Copyright 2002, Delmar, A division of Thomson Learning Chapter 2 The Patient Interview

Copyright 2002, Delmar, A division of Thomson Learning Competencies Prepare an appropriate setting for the nurse-patient interview. Recognize the personal perceptions that facilitate or hinder the interview process. Define effective interviewing techniques. (continues)

Copyright 2002, Delmar, A division of Thomson Learning Competencies Describe problematic interviewing behaviors. Demonstrate how to transform problematic interviewing behaviors into more effective ones. Adapt the interview process for the patient with special needs. Adapt the interview process for elderly patients.

Copyright 2002, Delmar, A division of Thomson Learning Patient Interview Role of the nurse  Accepting, respectful, nonjudgmental attitude Role of the patient  Active participant

Copyright 2002, Delmar, A division of Thomson Learning Factors Influencing the Interview Approach Environment Confidentiality Time, length, duration Biases and preconceptions

Copyright 2002, Delmar, A division of Thomson Learning Stages of the Interview Process Stage I — joining Stage II — working Stage III — termination

Copyright 2002, Delmar, A division of Thomson Learning Factors Affecting Communication Active listening Nonverbal communication Distance Personal space

Copyright 2002, Delmar, A division of Thomson Learning Effective Interviewing Techniques Verbal techniques  Open-ended questions  Closed questions  Facilitation  Silence Nonverbal techniques  Touch  Attentiveness (continues)

Copyright 2002, Delmar, A division of Thomson Learning Effective Interviewing Techniques Listening responses Action responses

Copyright 2002, Delmar, A division of Thomson Learning Listening Responses Making observations Restating Reflecting Clarifying Sequencing Encouraging comparisons Summarizing Interpreting

Copyright 2002, Delmar, A division of Thomson Learning Action Responses Focusing Presenting reality Confronting Informing Collaborating Limit setting Normalizing

Copyright 2002, Delmar, A division of Thomson Learning Nontherapuetic Interviewing Techniques Requesting an explanation Probing Offering false reassurance Giving approval or disapproval Defending Advising

Copyright 2002, Delmar, A division of Thomson Learning Problematic Questioning Techniques Posing leading questions Interrupting the patient Engaging in talkativeness Using multiple questions Using medical jargon Being authoritative Having hidden agendas

Copyright 2002, Delmar, A division of Thomson Learning Interviewing the Patient with Special Needs Hearing impaired Visually impaired Speech impaired Aphasic Non-English speaking Illiterate Low level of understanding

Copyright 2002, Delmar, A division of Thomson Learning Tips for Using an Interpreter Use a trained medical interpreter. Allow time for patient and interpreter to converse prior to interview. Request interpreter translate patient replies, sentence by sentence. Allow extra time for completion of interview. (continues)

Copyright 2002, Delmar, A division of Thomson Learning Tips for Using an Interpreter Use brief questions. Maintain eye contact with the patient. Observe the patient’s nonverbal communication. Use preprinted questions when available.

Copyright 2002, Delmar, A division of Thomson Learning Tips for Interviewing— Special Circumstances The patient who is  Anxious and angry  Very ill  Sexually aggressive  Crying  Hostile  Under the influence of alcohol or drugs

Copyright 2002, Delmar, A division of Thomson Learning Tips for Interviewing the Elderly Patient Allow additional time Schedule more than one interview session Interview family or caregiver