Taking a Health History: Building a Health History: Asking Difficult Questions
Reflection: Taking a Health History
In the process of building the health history of the patient, I used both principles from science and art concepts of care. The process was similar to a job interview apart from the purpose of the information derived from answering the questions. This interviewing aimed at assessing the risks and social determinants of health so that an accurate and reliable health history could be established. Therefore, hard questions or questions deemed as sensitive or personal were necessary.
Experiences
Developing the script for the interview required both critical and reflective thinking to incorporate goal-oriented questions while at the same time minding the outcomes of the questions on the patient. The inclusion of the ‘hard’ questions was the critical step. Translating the evidence from clinical literature to suggest personal and direct closed questions was the first step towards developing.
Teenage pregnancy impacts both the teenager and parents, guardians, or the custodian economically and socially. To the teenager, the health burden of adolescent pregnancy increases due to the imbalance between the physiological demands and available physical and physiological body supply in that age group. Therefore, holistic care should take into account these factors.
In the process of developing a health history, I targeted the questions toward establishing additional risks that could worsen these imbalances in biophysical and physiological imbalances in demand and supply. I also focused the interview on establishing a ground for planning for prenatal and postnatal care interventions and evaluation.
Including the emotional outcomes of the health problem for the patients was guided by the idea that during the teenage period, physiological and social outcomes can cause body image and mood outcomes. Therefore, I believe that I maximized opportunities to plan holistic care through this history-taking.
Asking the Questions
Asking the questions would require setting the patient in the right mind and mood. Difficulties with had questions are related to the patient and clinician’s perceived impacts on the self-image. Fear of breaking the trust between the clinician and the patient also complicates asking hard questions. The clinician will target hornet answers and build a reliable health risks profile.
The patient can withhold honest responses to the questions due to a lack of trust that the clinical will maintain confidentiality or may judge them (Nasirian et al., 2018). Therefore, reassurance and active listening are some of the strategies that would improve the outcomes of the actual interview. The positioning with the patient, the body language, facial expressions, the tone of the questions, and the tone of the clinician’s responses are critical in establishing authentic and truthful responses from the patient (Ball et al., 2018).
The presence of a guardian in the interview suggests they would be useful for corroborative health history, but may also limit the patient’s confidence in responding to sensitive questions. Therefore, the environment in terms of noise levels, lighting, and presence of third parties are key concepts I may consider when redoing the interview differently (Flugelman, 2021).
In sum, the development of the interview is artistic and scientific. Merging scientific and interpersonal interaction principles to achieve a reliable health history was the critical underpinning of the interview script development. To achieve different outcomes, environmental considerations would be key in influencing the authenticity and reliability of patient responses and establishing a therapeutic relationship.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2018). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). Mosby.
Flugelman, M. Y. (2021). History-taking revisited: Simple techniques to foster patient collaboration, improve data attainment, and establish trust with the patient. GMS Journal for Medical Education, 38(6), Doc109. https://doi.org/10.3205/zma001505
Nasirian, M., Hosseini Hooshyar, S., Haghdoost, A. A., & Karamouzian, M. (2018). How and where do we ask sensitive questions: Self-reporting of STI-associated symptoms among the Iranian general population. International Journal of Health Policy and Management, 7(8), 738–745. https://doi.org/10.15171/ijhpm.2018.18