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week 63 > Diagnostic processing & Patient history-Pafford > Flashcards

Diagnostic processing & Patient history-Pafford Flashcards

1
Q

What must be found before treatment planning?

A

Accurate diagnostic information

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2
Q

What is the foundation of the diagnostic process?

A

Data collection (information gathering)

  • different types
  • must be complete and accurate
  • form a specific patient database of info that helps with future decisions
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3
Q

What is included in data collection

A
  • findings from asking questions
  • observing and examining structures
  • diagnostic tests
  • consults w/physicians, dentists, specialists
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4
Q

What type of information is obtained during data collection?

A
  • patient history
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5
Q

What information is obtained obtained in patient history?

A
  • dentist learns everything about their patient before they begin treatment
  • dentist has to be an investigator
  • no set amount of historical information required
  • volume and complexity of information collected is dependent on the patients problems, goals, wishes, and lifestyle factors
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6
Q

Components of patient history

A
  • Demographic data
  • chief complaint
  • History of Present Illness
  • Past medical history (general health history)
  • Past dental history (Oral health history)
  • Psychosocial history
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7
Q

What information is collected regarding demographic data

A
  • name
  • address
  • phone #
  • physicians name
  • 3rd party information=insurance
  • SSN
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8
Q

What information is recorded as a patient’s chief complaint

A
  • primary reason for visit
  • symptom or request in patients own word
  • pay careful attention to this statement
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9
Q

What information is collected as history of present illness

A
  • history of chief complaint
  • sometimes requires prompting to get the details
  • should include:
    • time frame
    • description
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10
Q

What information is collected in past medical history(General health History)?

A
  • Comprehensive health history
    • review of all the patients past and present illnesses
    • Review of systems (ROS)
    • meds (OTC and Rx)
  • allows dentist to recognize health problems that may affect dental treatment
  • info suggestive of new problems that were previously unrecognized, undiagnosed, or untreated
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11
Q

What information is collected in past dental history?

A
  • Asks questions like:
    • date of last dental visit/exam
    • frequency of dental visits
    • if infrequent why?
    • types of treatment received?
    • history of any problems while receiving dental care
    • oral hygiene practices
    • problems with previous dental visits
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12
Q

What information is collected in psychosocial history/social history/family history?

A
  • investigate the patients attitude about the profession, including priorities, expectations, and motivations for seeking care
  • financial status/occupation
  • available time for tx
  • mode of transportation for dental visits
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13
Q

What information is obtained during a clinical exam?

A
  • Comprehensive clinical exam includes:
    • physical examination (PE)
    • Intraoral and extra oral soft tissue examination (IEOE)
    • periodontal examination
    • Examination of teeth (hard tissue exam()
    • Radiographic exam
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14
Q

Dental findings can include

A
  • Sings
  • symptoms
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15
Q

What are signs

A
  • findings discovered by the dentist during examination
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16
Q

What are symptoms

A
  • Signs reported by the patient bc they are causing problems
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17
Q

What is the purpose of the First Data Collection Appointment?

A
  • Health History
  • health questionnaire provides information about a patients well begging and highlights any potential problems
    • local and systemic conditions that may affect tx
  • any positive responses or questionable answers should be explored during the patient interview
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18
Q

What is the purpose of the patient interview during the first data collection appointment?

A
  • establish a rapport with patient
  • address physical problems that may affect tx
  • determine the patients expectations for restorative care
  • patients psychological make up will influence the difficulty of the clinical tx and success or failure of tx outcomes
19
Q

What are Dr. M. M. House 4 classification of patients?

A
  1. Philosophical
  2. Exacting
  3. Hysterical
  4. Indifferent
20
Q

What is a philosophical patient

A
  • Mentally well adjusted
  • easy going
  • accept responsibility for their lost teeth
  • little trouble to the dentist
21
Q

What is a Exacting Patient?

A
  • Highly demanding
  • Perfectionist
  • high expectations
    • dentist should set clear expectations
  • additional appointment time may be needed to meet patients demand, time, effort, patience
22
Q

What is a Hysterical patient?

A
  • Apprehensive
  • complain without justification
  • do not accept responsibility for dental condition
  • debilitating systemic or psychological diseases
  • minimal probability of success unless attitude changes
23
Q

What is an indifferent patient?

A
  • lack of motivation or concern for their condition
  • ignore instructions
  • uncooperative during treatment
  • poor prognosis unless patient becomes accountable and responsible
24
Q

How can we ascertain the patients expectations

A
  • Listen, don’t lecture
  • observe the patients body language
  • speak to the person in terms they can understand and appreciate
25
Q

What are some things to do during patients interview?

A
  • dentists attitude and behavior can have a direct impact on the success of treatment
  • face the patient
    • at eye level
  • make eye contact
  • demonstrate active listening
    • appropriate head nodding
    • verbal following
      • short responses “I see” “I understand”
    • verbal reflection
      • paraphrasing to demonstrate understanding
26
Q

What are ways to collect patient history?

A
  • Questionnaire and Forms
  • Patient intervies
27
Q

What should you observe about patients during the patient interview?

A
  • Speech difficulties
  • Neuromuscular deficits
  • Lip length, mobility, support
  • facial changes that indicate a decreased VDO
28
Q

What are the pros and cons of questionnaires and forms?

A
  • Pros:
    • quick
    • no special skill required to administer
    • standardized approach
    • customizable
  • Cons:
    • answers may not be complete
      • miss important findings
    • severity of condition may not be reflected subject to misinterpretation
    • easier for patients to falsify information
29
Q

What are the benefits of patient interviews?

A
  • Customizable to the individual patient
  • can ask a combination of closed and open questions to get information
30
Q

Types of questions?

A
  • Open
  • Closed
  • Simple
  • Compound
31
Q

Open Question

A
  • invites listener to respond with maximum freedom
  • give generalities
32
Q

examples of open questions?

A
  • What questions do you have?
  • What parts of the lecture were the most useful?
33
Q

Closed Questions

A
  • Guide and limit responses
  • hone in on specifics
34
Q

examples of closed questions?

A
  • Do you have any questions?
  • Was the lecture useful?
  • Do any of your teeth hurt?
35
Q

Simple questions

A
  • concise
  • express only one element
36
Q

Examples of simple questions?

A
  • Do you brush your teeth regularly?
  • Do you floss regularly?
37
Q

Compound questions?

A
  • more than one element or content area
38
Q

Biased questions

A
  • aka leading questions
  • suggests a response or makes a certain response more likely
39
Q

examples of biased questions?

A
  • You enjoy this course, don’t you?
  • You feel ok now, don’t you?
40
Q

Unbiased questions

A
  • Allow adequate and accurate listener response
41
Q

Unbiased question examples

A
  • What about this course is enjoyable?
  • how would you describe how you feel now?
42
Q

How do you use the different types of questions in a patient interview?

A
  • Open ended questions
    • patient has freedom of response
  • Facilitation
    • creating atmosphere for communication
  • Closed ended questions
    • looking for a specific response to a specific question
43
Q

The first five minutes spent with a patient represent the most important period of dentist-patient interaction. Patients should feel that the dentist is genuinely interested in them and in helping to solve their dental problems”

A

“We should meet the mind of the patient before we meet the mouth of the patient.”

week 63 (7 decks)

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