1. Chapter 13 The Health Care Interview Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin

2. 13-2 Chapter Summary Creating a Collaborative Relationship Opening the Interview Getting Information Giving Information Counseling and Persuading Closing the Interview Summary

3. 13-3 Creating a Collaborative Relationship Sharing Control ▫Both parties must share control ▫Patients must be active and responsive ▫It takes two to form an effective relationship

4. 13-4 Creating a Collaborative Relationship Reducing Relational Distance ▫Dwell on similarities, not differences. ▫Enhance relationships through understanding. ▫Be relaxed and confident. ▫Show interest in the “individual.” ▫Maintain objectivity. ▫Be sincere and honest. ▫Maintain appropriate control during the interaction.

5. 13-5 Creating a Collaborative Relationship Appreciating Diversity ▫Gender influences communication and treatment. ▫Culture  Health communication differs in the global village ▫Be aware of how different people perceive roles and purposes in health care interviews.

6. 13-6 Creating a Collaborative Relationship Stereotypes ▫Health care providers often stereotype patients. ▫Stereotypes determine attitudes, and attitudes may determine care, treatment, and satisfaction. ▫So-called Good patients tend to get better treatment than bad patients.

7. 13-7 Creating a Collaborative Relationship Creating and Maintaining Trust ▫Confidentiality and trust go hand-in-hand. ▫Providers and patients cocreate trust.

8. 13-8 Opening the Interview Enhancing the Climate ▫The opening sets the tone for the entire interview ▫Location and setting promote collaborative interactions.

9. 13-9 Opening the Interview Being Sensitive and Personal ▫Use the opening to reduce apprehension ▫Neither rush nor drag out the opening ▫Politeness breeds politeness

10. 13-10 Opening the Interview Adapting the Opening ▫The opening must fit the situation ▫Get the whole story ▫Orient the patient

11. 13-11 Getting Information Barriers to Getting Information ▫Do not assume patients will provide accurate information. ▫Ask obviously relevant questions as soon as possible. ▫Weigh the ability of patients to respond. ▫Provider dominance deadens interactions. ▫Explain medical terms and procedures. ▫Ask focused, explicit questions.

12. 13-12 Getting Information Ways to Improve Getting Information ▫Encourage turn-taking ▫Asking and Answering Questions  The funnel sequence gives a sense of sharing control  Vary listening approaches Continued…

13. 13-13 Getting Information Ways to Improve Getting Information ▫ Telling stories  Encourage storytelling and listen  The less you talk, the more you say ▫ Listening, Observing, and Talking  Be patient and persistent  Use leading questions with caution ▫Ineffective Methods  Single-Medium Messages  Information Overload

14. 13-14 Getting Information Addressing the Language Barrier ▫Communication breakdowns are the most common root cause of health errors that harm patients ▫Successful programs have included comprehensive interpreter services

15. 13-15 Giving Information Causes for Loss and Distortion of Information ▫Attitudes of Providers ▫Problems with Patients ▫Ineffective Methods

16. 13-16 Giving Information Giving information more effectively ▫Give information that seems authentic. ▫Encourage patients to ask questions. ▫Do not overload patients with information. ▫Organize items of information systematically so that they are easy to recall. ▫Practice good communication skills. ▫Use a variety of media to present information. ▫Include a number of sources in the process. Continued...

17. 13-17 Counseling and Persuading Barriers to Effective Counseling and Persuading ▫Watch for hints and clues about concerns about real problems. ▫Providers my try to dodge unpleasant exchanges. ▫Know yourself to understand others.

18. 13-18 Counseling and Persuading Effective Counseling and Persuading ▫Five Critical Relational Factors  Empathy  Trust  Honesty  Mutual Respect  Caring Continued…

19. 13-19 Counseling and Persuading Effective Counseling and Persuading ▫Selecting an appropriate interview approach. ▫Providing an appropriate climate. ▫Encouraging interaction. ▫Considering solutions.

20. 13-20 Closing the Interview The closing must be a collaborative effort Important questions and revelations occur during the closing

21. 13-21 Summary The health care interview is common, difficult and complex. Situations vary from routine to life threatening. A collaborative and productive relationship will reduce the anxiety, fear, hostility, and reticence that often accompanies health care interviews. The provider and consumer must realize that good communication is essential for effective health care interviews. Skills require thorough training and practice.