The Interview Flashcards
What is a Health History Interview?
A conversation with a purpose.
Relating effectively with the patient.
Formulation of a hypothesis or series of hypotheses.
A Conversation with a Purpose.
What are its 3 goals?
- Establish a trusting relationship–***Purpose of interview, establish a trusting rapport.
- Gather Information–
- Offer Information–such health care promotion.
What are two ways to Relate Effectively with the Patient?
How do you execute those two ways?
Convey respect–Convey establishment of authority and trust for you as DPT and convey respect for patient and patient’s situation.
Promote trust–Can be effectively created with communication.
Once you have formulated a hypothesis, or several of them, how do you refine it?
Test hypotheses with more detailed questions.–Use the goal of creating a hypothesis as a means to focus the interview.
The approach to the interview…
What are the 3 parts to the approach before the interview?
Review the Medical Record–age, gender, insurance, meds, intake sheet, pain diagram, etc.
Self reflection–clarify how our own expectations affect what we hear and how we react (your values and biases…your cultural identity.)
Behavior and Appearance–you send messages through words, attention, voice tone, body language; also do not underestimate the affect of cleanliness, hygiene, attire, etc.
The approach to the interview…
What are the 3 components to the approach when it comes to initiating the interview itself?
Proper lighting–lighting, temperature, necessary equipment, proper draping, etc.
Note taking–maintain good eye contact especially when the patient is talking about sensitive/disturbing material.
Greeting the patient/establishing rapport–proper introduction, proper title to address patient; always be attuned to the patient’s comfort; also maintain proper confidentiality if others are present.
The approach to the interview–
What are the 3 components that relate to establishing the course and flow of the interview?
Establishing the agenda–start with open ended questions…“Why are you here today?”, “How can I help you?” (Interview should be like a funnel…start with big, open-ended question…then begin narrowing it down.)
Inviting the patient’s story–DO NOT INTERRUPT, use phrases like “I see…” or “go on…” Use encouraging body language (nodding the head affirmatively, showing expressions of concern).
Claryifying the paitent’s story–REPEAT back o the patient what you believe the patient has told you. (repeating is very important to make sure you have it correct. Repeating an order at McDonald’s.)
Describe the SILENT PATIENT
Patient may be collecting thoughts, patient may be depressed and lack spontaneity, patient may be overwhelmed–are you moving too fast. (This comes from a variety of situations)
Describe the Confusing Patient
Patient may have a SOMATIZATION DISORDER (pt w/ complicated medical hx and sx’s not attributable to an organic cause) may be in play; bizarre descriptions may seem peculiar to you, patient may be psychotic.
Describe the Patient with Altered capacity.
Dementia
Describe the Talkative Patient
Allow a few minutes of rambling but you may need to courteously interrupt.
Describe the Crying Patient
Pause, be empathetic–give permission to cry–offer tissue, be affirmative “I’m glad you were able to express your feelings.” (Be firm and respectful, and get back on track for communication.)
Describe the Angry/Disruptive Patient
Sick, uncomfortable people are often angry, accept angry feelings. Regarding the disruptive patient, alert SECURITY STAFF, maintain non-threatening posture.
Describe the Language barrier patient
find an interpreter
Describe the patient with low literacy
Be aware; “How comfortable are you with filling out a medical form?”
