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5. to enhance the patients integration into the family and community and
6. to evolve a model for the total health care of the rural aged.

Preparatory Phase (April 1984-July 1984)

The Primary Health Centre at Kallandiri, 17 kms from Madurai was chosen as the base for the study. Kallandiri PHC with its 17 sub-centres caters to the population of 97,000 with an estimated population of 4656 aged 60 and above (1981 census; Area Map attached). The first four months were utilised towards the Organisation of Geriatric Clinic at Kallandiri PHC premises with the permission from Directorate of Primary Health Centre, Govt. of Tamil Nadu, seeking the co-operation of PHC staff, recruitment of project staff and in training in administering the specially developed schedules. A special study proforma (Appendix I), a screening schedule with 45 symptoms, (modified form from Phase I-Section II, Appendix I), ICMR scale for measuring Socio-economic Status, Family and social Integration Assessment Schedules (weighted and modified from the one used in the Phase I study-Appendices II, III) and an Intervention Schedule were evolved. Khatri's Family Jointness Scale was utilised for assessing the degree of Family Jointness. Besides the services of the consultants at the Government Rajaji Hospital, Madurai, the services of the following were utilised for intervention: The District Tuberculosis Officer, ICMR Tuberculosis Research Centre, Govt. Rajaji Hospital and the District Leprosy Officer, Madurai.

Training Programme for PHC Medical Officers & MPHWs

The PHC Medical Officers were imparted suitable training to develop necessary skills in detection, management and referral of the common medical and psychiatric problems in the rural aged. The staff from Madurai Medical College, (specialists in various fields) offered their services towards this Programme. This included didactic lectures as well as case demonstrations.

An evaluation questionnaire (Appendix IV) was developed to test the skills achieved and knowledge gained by the PHC Medical Officers at the completion of training. The data was compared with the finding on PHC Medical Officers from outside the catchment area of Kallandiri PHC. The multi choice questionnaire (MCQ) consisted of 80 questions pertaining to all the fields in which training was imparted (psychiatry, Central Nervous System, Internal Medicine, Cardiovascular, Ophthalmology, ENT, Oncology, Respiratory, Urology, Rheumatology, Dermatology).

The training material was pretested on three medical officers from three different PHCs other than Kallandiri viz., Muthanendal, Thirupparankundram and Samayanallur PHCs. One mark was allotted to each of the 80 questions in the evaluation questionnaire with a maximum of 80 marks. The total marks obtained by the three medical officers put together in every field in which training was imparted were recorded separately. After the training programme for Kallandiri PHC MO's was completed, the same evaluation questionnaire was administered to the three medical officers of Kallandiri PHC and their total marks obtained in every field in which the training was imparted were recorded separately. The analysis of the performances

 Khatri, A. A. (1970) Manual of Scale to measure Jointness of families in India. B. M. Institute, Ahmedabad, India.
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