22 terms

The interview: ch.3

Jarvis 6th Ed. ch. 3,4,8,9, 10
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Terms in this set (...)

Ethnocentrism
perception that your own life is the most desirable, acceptable or best; to act superior to others.
Telegraphic speech
3 or 4 worded simple sentences used by 3&4 yr olds.
8 reasons why the interview is contract
1) Time & Place interview/exam
2) Intro/brief explanation of your role
3) Purpose of interview
4) How long it will take
5) Precipitation from involved parties
6) Presence of other people
7) Confidentiality
8)Cost (financial liability)
7 Key points in preparing for the physical setting of the interview
1) Room temp
2) Lighting
3) Reduce noise
4) Reduce distractions
5) Appropriate distance- 4-5 feet/2x arm length
6) Equal arranged seating-eye level, chairs at 90 degrees
7) Face-to-face positioning
Pros and Cons of note taking/EHR (electronic health recording (during interview)
Cons- breaks eye contact, shifts attention, diminishes sense of patients importance, disrupts observation of non-verb communication, can appear threatening to patient during sensitive areas of the Hx (health history).

Pros- accurate details about hospitalizations, ROS, and family history
Open-end v.s. Closed-end questions and guidelines
Direct questions- avoid bombarding with long list of questions. Use for specific information. Limits interaction. e.g: Are your headaches on one side or both?
Open questions- avoid allowing patient to run off. Use for narrative information, feelings, it builds rapport. e.g: Tell me about your headaches.
9 types of examiner responses assisting the narrative
1) Facilitation- encourage more info
2) Silence- time to think
3) Reflection- repeating phase back to patient
4) Empathy-relating to patients discomfort
5) Clarification-simplify words
RECALL in last below responses- shift from patient to care provider.
6) Confrontation - "you say that it doesn't hurt but when I tough you here you grimace."
7) Interpretation- Infrence
8) Explanation- factual and objective infromation
9) Summary- review what patient said with them
10 traps of interviewing
1) False Re-assureance
2) Unwanted advice
3) Using Authority
4) Avoidance Language
5) Distancing
6) Jargon
7) Leading and biased questions
8) Talking too much
9) Interrupting
10) Why questions
interviewer: 7 non-verbal behaviors
1)Physical appearance - professional
2)Posture - note patient's posture, too! Be relaxed, open
3) Gestures - occasionally
4) Facial expression - animation, interest
5) Eye contact - appropriate contact, but do not stare
6) Voice - tone, intensity, rate of speech
7) Touch - appropriate; can be misinterpreted; always ask for permission!
Useful closing phrases
"Is there anything else you would like to mention?"
"Are there any questions you would like me to ask?"
"Are there any areas that I should have asked about?"
Interview older adult: special consideration
AVOID Elderly speak: honey, sweetie, darling, Inappropriate plural nouns "Are we ready for our interview". Tag questions, "You would rather sit in this soft chair, wouldn't you?"
Communications needs of children
Nonverbal communication is key.
2-6yr olds: are egocentric.
2yrs = telegraphic speech
3= more complex
3-4 yr olds = telegraphic
5-6= simple sentences.
School- Age: special consideration
7-12year are more objective and realistic. At this age they are verbally able to add important data to their health history.
Adolescent: special consideration
growth spurt, primary and secondary sex characteristics, muscular development, maturation of reproductive organs. They speak in Monosyllables and require your respect. Play it straight with them or you will lose them. Explain every step to them. They are more sensitive to non-verbal communications. After rapport is acquired you may address topics such as: smoking, drug abuse, sex, suicidal thoughts, depression. State laws vary about confidentiality with minors. Praise every action that is healthy, they unhealthy habits that are risky are a key opportunity for you to discuss interaction.
Interviewing the Parent:
Focus questions to the parent. (1-6yrs). If sensitive topics arise, explore them latter when the parent is alone. You can provide toys for child. Through the interview be alert to the ways that the child interacts. (special note person in room might not be the father ask "Is Dyllin's father in good health.)
AcuteIII People:
priority and use brief questioning.
Under the Influence: simple direct questions. Ask when the last time they drank or had drugs and type of drug. (Details in chapter 6).
Sexually Aggressive people:
Put them in their place (sex harassment)
Crying:
Do not go on to a new topic, let the person cry and offer a tissue. If they are on the verge of crying acknowledge it.
Anger:
Do not take personally
Threat of violence: red flag behaviors-
pacing, vacant stares, confusion, statements out of touch with reality, clenching fist, history of great loss (spouse family member, job) history of drug abuse. Never use loud voice always act interested in what the person is talking about.
5 non-verb, cross-cultural communication
1) vocal- pitch, tone, quality of voice
2) action- posture, facial expression, gestures
3) object- clothes jewelry and hair style
4) eyecontact
5) touch
If you do not have interpreter
-polite and formal
-unhurried manner
-simple words
-use gestures
-validate