The Patient Communication and Interview

What is communication?

the process of transmitting messages & interpreting meaning (more listening, less talking)

Why is effective communication effective?

- encourages closeness

- reduces anxiety & emotional stress

WHY have effective verbal AND non-verbal communication?

it demonstrates understanding & respect for human dignity & individually

HOW can you demonstrate effective VERBAL communication?

1. look at patient clues (anything that can impeded communication like missing hearing aids or sedation)

2. eye contact

3. introduce yourself

4. speak at a reasonable rate (almost slow)

5. use non-technical language (laymen's terms)

6. obtain verbal and non-verbal cues for understanding

HOW can you demonstrate effective NON-VERBAL communication?

1. reinforce spoken words with hand gestures and facial expressions

2. substitute head nodding and turning away for the spoken word

3. establish territory & space (hands extended & leaning forward)

What are a few things to be aware of with non-verbal communication?

- be relaxed and smile

- face the patient when you or they are speaking

- avoid seeming rushed or frazzled

- don't scowl or roll your eyes

- avoid using large swinging hand gestures

What does AIDET stand for?

A: acknowledge (greet w/ eye contact, smile, and name)

I: introduce (politely who you are, department, and what you're going to do)

D: duration (give a healthy guess of procedure duration, but always update them)

E: explanation (what you're doing, how procedure works & who to contact for help while communicating step they need to take)

T: thank them (foster an attitude of gratitude)

What is the purpose of the patient interview?

to obtain as much OBJECTIVE (signs that others can see) and SUBJECTIVE (symptoms that patient feels) data to determine the patient's chief complaint

What is the Sacred Seven?

1. localization

2. severity

3. quality

4. aggravating or alleviating factors

5. onset

6. chronology

7. associated manifestations

What does localization mean in the Sacred Seven?

exact area as possible for chief complaint

What does severity mean in the Sacred Seven?

intensity, quantity, or extent of problem (like 1-10)

What does quality mean in the Sacred Seven?

character of symptoms (like dull, achy, throbbing, stabbing, etc.)

What does aggravating or alleviating factors mean in the Sacred Seven?

things that intensify or relieves symptoms

What does onset in the Sacred Seven mean?

what the patient was doing when the condition began

What does chronology in the Sacred Seven mean?

duration since onset, frequency & course

What does associated manifestations in the Sacred Seven mean?

other symptoms w/ chief complaint

List a couple of ways of how we get data from interview questions (therapeutic communication)

- open-ended questions to let patient tell the story

- facilitation encourages elaboration (nod or say yes, okay go on)

- silence can help with accuracy and elaboration (give patient time to remember)

- probing questions to provide more detail (focus interview)

- repetition clarifies information (rewording)

- summarization verifies accuracy (condensing)

When interviewing, avoid...

directed or leading questions (don't put words in their mouth)

When interviewing, focus...

on your patient during the interview

When interviewing, show...

the patient you are listening by summarizing, repeating, and writing down information

When interviewing, consider...

the type of complain when asking follow up questions

When first meeting your patient, ensure you have the 4 CORRECTS...

- patient

- information

- exam

- exam prep

Make sure you have the correct PATIENT...

- full name

- date of birth

Ensure correct patient INFO by...

- asking patient to verify physician

- asking patient about any illness listed on exam

- asking patient about any medications listed on the order

- asking the patient for correct height and weight and checking and if IV or contrast media is to be used

- asking females of childbearing age about pregnancy

Make sure you are doing the correct EXAM by

- asking the patient why they are here

- state the exam you'll be performing

- verify what the doctor told the patient

- make sure patient followed prep (such as NPO and withheld meds)