zarar görebileceği düşünüldüğünde, dördüncül koruma ve aşırı medikalizasyon kavramı bu bağlamda büyük önem taşımaktadır. Aşırı medikalizasyonu azaltmak ve dördüncül korumayı sağlamak için; hastaların karar verme sürecine katılımı ve ortak karar alma, güvenilir hasta-hekim ilişkisi kurulması, birinci basamak sağlık hizmetlerinin teşvik edilmesi ve sevk sisteminin düzenlenmesi önem taşımaktadır.

Keywords

medikalizasyon, koruyucu sağlık hizmetleri, koruyucu hekimlik

quaternary prevention and over-medicalization

Abstract

Quaternary prevention involves identifying patients who are at risk of over-medicalization and protecting patients from unnecessary medical intervention. In fact, patients are currently at risk of unnecessary over-diagnosis and over-treatment as technology progresses and the use of health-care services grows. Over-medicalization is described as medical treatments that have not been validated in terms of patient benefits, are potentially detrimental, and so incur unnecessary expenses. These have a negative social, psychological, and economic impact on patients, while also increasing dissatisfaction and the financial burden on the health-care system. Given the potential for long-term harm from medical interventions, the concept of quaternary prevention and over-medicalization is significant in this particular setting. Patients' engagement in decision-making and shared decision-making, building a trustworthy patient-physician relationship, expanding primary health care services, and regulating the referral system are all crucial to minimizing over-medicalization and providing quaternary prevention.

Keywords

medicalization, Preventive Health Services, Preventive medicine

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