Communication and Interview Techniques
I was obliged to interview an 85-year-old female who presented with declining health and various health concerns. According to Ball et al. (2019), patient comfort and privacy are paramount to an interactive session that aids in capturing patient history. Therefore, I located a private room with good lighting and chairs to interview the patient.
Besides, I considered that old age is accompanied by various sensory deficits, including eyesight and hearing, so I came up with writing materials that could be used in case of difficulties. Then I sat in front of the patient, maintained eye contact, and spoke fluently and slowly for the patient to capture. I introduced myself and stated the reason for the interview. I inquired about various components of history, including chief complaints, past medical history, social and drug use history, family history, and general health.
Concerning her chief complaint, she stated difficulty in swallowing and frequent headaches. She elaborated that these problems were long-standing. About her past medical history, she reported problems with hypertension, stroke, and diabetes, all of which she was not receiving any treatment for.
On social and drug history, she reported no history of smoking or alcohol drinking but reported living alone with no family. She lost most of her family members to a hurricane, while others flew away with no whereabouts. Besides, she reported not working and depended on well-wishers, therefore, could not get a balanced diet. I also assessed the patient`s living arrangements, medication, and health risks according to age, gender, and demographic factors.
Building this history requires the employment of various communication techniques. First, I built rapport with the patient, thus making her comfortable sharing her concerns. Secondly, I employed the use of open-ended questions while involving active listening.
Open-ended questions allow for in-depth discussion and help gather as much information as required (Diamond-Fox, 2021). Besides, employing active listening and providing patients ample time to answer the question further helps find concrete information (Chow et al., 2019). Finally, I empathized with the patient and stayed neutral while refraining from being judgmental and making unnecessary interruptions.
Health-Related Risk and Assessment Tools
Because old age increases the risk of various conditions and health risks, it is imperative to perform a complete assessment in elderly patients, including my client. Fractures resulting from bone fragility and falls are risk factors in many elderly patients (Prabhakaran et al., 2020).
Old age is marked by changes in physical, cognitive, and emotional well-being. Eyesight loss and comorbidities associated with old age increase the risk of falls, resulting in fractures that limit movement. This results in increased risks of other comorbidities, such as increased level of dependence and elevated risk of mortality (Chow et al., 2019).
Therefore, I find it imperative to ask the client about her recent history of falls and learn more about what might have transpired. Luckily, my client denied any falls. However, she had the risk of falls as guided by the fall risk assessment tool. Apart from falls, assessing other aspects of patient life requires the inclusion of other tools, including stroke, psychosocial, and nutritional assessment tools (Adly et al., 2020). Assessing these issues is important as old age increases the risk of depression, suicide, malnutrition, and comorbidities such as stroke.
Considering the patient`s age, gender, demographic factors, poor living conditions, lack of support system, and poor health status, asking targeted questions help in finding more concerns from the patient. The following are my targeted questions for this patient:
- What are the priorities you aspire to be addressed during this visit?
- How do you cope with your daily living, given that you have no support system?
- What do you think about joining a community welfare group?
- Have you fallen recently?
- Do you have other physical and emotional health concerns affecting your life?
- What makes you come to the hospital today?
- Are there medications you have been taking recently?
Adly, N. N., Abd-El-Gawad, W. M., & Abou-Hashem, R. M. (2020). Relationship between malnutrition and different fall risk assessment tools in a geriatric in-patient unit. Aging Clinical and Experimental Research, 32(7), 1279–1287. https://doi.org/10.1007/s40520-019-01309-0
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel\’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Chow, R. B., Lee, A., Kane, B. G., Jacoby, J. L., Barraco, R. D., Dusza, S. W., Meyers, M. C., & Greenberg, M. R. (2019). Effectiveness of the “Timed Up and Go” (TUG) and the Chair test as screening tools for geriatric fall risk assessment in the ED. The American Journal of Emergency Medicine, 37(3), 457–460. https://doi.org/10.1016/j.ajem.2018.06.015
Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level. British Journal of Nursing (Mark Allen Publishing), 30(4), 238–243. https://doi.org/10.12968/bjon.2021.30.4.238
Prabhakaran, K., Gogna, S., Pee, S., Samson, D. J., Con, J., & Latifi, R. (2020). Falling again? Falls in geriatric adults-risk factors and outcomes associated with recidivism. The Journal of Surgical Research, 247, 66–76. https://doi.org/10.1016/j.jss.2019.10.041
Communication and Interview Techniques Instructions
Please be mindful of plagiarism and APA format, I have included the rubric. Please use my course resources as one of my references as instructed. Please include Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel\'s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby as one of the references.
Required Readings (click to expand/reduce)
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel\'s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 1, â€œThe History and Interviewing Processâ€
This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.
Chapter 5, â€œRecording Informationâ€
This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
Chapter 2, \"The Comprehensive History and Physical Exam\" (pp. 19â€“29)
Adly, N. N., Abd-El-Gawad, W. M., & Abou-Hashem, R. M. (2019). Relationship between malnutrition and different fall risk assessment tools in a geriatric in-patient unit. Aging Clinical and Experimental Research, 32(7), 1279â€“1287. https://doi.org/10.1007/s40520-019-01309-0
Chow, R. B., Lee, A., Kane, B. G., Jacoby, J. L., Barraco, R. D., Dusza, S. W., Meyers, M. C., & Greenberg, M. R. (2019). Effectiveness of the â€œTimed Up and Goâ€ (TUG) and the Chair test as screening tools for geriatric fall risk assessment in the ED. The American Journal of Emergency Medicine, 37(3), 457â€“460. https://doi.org/10.1016/j.ajem.2018.06.015
Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level. British Journal of Nursing, 30(4), 238â€“243. https://doi.org/10.12968/bjon.2021.30.4.238
Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation as well as other support resources:
Shadow Health. (2021). Welcome to your introduction to Shadow Health. https://link.shadowhealth.com/Student-Orientation-Video
Shadow Health. (n.d.). Shadow Health help desk. Retrieved from https://support.shadowhealth.com/hc/en-us
Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide
Document: Shadow Health Nursing Documentation Tutorial (Word document)
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin\'s diagnostic examination (11th ed.). New York, NY: McGraw- Hill Medical.
Chapter 2, \"History Taking and the Medical Record\" (pp. 14â€“27)
Required Media (click to expand/reduce)
Welcome and General Course Guidelines
Dr. Tara Harris reviews the overall guidelines and the expectations for the course. Consider how you will manage your time as you review your media and Learning Resources throughout the course to better prepare for your Discussions, Case Study Lab Assignments, Digital Clinical Experience (DCE) Assignments, and your Midterm and Final Exams (14m).
Module 1 Introduction
Dr. Tara Harris reviews the overall expectations for Module 1. Please pay special attention to the registration requirements for your use of Shadow Health for your Digital Clinical Experience (DCE) Assignments as well as the criteria for the DCE Assignments (3m).
Building a Comprehensive Health History - Week 1 (19m)
Discussion: Building a Health History
Effective communication is vital to constructing an accurate and detailed patient history. A patientâ€™s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patientsâ€™ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
Photo Credit: Sam Edwards / Caiaimage / Getty Images
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patientâ€™s social determinants of health?
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Identify any potential health-related risks based upon the patientâ€™s age, gender, ethnicity, or environmental setting that should be taken into consideration.
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel\'s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
PLEASE USE THIS PATIENT PROFILE TO ANSWER THE QUESTION.
85 year old white female living alone with no family in declining health .
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.