Patient Interview Flashcards
True or False
Typically, patient interview precedes the systems
review and the tests and measures, but it may also
occur concurrently.
What should the patient interview used in conjunction with to determine your assessment?
Patient interview should be used in conjunction with
the systems review and tests and measures to help
determine your assessment.
How do you conduct the patient interview?
The method of questions should be individualized for the patient.
The patient interview should flow as an active conversation.
Why do you you use open ended questions in the patient interview?
Open-ended questions should be used initially to
encourage the patient to provide narrative
information, help determine the patient’s chief
complaint, and to decrease the opportunity for bias on
the part of the clinician.
When do you start to ask more specific questions?
When you need to help focus the examination and deter irrelevant information.
Whenever possible to avoid leading the patient into a particular response what type of questions should be asked?
Neutral Questions avoid leading the patient into a particular response.
ECHOWS stands for what?
Establish Rapport • Chief Complaint • Health History • Obtain Psychosocial Perspective • Wrap-up • Summary of Performance
Establish Rapport
- Introduction/ greeting
- Orients patient to the flow of the visit
Chief Complaint (Report)
Reason for visit (chief complaint; location of symptoms)
• Functional status in various roles and realms (home, work, school,
social)
- Patient’s goals and expectations for treatment and prevention
- History of chief complaint
- Location and behavior of symptoms: aggravation, alleviation, nature
- Previous examination/tests/interventions for chief complaint
Chief Complaint (Report) Location and behavior of symptoms
• Includes: – Intermittent or constant – Description – How long symptoms last (irritability) – Quantification of symptoms, 24-hr presentation
Health History
Review of constitutional symptoms (fatigue, weakness,
fever, sweats, night pain, unexplained weight loss/gain,
confusion)
• Review of body systems
• Surgeries (type and date)
• Allergies (include latex and to drugs)
• Other illnesses/health conditions
• Medications: Prescriptions and OTC/herbals
• Health habits: substance abuse (caffeine, tobacco,
alcohol) and exercise
• Abuse history (family violence, sexual, physical &/or
emotion abuse)
• Pertinent family medical history
Health History Red Flags
- Fever Chills or night sweats
- Recent unexplained weight changes
- malaise or fatigue
- unexplained nausea or vomiting
- unilateral bilateral or quadrilateral parathesias
- shortness of breath
- dizziness
- nystagmus
- bowel or bladder dysfunction
- severe pain
- radiculopathy associated with 2 or more levels
Obtain Psychosocial Perspective
- Patient perception of chief complaint
- Family, social, and personal circumstances
- Environmental barriers/ accommodations
Wrap-UP
- Asks patient about additional questions
- Transition into physical exam…gives clear information about the next steps of the examination process
Summary of performance
• Attends to patient comfort and privacy
• Logical sequencing/follows an organized format
• Questioning strategies (eg, avoids leading questions, avoids duplication,
explain rational for questions, all questions are relevant)
• Verbal communication strategies (avoid jargon and repetitive verbal habits
(umm)s, checks for patient understanding, rephrases/summarizes, uses
transition statements)
• Documents without interfering with the flow of the interview/not
distracting
• Attentive listening (interrupts the patient only when redirecting is needed)
• Respect and interest toward patient; makes a personal connection
• Non-verbal behavior (eg, distance and eye contact are comfortable for
patient, responds to non-verbal patient cues)
• Social skills (eg, empathy, poise, hands embarrassing/sensitive topics,
accepts & legitimizes patient’s feeling and beliefs)
