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HOW TO COUNSEL A PATIENT? 
JAIN, Peeyush 
Escort Heart Institute and Research Centre, New Delhi

For a number of health related behaviours (e.g., smoking problem, drinking, and physical inactivity), there is evidence that physicians can change patient behaviour by simple counselling. For many other behaviours, the effectiveness of clinician counselling has been demonstrated only over the short term or in specialized settings involving intensive counselling. Patient education involves more than telling people what to do or giving them an instructional pamphlet. The basic principles guiding physician based counselling are: (i) Frame the teaching to match the patient's perception, (ii) Fully inform patients of the purposes and expected effects of interventions and when to expect these effects, (iii) Suggest small changes, rather than large ones, (iv) Be specific, (v) It is sometimes easier to add new behaviours than to eliminate established behaviours, (vi) Link new behaviours to old behaviours, (vii) Use the power of profession, (viii) Get explicit commitments from the patients, (ix) Use a combination of strategies, (x) Involve office staff, (xi) Refer when appropriate and (xii) Monitor progress through follow-up contact.


CONCEPT OF A HEALTHY PERSON AND HEALTH-ILLNESS BEHAVIOUR IN BHOPAL SLUMS
JAIN, Uday 
Barkatullah University, Bhopal 

Present paper aims to discuss a shared concept of a healthy person in a community and its relationship with health-illness behaviour. A sample of one hundred housewives from two slums of Bhopal were interviewed about the characteristics of a healthy person in their families and their activities related to prevention care, treatment, consultation of physicians and knowledge of folk medicines. Results suggest that absence of illness and feelings of happiness are the main characteristics of a healthy person as reported by the respondents. A sizable number of respondents still use folk medicines in the treatment of common diseases, however, consultancy with a physician after 2-3 days' onset of illness is increasing. For prevention of disease the respondents reported observance of possible cleanliness in the house. These results are discussed in the light of health-behaviour model.


FAMILY REACTIONS IN THALASSEMIA. 
JAMAL, Gulgoona & GUPTA, Ashum 
University of Delhi   

The study investigated parents' (N=40) view on the effects of family life post diagnosis, their satisfaction with service, the support they needed and obtained, the cognitive appraisal and their ability to cope with thalassemia. Levels of parental psychological distress were assessed, using the Malaise Inventory. About 70 per cent of mothers and 50 per cent of fathers scored high on emotional distress. Negative effects on parental employment, financial condition and family relationships, lack of emotional support, lack of cognitive appraisal and inability to cope were associated with higher levels of distress.


PERCEPTIONS OF QUALITY OF ENVIRONMENT 
KAPOOR, S.K. & BROOTA, K.D.
University of Delhi 

Simmel (1930) put forward the idea that living in a city was a source of psychological disturbance in the sense that excess of information forced the individual to protect himself by filtering out stimuli and avoiding social contacts. Pollution can effect human health over a broad range of biological responses (Newill, 1974). The perceived quality of an environment is part of the overall perception. The notion of negative environment quality was used, specifically four forms of pollution: water, air, crowding and noise pollution. The objective of the study is to investigate whether the subjects do perceive pollution and what are the specific perceptions they hold towards it. An environmental perception test was constructed which consisted of a set of 20 photographs: 5 each of water, air, crowding and nose pollution. Eighty subjects were included in the sample who were divided according to age, income level and gender. Results showed that students exhibited greater sensitivity of perception towards environmental quality than the middle-aged sample, the middle-income sample was found to possess a greater sensitivity towards environmental quality as compared to the lower income group; the water and air forms of pollution elicited greater sensitivity of perception as compared to crowding and noise pollution.


ANXIETY, SELF-ESTEEM AND SOCIAL FUNCTIONING IN ADOLESCENTS WITH THALASSEMIA 
KAUR, Satinder & GUPTA, Ashum 
University of Dlehi

Thalassemic children's trait anxiety and self esteem perception of social and school functions and their concerns about illness and expectations for the future were compared with those of healthy children of the same age and social background. They were more often absent from school, their leisure activity was more sedantary, had lesser ability to run and had a tendency to fall ill more often and were more pessimistic about future. The importance of perspective on serious disease upon day-to-day functioning, as opposed to emphasizing inferred psychological deviance needs to be emphasized.

ABSTRACTS
(SAAP-Delhi Con.-1999)
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