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PA Exam #2-Chapter 3 (Interviewing & Health Hx)
Terms in this set (43)
Describe the Patient's Perspective- explain FIFE
Patient's FEELINGS including fears or concerns, IDEAS about nature of problem, effect of problem on pt's life and FUNCTION, and pt's EXPECTATIONS of disease; FIFE= feelings, ideas, function, and expectations
What is the primary goal of clinician during the patient interview?
to listen and improve the well-being of the pt through a trusting and supportive relationship
The _________ process that generates the patient's story is fluid and requires empathy, effective communication, and the relational skills to respond to patient's cues, feelings, and concerns.
The interviewing process is _______-ended and draws on a range of techniques that affirm and empower the patient such as active listening, guided questioning, nonverbal affirmation, empathic responses, validation, reassurance, and partnering.
The ______ ______ ________ is a structured framework for organizing patient information into written or verbal form.
Health History Format
More "clinician-centered" closed-ended yes/no questions are more pertinent to ______Hx, ______Hx, and the ________ and _________Hx
Medical Hx, Family Hx, and the Personal and Social Hx
The part of the health history that requires the MOST closed-ended questions of all is the __________
Review of Systems (ROS)
This type of history is performed for new patients in the office, hospital, or long-term care setting....
Comprehensive Health History
This type of history is performed for a specific complaint, is a more limited interview tailored to that specific problem......
Focused or Problem-oriented history
This requires listening closely to what the patient is communicating, being aware of pt's emotional state, and using verbal and nonverbal skills to encourage the patient to continue and expand on both concerns and fears.
__________ responses are vital to patient rapport and healing and convey that experience some of the patient's suffering.
To express _________, you must first recognize the patient's feelings and elicit these feelings rather than assume how the patient feels.
Guided questioning should proceed from ________ questions to ________ questions.
general questions to specific questions
Moving from open-ended to focused questions, using questioning that elicits a graded response, asking a series of questions one at a time, and offering multiple choices for answers is what type of questioning?
Clarifying what the patient means, encouraging with continuers, and using echoing is what type of questioning.
You can mirror the patient's ______ or qualities of speech such as pacing, tone, and volume to increase rapport.
Eye contact, facial expressions, and posture are types of what communication?
What is it called when you provide verbal support the legitimizes the patient's emotional experience?
The first step to effective _________ is identifying and accepting the patient's feelings without offering _________ at that moment.
Reassure the patient that regardless of what happens with their disease, as their provider/student you are committed to a continuing ________________.
Giving a capsule ___________ lets the patient know you have been listening carefully, clarifies what you know and what you don't, and allows you to organize your clinical reasoning and convey your thinking to the patient.
Evoking the patient's perspective, conveying interest in the person, not just the problem, following the patient's lead, eliciting and validating emotional content, sharing information with the patient, making your clinical reasoning transparent, and revealing the limits of your knowledge are part of what?
Empowering the patient: Principles of Sharing Power
Before seeing the patient, review the _____________ to gain valuable information about past diagnoses, treatments, and health problems.
The sequence of the Interview
1. Greet the patient and establish rapport
2. Establish an agenda
3. Invite the patient's story
5. Identify and respond to the patient's emotional cues
6. Expand and clarify the patient's story
7. Generate and test diagnostic hypotheses
10. Take time for self-reflection
4. Explore the patient's perspective
8. Share the treatment plan
9. Close the interview
What are the 7 attributes of a symptom?
Setting in which it occurs
_________-_________ brings a deepening personal awareness to our work with patients and is one of the most rewarding aspects of providing patient care.
_______ is a system of shared ideas, rules and meaning that influence how we view the world, experience it emotionally, and behave in relation to other people
_______ are the standards we use to measure our own and others' beliefs and behaviors
Accept ________ feelings from patients and allow them to express such emotions without getting _______ in return.
As you begin working with the interpreter, make questions clear, short, and simple and speak directly to the _______
Guideline for working with an interpreter= INTERPRET
I=introductions- introduce all individuals in the room
N=Note goals- goals of the interview
T= Transparency- let pt know everything said will be interpreted
E= Ethics-use qualified interpreters
R= Respect Beliefs-of the patient
P=Patient focus-patient should remain the focus
R=Retain control-as provider remain in control of the interaction
E=Explain-use simple language and short sentences with interpreter
T=Thanks-thank interpreter and patient for their time
What do you do if patient has partial hearing impairment or can read lips?
face them directly in good light
What do you do if patient has a unilateral hearing loss?
sit on the hearing side
What do you do if patient has a hearing aid?
Make sure hearing aid is working and eliminate background noises such as television
CAGE questions most widely used for assessing alcohol intake; what does it stand for?
A- annoyance when criticized
G- Guilty feelings
Injuries that are unexplained, seem inconsistent with patient's story, are concealed by the patient, or cause embarrassment are clues of what type of abuse?
Sexual or physical abuse
Delay in getting treatment or fear of the pelvic examination or leaving the exam room are signs of what type of abuse?
Sexual or physical abuse
What is the name of an individual who can act for the patient in life-threatening situations?
A health care proxy
What is another name for "Primum non nocere" which involves doing no harm to the patient?
The dictum that the clinician needs to "do good" is....
What is the name of the patient's right to determine what is in their own best interest?
What is the name of health professionals being obligated not to tell others what we learn from our patients?
What is involved in the Tavistock Principles?
Rights- People have right to health care and health
Balance- care of individual patient is central but health of population is also important
Comprehensiveness- treat illness and ease suffering, minimize disability, prevent disease, promote health
Cooperation- Health care succeeds only if we cooperate with those we serve, each other, and those in other sectors
Improvement- improving health care is a serious/continuing responsibility
Safety- do no harm
Openness- being open, honest, and trustworthy is VITAL in health care
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