Ch3 notes

Question 1

patient centered interviewing

Answer 1

following the patient’s lead to understand their thoughts, ideas, concerns and requests, without adding additional information from the doctor’s perspective

Question 2

health history format

Answer 2

a structured framework for organizing patient information in written or verbal form

Question 3

the techniques of skilled interviewing

Answer 3

active listening, empathetic responses, guided questioning, nonverbal communication, validation, reassurance, partnering, summarization, transitions, empowering the patient

Question 4

active listening

Answer 4

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

Question 5

empathy

Answer 5

the capacity of the clinician to identify with the patient and feel the patient’s pain as the clinician’s own

Question 6

types of guided questioning

Answer 6

• 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

Question 7

preparation steps that are crucial to success

Answer 7

reviewing the medical record, setting goals for the interview, reviewing your behavior and appearance, and adjusting the environment

Question 8

the sequence of the interview

Answer 8

1. greeting the patient and establishing rapport
2. establishing the agenda
3. inviting the patient’s story
4. exploring the patient’s perspective
5. identifying and responding to the patient’s emotional cues
6. expanding and clarifying the patient’s story
7. generating and testing diagnostic hypotheses
8. sharing the treatment plan
9. closing the interview
10. taking time for self-reflection

Question 9

disease

Answer 9

the explanation that the clinician brings to the symptoms

Question 10

illness

Answer 10

how the patient experiences all aspects of the disease

Question 11

FIFE

Answer 11

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

Question 12

Acronym for responding to emotional cues

Answer 12

Naming, Understanding/legitimization, and Respecting

Question 13

big four lifestyle habits

Answer 13

smoking, excessive drinking, lack of exercise, and unhealthy diet

Question 14

motivational interviewing

Answer 14

• 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

Question 15

cultural competence

Answer 15

a set of attitudes, skills, behaviors, and policies that enable organizations and staff to work effectively in cross-cultural situations

Question 16

cultural humility

Answer 16

a process that requires humility as individuals continually engage in self-reflection and self-critique as lifelong learners and reflective practitioners

Question 17

culture

Answer 17

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

Question 18

what are the three dimensions of cultural humility?

Answer 18

self awareness, respectful communication, and collaborative partnerships

Question 19

self awareness

Answer 19

learn about your own biases

Question 20

respectful communication

Answer 20

work to eliminate assumptions about what is normal

Question 21

collaborative partnerships

Answer 21

build your patient relationships on respect and mutually acceptable plans

Question 22

values

Answer 22

the standards we use to measure our own and other’s beliefs and behaviors

Question 23

biases

Answer 23

the attitudes or feelings that we attach to perceived differences

Question 24

what do you do if the patient is silent?

Answer 24

watch for non verbal cues

Question 25

what do you consider if a patient is confusing

Answer 25

delirium in acutely ill or intoxicated patients and dementia in the elderly

Question 26

decision making capacity

Answer 26

the ability to understand information related to health, to make medical choices based on reason and a consistent set of values, and to declare preferences about treatments

Question 27

how do you focus a talkative patient?

Answer 27

ask them what their top concern in

Question 28

Guidelines for working with an interpreter

Answer 28

Introductions, Note goals, Transparency, Ethics, Respect beliefs, Patient focus, Retain control, Explain, Thanks

Question 29

guidelines for broaching sensitive topics

Answer 29

• the single most important rule is to be nonjudgmental

- explain why you need to know certain information

Question 30

tolerance

Answer 30

a state of adaption in which exposure to a drug induces changes that result in a dimunition of one or more of the drug’s effects over time

Question 31

physical dependence

Answer 31

a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of the antagonist

Question 32

addiction

Answer 32

a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug abuse, compulsive use, continued use despite harm, and craving

Question 33

5 stages in response to the loss or anticipatory grief or impending death

Answer 33

denial and isolation, anger, bargaining, depression or sadness, and acceptance

Question 34

ethics

Answer 34

a set of principles crafted through reflection and discussion to define right and wrong