Chapter 3 The Interview

A health interview

is a structured interaction between you and the patient.

The terms governing this interaction should be

stated clearly at the start of the interview so that openness and trust are facilitated. Your mutual goal is the patient’s optimal health

Communication is

the exchange of information so that each person clearly understands the other

Communication is based on

behavior, conscious and unconscious, remembering that all behavior has meaning.

When exchanging information, both individuals engage in

verbal and nonverbal communication, which can affect communication.

Four internal factors promote good communication

liking others, expressing empathy, the ability to listen, and self-awareness.

You can foster good communication with certain external factors

ensuring privacy, preventing interruptions, creating a conducive environment, arranging equal-status seating, wearing appropriate attire, and documenting responses

The interview has three phases:

Introduction, a working phase, and a closing.

During the first phase,

begin the interview by introducing yourself and your role.

During the working phase

gather data. Start with open-ended questions, which ask for narrative information. Then use closed or direct questions, which ask for specific information in short, one- or two-word answers

During the closing,

signal that the interview is ending, which gives the patient one last chance to share concerns or express himself or herself. Also briefly summarize what you learned during the interview.

Through facilitation, silence, reflection, empathy, and clarification, you react to the facts or feelings the patient has communicated.

Your response focuses on the patient’s frame of reference

Through confrontation, interpretation, explanation, and summary,

your response focuses on your own frame of reference, expressing your thoughts, and feelings.

avoid the 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,

And using “why” questions.

Pay attention to nonverbal modes of communication, which include:

Physical appearance,

Posture,

Gestures,

Facial expression,

Eye contact,

Voice,

And touch.

Modify communication techniques based on each

patient’s developmental stage,

Learn to communicate effectively with

patients who have special needs

When a patient comes from a different culture,

modify your approach as needed. Behaviors that one culture views positively may have different, possibly negative, connotations in another culture

For a patient with limited English proficiency or hearing impaired, u

use a sign language interpreter or a bilingual team member or a trained medical interpreter whenever possible.

SBAR stands for

situation, background, assessment, recommendation