The Interview Outline 1 PDF

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NURS 3801- Health Assessment Across the Lifespan Process of Communication: sending and receiving Communication is behavior, conscious and unconscious, verbal and nonverbal All behavior has meaning Body language: posture, gestures, facial expression, eye contact, foot tapping, touch, even where you place your chair Successful communication requires mutual understanding by sender and receiver Process of Communication: Internal Factors/External Awareness of internal and external factors INTERNAL Empathy Ability to listen EXTERNAL Privacy Interruptions Physical environment and dress Documenting/computer Question ?? What are the characteristics of a successful interview? The Interview Introducing the interview Introduce self Explain purpose Working phase Data-gathering phase Closing phase Ease into the close Summarize the interview The Interview Contract Terms Time and place of interview and physical examination Introduction of and explanation of health care provider’s role Purpose of interview How long it will take Expectation of participation for each person Presence of others (family, etc.) Confidentiality and to what extent it may be limited Any costs that the patient must pay Question ??

In a recent University of Florida study physicians were observed doing patient interviews; how long did it take before the physician interrupted the patient? Open-Ended Questions Ask for narrative responses State topic only in general terms

Closed or Direct Questions Ask for specific information Elicit short one- or two-word answers, a yes or no answer, or a forced choice Use them in the following situations: After opening narrative to fill in details person may have left out When you need many specific facts about past health problems or during review of systems To move the interview along Question ??  Empathy 

Clarification

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Confrontation

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Interpretation

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Explanation

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Summary

Ten Traps of Interviewing:  Providing false assurance or reassurance  Giving unwanted advice  Using authority  Using avoidance language  Engaging in distancing  Using professional jargon  Using leading or biased questions  Talking too much  Interrupting  Using “why” questions Nonverbal Behaviors Five types of nonverbal behaviors convey information about person

Vocal cues: pitch, tone, and quality of voice, including moaning, crying, and groaning Action cues: posture, facial expression, and gestures Object cues: clothing, jewelry, and hairstyles Personal space: interpersonal transactions and care of belongings Touch: involves use of personal space and action Question ?? Which of the following would be the best way address a patient age 40? Culture and Genetics Gender Being aware of cultural norms during interview and examination process Maintaining privacy and modesty Sexual orientation Maintaining neutrality related to patient’s presentation Being aware of your own personal bias and baggage Developmental Competence Interviewing the caregiver Communicating with different ages across the life cycle Infants Toddlers and preschoolers School-age children Adolescents Adults and older adults Interviewing People with Special Needs Hearing impaired Acutely ill Under influence of street drugs or alcohol Those who must be asked personal questions Sexually aggressive Crying Angry and threatening violence Anxious Health Literacy: does the patient understand? Effective communication A patient may be literate but not understand Can use pictures if needed (p. 47) Question ?? Which of the following would be techniques you might use in your unit or clinic to improve health literacy?  Teach back or use of return demonstration....