patient centred comm Flashcards
what is a patient centred interview
understanding the patient as a unique human being
the interviewer identifies, acknowledges and responds to the patient in a way that encourages the patient to participate and ensures their own agenda becomes part of the consultation process
opposite to doctor centred approach/paternalism - drs agenda dominates, problem is described in biomedical conditions and pts voice is absent
advantages
allow basic medical tasks to be identified
informative
fascilitive - all concerns are likely to be answered
resoinsive - to patients emotional needs and concerns
participatory - patients have a responsible and authentic role
explore patients main reasons for the visit, concerns and need for information
integrated understanding of the patients world
common ground
enhance prevention and health promotion
outcomes of a pt centred interview
improved diagnostics increased patient satisfaction increased concordance improve recovery reduce symptoms
6 headings of patient centred interviewing
allow them to express major concerns
seek patients specific requests
elicit patients explanations of their illnesses
facilitates patients expressions of feelings - separate fact from opinion
give patients information
involve patients in decision plan
Calgary-Cambridge model
sets interview in phases - specific objectives for each phase initiate session establish rapport greet patient introduyce self demonstrate interest open qns gather info explore problems understand the patients perspective explore emotional aspects of experience provide structure physical exam keep communicating pick up cues explaining and planning comprehensive and appropriate info obliged to give some info even if the patients don't want it closing the session maintain rapport review build relationship throughout build relationship and establish rapport involve patient - share thoughts and ideas enhance understanding - provide a rationale for the questions you ask consent confidentiality structure summarise at end of line of enquiry signpost the next section of interview structure in logical way
Transferred clinical method
xplore disease and illness experience disease - history and exam feelings about being ill, ideas, how impact function, expectations - FIFE understand whole person awareness of whole life context they live in common ground define problem establish goalss identify roles to be take by patient and dr incoorperate prevention and health promotion educate enhance dr-patient relationship compassion trust and sharing of power self awareness appretiation of unconscious aspect of relationship - transference and counter-transference beinhg realistic about time participate in team building recognise effective use of physical and other resources
things to do when gathering info
allow pt to finish first few sentences survey for other problems set agenda clarify pt terms interim summaries signpost/transition avoid unexplained jargon
