Chapter 13The Health Care Interview

Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin

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Chapter Summary• Creating a Collaborative Relationship• Opening the Interview• Getting Information• Giving Information• Counseling and Persuading• Closing the Interview• Summary

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Creating a Collaborative Relationship• Sharing Control

▫Both parties must share control▫Patients must be active and responsive▫It takes two to form an effective

relationship

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Creating a Collaborative Relationship•Reducing Relational Distance

▫Dwell on similarities, not differences.▫Enhance relationships through

understanding.▫Be relaxed and confident.▫Show interest in the “individual.”▫Maintain objectivity.▫Be sincere and honest.▫Maintain appropriate control during the

interaction.

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Creating a Collaborative Relationship•Appreciating Diversity

▫Gender influences communication and treatment.

▫Culture Health communication differs in the global

village▫Be aware of how different people perceive

roles and purposes in health care interviews.

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Creating a Collaborative Relationship•Stereotypes

▫Health care providers often stereotype patients.

▫Stereotypes determine attitudes, and attitudes may determine care, treatment, and satisfaction.

▫So-called Good patients tend to get better treatment than bad patients.

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Creating a Collaborative Relationship•Creating and Maintaining Trust

▫Confidentiality and trust go hand-in-hand.▫Providers and patients cocreate trust.

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Opening the Interview

•Enhancing the Climate▫The opening sets the tone for the entire

interview▫Location and setting promote collaborative

interactions.

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Opening the Interview

•Being Sensitive and Personal▫Use the opening to reduce apprehension▫Neither rush nor drag out the opening▫Politeness breeds politeness

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Opening the Interview

•Adapting the Opening▫The opening must fit the situation▫Get the whole story▫Orient the patient

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Getting Information

•Barriers to Getting Information▫Do not assume patients will provide

accurate information.▫Ask obviously relevant questions as soon as

possible.▫Weigh the ability of patients to respond.▫Provider dominance deadens interactions.▫Explain medical terms and procedures.▫Ask focused, explicit questions.

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Getting Information

•Ways to Improve Getting Information▫Encourage turn-taking▫Asking and Answering Questions

The funnel sequence gives a sense of sharing control

Vary listening approaches

Continued…

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Getting Information•Ways to Improve Getting Information

▫ Telling stories Encourage storytelling and listen The less you talk, the more you say

▫ Listening, Observing, and Talking Be patient and persistent Use leading questions with caution

▫Ineffective Methods Single-Medium Messages Information Overload

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Getting Information

•Addressing the Language Barrier▫Communication breakdowns are the most

common root cause of health errors that harm patients

▫Successful programs have included comprehensive interpreter services

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Giving Information

•Causes for Loss and Distortion of Information▫Attitudes of Providers▫Problems with Patients▫Ineffective Methods

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Giving Information•Giving information more effectively

▫Give information that seems authentic.▫Encourage patients to ask questions.▫Do not overload patients with information.▫Organize items of information systematically

so that they are easy to recall.▫Practice good communication skills.▫Use a variety of media to present information.▫Include a number of sources in the process.

Continued...

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Counseling and Persuading

•Barriers to Effective Counseling and Persuading▫Watch for hints and clues about concerns

about real problems.▫Providers my try to dodge unpleasant

exchanges.▫Know yourself to understand others.

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Counseling and Persuading

•Effective Counseling and Persuading▫Five Critical Relational Factors

Empathy Trust Honesty Mutual Respect Caring

Continued…

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Counseling and Persuading

•Effective Counseling and Persuading▫Selecting an appropriate interview

approach.▫Providing an appropriate climate.▫Encouraging interaction.▫Considering solutions.

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Closing the Interview

•The closing must be a collaborative effort•Important questions and revelations occur

during the closing

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Summary• The health care interview is common, difficult

and complex.• Situations vary from routine to life threatening.• A collaborative and productive relationship will

reduce the anxiety, fear, hostility, and reticence that often accompanies health care interviews.

• The provider and consumer must realize that good communication is essential for effective health care interviews.

• Skills require thorough training and practice.