Особенности личностного и семейного функционирования родственников наркозависимых - Виктор Викторович Бочаров
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Приложение 1
Клиническая карта для родителей больного
1. Пол
• мужской (1)
• женский (2)
2. Возраст
3. Образование
• неполное среднее (1)
• среднее (2)
• среднее специальное (3)
• незаконченное высшее (4)
• высшее (5)
4. Трудовая деятельность
• не работаю в настоящее время (1)
• работаю в настоящее время (2)
5. Семейное положение
• холост (1)
• замужем (2)
6. Характер отношений с супругом
• дружеские (1)
• нейтральные (2)
• конфликтные (3)
• отчужденные (4)
7. Количество детей
8. Наличие аддиктивной патологии
• да (1)
• нет (2)
9. Наличие соматических заболеваний
• да (1) _______________
• нет (2)
10. Наличие ВИЧ-инфекции
• да (1)
• нет (2)
11. Наличие психических заболеваний
• да (1) _______________
• нет (2)
12 Наличие судимости
• нет (1)
• да (2)
• несколько (3)
13. Отбывал ли
