Chp 21 III The clinical Interview

Question 1

What factors play a great role in “The Clinical Interview”

Answer 1

1. Communication skills

2. Utilisation of specific interviewing techniques

Question 2

1. Communication skills

Name 4 benefits & reasons why it is important

Answer 2

1. through good physician-patient communication skills: Patient adherence with medical advice, detection of both physical and psychological problems, and patient satisfaction with the physician improve
2. Physician Skill of how to interview patient:
   a. private setting
   b. no obstacles between Dr. & Pt
   c. eye level participation
   d. trust & rapport needs to be established between both
   e. gathering “History of Physical/Psychological/social info” to identify pt problems
   f. Dr. to educate the Pt about the illness & motivate Pt to adhere to management recommendations
   g. If Pt is dangerous or threatening: gather hospital security
3. Interview should obtain: the Pt’s Psychiatric history/prior mental problems, drug&alcohol use, sexual activity, current living situation, source of stress
4. Young children interview:
   drawing pictures w/ child to establish comfort
   use open ended questions: eg: what is your sis name rather then tell me about your family Ask questions in third person “ why do you think this little boy is sad”

Question 3

Name 5 Factors Associated with Increase in Adherence to Medical Advice

Answer 3

1. Good physician–patient relationship
2. Short time pent in the waiting room
3. Written diagnosis and instructions for management
4. Recommending only one behavioral change at a time
5. Older physician

Question 4

Name 5 Factors Associated with Decrease in Adherence to Medical Advice

Answer 4

1. Poor physician–patient relationship
2. Long time spent in the waiting room
3. Verbal diagnosis and instructions for management
4. Recommending multiple behavioral changes at once
5. Younger physician = feeling of lack of experience & knowledge

Question 5

What are some specific interview techniques

Answer 5

1. Direct questions used to elicit specific information quickly form Pt during emergency situation eg: have you been shot?
2. Open-ended questions: obtain info about pt without closing off potential areas of import info

Question 6

Provide some examples of Specific Interviewing Techniques

Answer 6

1. Support & Empathy
2. Validation
3. Facilitation
4. Reflection
5. Silence
6. Confrontation
7. Recapitulation

Question 7

Ex of Support & Empathy

Answer 7

“You must have really been frightened when you realized you were going to fall.”

Question 8

Ex of Validation

Answer 8

“Many people would feel the same way if they had been injured as you were.”

Question 9

ex of Facilitation

Answer 9

“Please tell me more about what happened after your fall.”

Question 10

ex of Reflection

Answer 10

“You said that your pain increased after lifting the package?”

Question 11

ex of Silence

Answer 11

Waiting silently for the patient to speak

Question 12

ex of Confrontation

Answer 12

“You say that you are not worried about tomorrow’s surgery, but you seem really upset to me.”

Question 13

ex of Recapitulation

Answer 13

“Let’s go over what you told me. You fell last night and hurt your side.Have I gotten it right?”