Ch3 notes Flashcards
patient centered interviewing
following the patient’s lead to understand their thoughts, ideas, concerns and requests, without adding additional information from the doctor’s perspective
health history format
a structured framework for organizing patient information in written or verbal form
the techniques of skilled interviewing
active listening, empathetic responses, guided questioning, nonverbal communication, validation, reassurance, partnering, summarization, transitions, empowering the patient
active listening
the process of closely attending to what the patient is communicating, being aware of the patient’s emotional state, and using verbal and nonverbal skills to encourage the speaker to continue and expand upon important answers
empathy
the capacity of the clinician to identify with the patient and feel the patient’s pain as the clinician’s own
types of guided questioning
- moving from open ended to focused questions
- using questioning that elicits a graded response
- asking a series of questions, one at a time
- offering multiple choices for answers
- clarifying what the patient means
- encouraging with continuers
- using echoing
preparation steps that are crucial to success
reviewing the medical record, setting goals for the interview, reviewing your behavior and appearance, and adjusting the environment
the sequence of the interview
- greeting the patient and establishing rapport
- establishing the agenda
- inviting the patient’s story
- exploring the patient’s perspective
- identifying and responding to the patient’s emotional cues
- expanding and clarifying the patient’s story
- generating and testing diagnostic hypotheses
- sharing the treatment plan
- closing the interview
- taking time for self-reflection
disease
the explanation that the clinician brings to the symptoms
illness
how the patient experiences all aspects of the disease
FIFE
the patient’s Feelings, including fears or concerns about the problem
the patient’s Ideas about the nature and the cause of the problem
the effect of the problem on the patient’s life and Function
the patient’s Expectations of the disease, of the clinician, or of health care, often based on prior personal or family experiences
Acronym for responding to emotional cues
Naming, Understanding/legitimization, and Respecting
big four lifestyle habits
smoking, excessive drinking, lack of exercise, and unhealthy diet
motivational interviewing
- ask open ended questions - invite the patient to consider how and why they might change
- listen to understand your patient’s experience
- inform by asking permission to provide information, and then asking what the implications might be for the patient
cultural competence
a set of attitudes, skills, behaviors, and policies that enable organizations and staff to work effectively in cross-cultural situations
cultural humility
a process that requires humility as individuals continually engage in self-reflection and self-critique as lifelong learners and reflective practitioners
culture
the system of shared ideas, rules, and meanings that influences how we view the world, experience it emotionally, and behave in relation to other people
what are the three dimensions of cultural humility?
self awareness, respectful communication, and collaborative partnerships
self awareness
learn about your own biases
respectful communication
work to eliminate assumptions about what is normal
collaborative partnerships
build your patient relationships on respect and mutually acceptable plans
values
the standards we use to measure our own and other’s beliefs and behaviors
biases
the attitudes or feelings that we attach to perceived differences
what do you do if the patient is silent?
watch for non verbal cues
