一位 65 歲男性病人表示有興趣改善心血管健康，護理師在進行評估時，應強調哪項「初級預防」（Primary Prevention）措施？
A nurse is assessing a 65-year-old male client who is interested in improving his cardiovascular health. Which primary prevention intervention should the nurse emphasize?
- ATaking a low-dose aspirin daily to prevent a first heart attack.每日服用低劑量阿斯匹靈以預防首次心肌梗塞
- BMonitoring blood pressure daily at home.每日在家監測血壓
- CScheduling a cardiac stress test next week.安排下週進行心臟壓力測試
- DParticipating in a daily 30-minute brisk walking program.✓ 正解參與每日三十分鐘的快走運動
健康促進中的預防層次分為：初級（預防疾病發生）、次級（早期篩檢與診斷）、末級（減少失能與康復）。初級預防（Primary Prevention）的目標是透過健康生活形態來預防疾病的產生。選項 D（規律運動）是典型的初級預防，旨在透過強化生理功能來防止心血管疾病發生。選項 C（壓力測試）和選項 B（監測血壓）屬於次級預防，目的是在疾病徵兆出現時進行早期偵測。選項 A（預防性阿斯匹靈）在目前的臨床指引中爭議較多，且對於無風險的 65 歲老人，不再被視為首選的初級預防方式。因此，運動是護理師最應優先推薦的基礎健康促進策略。
Levels of prevention in health promotion are: primary (preventing the onset of disease), secondary (early screening and diagnosis), and tertiary (reducing disability and rehabilitation). The goal of primary prevention is to prevent disease through a healthy lifestyle. Option D (regular exercise) is a classic primary prevention measure aimed at strengthening physiologic function to prevent cardiovascular disease. Options B (stress test) and B (blood pressure monitoring) belong to secondary prevention, intended for early detection when signs of disease are present. Option A (prophylactic aspirin) is controversial in current clinical guidelines and is no longer considered a first-line primary prevention strategy for a 65-year-old without identified risk. Therefore, exercise is the foundational health promotion strategy the nurse should recommend first.
在美國，護理師常利用社區資源（如銀髮族運動計畫）來推廣初級預防；在台灣，長照 2.0 的「健康促進」站也提供類似服務。兩地臨床護理師皆須注意，阿斯匹靈的初級預防指引近年有重大更新，不可照舊有的觀念進行衛教。