Guidelines-in-an-Effective-Interview

Interview and Health History

 Interviewing – method of gathering information from the client

 Effective interviewing skills are vital for accurate and thorough collection of subjective data.

 Skills required for a good interview

 Professional

 Interpersonal

 Interviewing

 2 Foci of Interview

 Establishing rapport and trusting relationship

 Gathering information on the client’s status

 Phases of Interview

 Pre-Introductory

 Introductory

 Working

 Summary and Closing

A. Pre-introductory

 Medical record review

 Biographical data

 Identification of sensory problems

B. Introductory Phase

 Introduce self

 Explains purpose of the interview

 Discusses the types of questions

 Explains the reason for taking notes

 Assure confidentiality/ privacy accdg. To HIPAA (Health Insurance Portability and

Accountability Act)

 Trust and rapport

 Verbal and nonverbal communication

C. Working Phase

 Ask about:

 Reasons for seeking care

 History of present health concern

 Past health history

 Family history

 Lifestyle and Health Practices

 Review of Body Systems for current problems

 Developmental Level

 Listens, observe, and use critical thinking.

 Client collaborate to identify the client’s problems and goals.

D. Summary and Closing Phase

 Summarize information

 Validate problem and goals

 Identifies and discusses possible plans (nursing diagnoses and collaborative problems) with

the client

 “Is there any concern?”

Types of Communication

 Communication

 “the exchange of information or news”

 “the means of connection between people or places”

2 Types of Communication

A. Non-verbal - as important as the verbal communication.

1. The nurses:

 Appearance

 Demeanor

 Posture strongly influence how the client perceive the

 Facial expression question you asked.

 Attitude

 Facilitate eye level contact

 Never over-looked the importance of communication and take it for

granted.

 Appearance

 Comfortable

 Neat clothes

 Laboratory coat or uniform

 Name tag with credentials

 Neat hair

 Fingernails short and neat

 Minimal jewelry

 Demeanor - should be professional

 Display poise

 Focus on the client

 DO NOT

 Laugh

 Yell

 Mutter

 Overly friendly or “touchy”

 DO

 Greet the client calmly and focus attention on the client

 Facial Expressions

 often shows truly thinking (regardless of what you are saying)

 neutral and friendly

 What is the implication if your face looks angry?

 What will you do if you cannot hide your emotions (i.e. anger)?

 Attitude

 Nonjudgmental attitude regardless of belief, ethnicity, lifestyle, healthcare practice

 DO NOT appear shocked, disgusted, or surprised

 DO NOT impose to the client.

 Silence

 Time for reflection > accurate reporting and data collection

 Listening - the MOST IMPORTANT SKILL TO LEARN AND DEVELOP fully in order to

collect complete and valid data from the client.

 To listen effectively the nurse needs to:

 Good eye contact

 Smile

 Open body position

 Avoid preconceived ideas or biases about your client

 to listen effectively -- Keep an open mind and concentrate

 AVOID:

 crossing arms

 sitting back

 tilting head away from the client

 thinking about other things

 looking blank or inattentive

 engaging with an electronic device

 Distraction

 Distance - Best distance: within 2-3 feet; Standing - shows “superiority”

 Excessive or Insufficient Eye Contact - consider culture

B. Verbal Communication

 Open Ended Questions

 Close-Ended Questions

 Laundry List

 Rephrasing

 Well-placed phrases

 Inferring

 Providing Information as questions arise

 Verbal Communication: DONTs

 Biased or Leading Questions

 Rushing through an Interview

 Reading the Questions

 Special Considerations

1. Age

 NOTE: Normal aspects of aging do not necessarily equate with a health problem (mental

slowness)

 First: Assess hearing acuity

 Speak slowly

 Face the client at all times

 Speak on the side with good acuity

 DO NOT yell at the client.

 If forgetful or confused:

 Presence of significant others

2. Culture

 Pain expression

 Listening

 Variation in use of meaning of nonverbal communication e.g.

 Eye contact

 Gestures

 Slightly bowed stance – respect

 Demeanor

3. Emotional Variations

 Anxious Client

 Simple, organized information

 Explain role and purpose

 Simple and concise questions

 Do not be anxious

 Do not hurry and decrease stimuli

 Angry Client

 Calm, reassuring, in-control manner

 Allow to ventilate feelings

 Do not argue or touch the client

 Obtain help

 Avoid arguing

 Facilitate personal space

 Depressed Client

 Express interest in understanding the client

 Do not try to communicate in an upbeat/encouraging manner

 Manipulative Client

 Provide structure and set limits

 Differentiate between manipulation and reasonable request

 Seek objective opinion from colleagues

 Seductive Client

 Set firm limits

 Avoid responding to subtle seductive behaviors

 Encourage use of appropriate coping methods

 Discussing Sensitive Issues

 Be aware of your own thoughts and feelings about

 Dying

 Spirituality

 Sexuality

 Ask simple, nonjudgmental questions

 Allow time for ventilation of feelings

 Refer as appropriate.