THE PATIENT

INTERVIEW
Presented by :
Vivian Salando- Consolacion, RN
BSN Level 2- Clinical Instructor
Bicol University Polangui Campus
 Learning Objectives:
❖ Explain the basic communication skills needed when performing a patient interview

❖ Describe the components of the patient interview.

❖ Compare and contrast the different patient interview approaches .

❖ Adopt the interview technique based on the needs of the patient.

❖ At the end of this topic , the student will know the best practices to follow on how to

collect information from the patient.

 INTRODUCTION
➢ The patient interview is the primary way
of obtaining comprehensive
information about the patient in order to
provide effective patient-centered care.

➢ Nurses who communicate effectively

are better able to collect assessment
data. It is essential for the establishment
of a nurse- client relationship.

➢ Excelling in these communication skills

is a learned technique that takes time
and practice to master.
A methodological approach is used to obtain
information from the patient.

> Startwith determining the patient’s chief

complaint , also known as the reason for
the health care visit.
➢ Explore patient specific complaint and
problem.
➢ Includes inquiry about patient medical,
medication, social problem and family
history taking .
Communication skills and questioning
techniques , especially when it comes to
communicating with patients, are
learned and take time to develop.
In this topic , examines the most
pertinent skills required to conduct
a comprehensive medication
/patient history.
 01
Skills and questioning
technique
 QUESTIONING TECHNIQUE INCLUDE:

1. Active Listening 2. Empathy 3. Building rapport

4. Open- ended 5. Leading 6. Silence

questions questions

8. Non Verbal
7. ‘WHY’ questions Communication
Cues
1) Active Listening
1st communication skill
to be mastered.
Listening vs. active Listening
LISTENING –
➢ is defined as hearing what is being
said.

ACTIVE LISTENING is a dynamic process

that includes both hearing what is
being said as well as processing and
interpreting the words that are spoken
(and /or not spoken) to understand the
complete message that is being
delivered.
LISTENING –is a passive process.

ACTIVE LISTENING- requires the listener

to consciously choose to give the patient
attention and concentration that is free
of distractions and interruptions, both
external and internal.
2) EMPATHY- defined as
the “ intellectual
identification with or indirect
experiencing of the feelings,
thoughts, or attitudes of
another.”
 Empathy vs Sympathy

➢ When you place ➢ Is when you feel sorry

yourself in your patient’s for the patient but do
situation and respond
not feel the same
based on either similar
personal experiences. emotions or not in the
➢ Is the ability to share same situations.
another persons feelings ➢ Feeling of pity and
and emotions as if they sorrow for someone
were your own. else misfortune
➢ Examples:
“ I understand what you feel”
“ I can feel the pain you feel”
 Tips for practicing Empathy
Work on listening to Try to understand
people without people, even when
interrupting you dont agree with
them
Pay attention to body Ask people
language and other questions to learn
types of nonverbal more about them
and their lives.
communication

➢ Imagine yourself in another

persons shoes.
 3) Building Rapport
❑ Good rapport creates a close and harmonious
relationship with patients. It allows you to understand
your patients feelings and communicate well with
them .

> Start the interview, by greeting the patient name, >

make sure you pronounce the patient name correctly.
> Interacting respectfully with the patient , making
patient feel comfortable will build excellent rapport.
 4) Open-and-closed Ended Questions

OPEN-ENDED questions, are

questions that require the
patient to answer with more
than a simple yes or No or nod
of the head
Closed-ended questions, limit the patients
response to either YES or No or nod of the
head.

Open-ended ex. Close –ended .ex.

How are you feeling today? Are you feeling well today?
 5) LEADING QUESTIONS
> are those that suggest a particular answer. To
obtain an accurate response to your * questions,
LEADING Questions should be avoided.

Example
NURSE: “You do not miss any doses of you * Bec.the question implies that the
medication, do you?”
Patient: “NO I don’t”
patient should not be missing doses, &
rather than contradicting your
expectation, the Pt. merely agree.
 6) SILENCE

➢ By allowing moment of silence after asking a

questions, the patient is able to reflect upon your
question and provide a more thoughtful & accurate
response.
Silence may also indicate , the patient has not understood your
questions.
NON VERBAL cues will help determine the difference. (eg.
Facial expression, tone of voice, eye contact, body movement.)
,
7) WHY
● AVOID “WHY” questions.

● Example:
instead of asking “ WHY do you miss your
doses?
you might ask : “ WHAT causes you to
miss your doses?”

** with WHY” method , the patient may feel the

need to defend him or herself.
** the “WHAT” method allows the patient to
reflect on his/her reasons without feeling as
though you are offering judgement.
 8) NONVERVAL Communication
❖ Is sending of message to or from
your patient without the use of
words.
❖ Plays an important role in your
interactions with your patients.
● Types of Nonverbal
Communication:
➢ Tone of voice
➢ Choice of language
➢ Facial expressions
➢ Body posture and position
➢ Gestures and movements
➢ Eye contact
❖ The Process of Communication
• Exchanging information
• The vehicle that carries you and your
patient
through the interview.
• A two-person interaction has two roles:

SENDER and RECEIVER

 Factors that can affect communication
● ❑Liking others - the patient
must feel that he/she is
accepted unconditionally.
❑Empathy- recognizing and
accepting the other person’s
feelings without criticism.
❑Ability to listen- listen to
what the person says.
● ❑Self Awareness –
recognize and set aside
personal prejudices
● External Factors relate
mainly to the physical setting
● ❑Ensure Privacy
● ❑Refuse interruptions
● ❑Physical Environment
● ❑Dress
● ❑Note-Taking
● ❑Electronic Health Record
(HER)
 Preparing the Physical Setting
❑ Set the room temperature at a comfortable level.
❑ • Provide sufficient lighting.
❑ • Secure a quiet environment.
❑ • Remove distracting objects or equipment.
❑ • Place the distance between you and the patient at 4 to 5 feet.
❑ • Arrange equal-status seating placing the chairs at 90 degrees.
❑ • Arrange a face-to-face position for a hospitalized bedridden patient.
❑ • Wear your uniform or lab coat and name tag
The Interview has three phases:

❑Introduction
❑Working
❑Closing
Techniques of Communication during the phases of
Interview
❑ Introducing the Interview
❑ • Keep the introduction short and formal.
❑ • Address the person, using his or her surname.
❑ • Shake hands if appropriate.
❑ • Introduce yourself and state your role in the agency.
❑ • If you are a student, say so.
❑ • Explain the reason for this interview
❑ • Assure the confidentiality of information
❑ • Make sure that the client is comfortable
❑ • Ask an open-ended question.
❑ • Let the person proceed.
❑ The Working Phase

● Data gathering phase.

● Includes your questions to the patient
and your responses to what the patient
has said.
● Use a combination of open-ended and
close questions during the interview.
 ❑ Open-ended ❑ Close or direct
questions – asks for questions – asks for
narrative information specific information: short
answer, one or two words,
yes or no.
Examples :
“Tell me how can I help Example: “ Are your
you.” headaches on one
“ What brings you to the side or both?
hospital?”
Types of VERBAL RESPONSES to assist the narrative:

1. Client’s perspective
❑ Facilitation – encourages the client to say more.
Example: mmhmm, go on, uh-uh; maintaining eye contact, nodding yes.
❑ Silence – communicates that the client has time to think
Example: waiting for response without interruption; counting
silently 1 to 10
❑ Reflection –echoes client’s words by repeating part of what person has
just said.
❑ Empathy – names a feeling and allows its expression
❑ Clarification – useful when person’s word choice is ambiguous or
confusing
▪ Examiner’s perspective
❑ Confrontation – clarifying inconsistent information.
❑ Interpretation – links events, makes associations, implies
cause.
❑ Explanation – informing the person, sharing factual and
objective information
❑ Summary – condenses facts and validates what was
discussed during the interview; allow client time to make
corrections
 Ten Traps of Interviewing
These traps should be avoided because these restricts the person’s
response and create obstacles.
1. Providing False assurance or reassurance
2. Giving unwanted advice.
3. Using Authority
4. Using Avoidance language
5. Distancing
6. Using Professional Jargon ( eg. Medical terminology/ talk that
does not understand)
7. Using leading or Biased questions
8. Talking too much
9. Interrupting
10. Using “why questions”
 Non-Verbal modes of Communication

• Physical Appearance
• Posture
• Gestures
• Facial Expression
• Eye Contact
• Voice
• Touch
 ❑ Closing the Interview
• Should end gracefully.
• Ask the person “ Is there anything else you would like to
say?”
• To indicate closing say “ Our interview is just over.”
• Summarize what you have learned during the interview.
• The summary is the final statement that includes
o Positive health aspects
o Any health problems that have been identified
o Any plans for actions
o An explanation of the following physical exam

➢ • Thank the person for the time spent and his/her cooperation.
 “Nursing school will be a
challenge……Get ready!