Transcript
1. Solution Manual Physical Examination and Health Assessment Canadian 2nd Edition by Jarvis Link full download: https://testbankservice.com/download/solution-manual- physical-examination-and-health-assessment-2nd-canadian-edition-by-jarvis Chapter 04: The Interview Answer Key – Answer to Study Guide Questions 1. Time and place of the interview and succeeding physical examination • Introduction of yourself and a brief explanation of your role • The purpose of the interview • How long it will take • Expectation of participation for each person present • Presence of any other people (such as family members, other health professionals, or students) • Confidentiality and to what extent it may be limited • Any costs that the patient must pay 2. • Ensure privacy 2. • Refuse interruptions • For the physical environment: – Set the room temperature to a comfortable level – Provide sufficient lighting – Reduce noise – Remove distracting objects or equipment (leave professional equipment needed for the examination) – Consider the distance between yourself and the patient, and position yourself with 1 ½ metres (twice an arm’s length) between you – Arrange equal-status seating—both should be seated comfortably, at eye level – Arrange your own seat in a face-to-face position when interviewing a patient in bed. • The patient should remain dressed in clothing, except in emergency cases. • The interviewer should be wearing conservative, appropriate clothing. • Keep note-taking to a minimum, and try to focus your attention on the patient. 3. Pros of note-taking: • It is difficult to rely on memory alone to furnish details of previous hospitalizations or other information the patient may provide. Cons of note-taking: • Breaks eye contact. • Shifts attention away from the person, thus reducing his or her sense of 3. importance. • It can interrupt the patient’s narrative flow. • It impedes the interviewer’s observation of the patient’s nonverbal behaviour. • When discussing sensitive issues, it may be threatening to the patient. 4-2 4. The open-ended question asks for narrative information; it states the topic to be discussed, but only in general terms. These questions let the person express him- or herself fully. The closed or direct question asks for specific information; it elicits a short one- or two-word answer, such as a yes or no, or a forced choice. The direct question limits the patient’s answer. 5. • Facilitation—These responses encourage the patient to say more or to continue with the story. Examples: ―mm-hmm,‖ ―go on,‖ ―continue,‖ or ―uh-huh.‖ • Silence—Silent attentiveness, especially after open-ended questions, communicates that the patient has time to think and organize what he or she wishes to say without interruption from the interviewer. • Reflection—This response echoes the patient’s words; by repeating what the person has just said, further attention is focused on a specific phrase, and this helps the 4. person elaborate on the subject. Example: see p. 50. • Empathy—An empathic response recognizes a feeling and puts it into words. It names the feeling and allows for it to be expressed. An empathic response helps the patient to feel accepted, and to deal with the feeling openly. Example: see pp. 50– 51. • Clarification—If the person’s word choice is confusing or ambiguous, clarification can be requested to ask for a better explanation of his or her thoughts. Example: see p. 51. • Confrontation—The interviewer, when observing a certain action, feeling, or statement, gives his or her honest assessment about what is seen or felt. The feedback may focus on a discrepancy, the person’s affect, or inconsistencies in the person’s story. Example: see p. 51. • Interpretation—Based not on direct observation but rather on inference or conclusion. Example: see p. 51. • Explanation—Sharing factual and objective information. Example: see p. 51. • Summary—A final review of what the interviewer understands that the patient has said. It condenses the facts, and serves as the interviewer’s perception of the health problem or need. 6. (1) Providing false assurance or reassurance 5. (2) Giving unwanted advice (3) Using authority (4) Using avoidance language (5) Engaging in distancing (6) Using professional jargon (7) Using leading or biased questions (8) Talking too much (9) Interrupting (10) Using ―why‖ questions For examples of the ten traps of interviewing, see pp. 52–53. 7. • Physical appearance • Posture • Gesture 4-3 • Facial expression • Eye contact • Voice • Touch 8. Answers may vary. See examples on p. 54. 6. 9. When interviewing an older person, be alert for expressions of hopelessness or despair about his or her present life or the future. Always address the person by the last name, such as ―Hello, Mr. Simmons.‖ Adjust the pace of the interview to the older person; it may take longer for an older person to tell his or her story, or he or she may require a longer response time. Do not try to hurry the interview along. Consider that physical limitations may cause older adults to fatigue earlier. Consider that hearing impairment may exist, and be sure to face the person fully and avoid shouting. Touch may be a helpful nonverbal skill that is important to older persons, and may convey empathy. 10. When working with a hearing-impaired person, first ask his or her preferred way of communication—by sign language, lip-reading, or writing. In order to perform a complete health history, a sign language interpreter will be needed. If the person prefers lip-reading, be sure to face him or her squarely and have good lighting on your face. Be aware that a beard or moustache or foreign accent may make lip- reading difficult for some people. Talk normally, without shouting or exaggerating lip movements—these actions distort your words. Speak slowly and supplement your voice with appropriate hand gestures. Written communication is efficient in sections of the health history such as past history, family history, or review of symptoms. 7. However, for some parts of the interview, writing is very time-consuming and laborious. 11. Responses may vary. See text, p. 58, for guidelines. 12. Communication patterns vary widely across different cultures. There are five types of nonverbal behaviours that convey information about a person: (1) Vocal cues (2) Action cues (3) Object cues (4) Use of personal and territorial space (5) Touch Some behaviours that may vary widely across different cultures include smiling and handshaking, interpretation of silence, and eye contact. 13. Refer to Table 4-3, Use of an Interpreter, p. 63.
