It is important to determine whether the patient is a smoker, an ex-smoker or a lifelong non-smoker. If the patienl smokes, the following information is required: form (cigarettes.
TABLE 1.8 The social history: areas of potential relevance
Birth injury or complications Early parental attachments and disruptions Schooling, academic achievements - difficulties Behavioural problems
Home life: emotional, physicai or sexual abuse' experiences of death and Illness interest and attitudes ol parents
Further education/occupation Higher education and further training
Occupation: current and previous exposure to hazard, e.g. chemicals, foreign travel, accidents and compensation claims Unemployment - duration and reason Attitudes to jab or unemployment
Financial circumstances including loss of Income and debts
Marital status: quality of relationship and any problems spouse's occupation, and attitudes to the patient's illness Sexual identity - any problems
Other occupants ol the house - any problems, e.g. violence, health and bereavement
lype ol home - size, owned or rented problems with the house neighbours Supporting friends or family
Community support: social and health services Involvement pastoral support and church involvement and other voluntary groups Attitudes to help being provided or offered
Habits Tobacco Alcohol Caffeine Illicit drugs
"Note: Inquiring about sexual abuse requires training and experience. and should be conducted, when indicated, by an appropriately trained clinician.
cigars or pipe); quantity (number of cigarettes/cigars or amount of pipe tobacco per day); duration. If the patient is an ex-smoker, the length of time since the practice ceased should be noted. Staining on the fingers or teeth should raise strong suspicion thai the patienl is or until recently was a heavy smoker. In smokers, the possibility of tobacco-related disease should be considered (Fig. 1.8).
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Many women who have recently given birth are always interested in attempting to lose some of that extra weight that traditionally accompanies having a baby. What many of these women do not entirely realize is the fact that breast-feeding can not only help provide the baby with essential vitamins and nutrients, but can also help in the weight-loss process.