Interviewing Skills and Health History (2).pdf

UNIT NO 02
INTERVIEWING SKILLS
AND HEALTH HISTORY
Waheed Shah
Senior Nursing Lecturer
CHR,BA,BSN, MPH,
MSc Nutrition,
Pediatrics Specialized
Diploma
DIR COLLEGE OF
NURSING & ALLIED
HEALTH SCIENCES
TIMERGARA
LOWER DIR KPK

Unit II-INTERVIEWING SKILLS AND
HEALTH HISTORY
BY
SEHRISH NAZ
RN, Post RN, MSN
Lecturer, Institute of Nursing Sciences, Khyber
Medical University
Subject: Health Assessment
6/6/2023 2
Post RN semester 1

6/6/2023 Post RN semester one 3

INTERVIEW
• A meeting of people face to face, especially for
consultation.
• The health history interview is a conversation
with a purpose to improve the well being of
the patient.
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Post RN semester 1

PHASES OF THE INTERVIEW
• Introductory phase
• Working phase
• Summary and Closing or termination phase
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Post RN semester 1

INTRODUCTORY PHASE
• Introduce yourself to the client
• Explains the purpose of the interview
• Discus the types of questions that will be asked
• Explain the reason for taking notes
• Assures the client that confidential information
will remain confidential
• Make sure that the client is comfortable
(physically and emotionally) and has privacy
• Develop trust and rapport at this point in the
interview
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Post RN semester 1

WORKING PHASE
• Work on components of health history
• Observe cues, and use critical thinking skills to
interpret and validate information received
from the client
• The nurse and client collaborate to identify the
client’s problems and goals
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Post RN semester 1

SUMMARY AND CLOSING OR
TERMINATION PHASE
• Summarize information obtained during the
working phase and validates problems and
goals with the client
• Identify and discus possible plans to resolve
the problem with the client
• Make sure to ask if anything else concerns the
client and if there are any further questions
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Post RN semester 1

INTERVIEWING MILESTONES
• Getting Ready: The Approach to the Interview
• Learning About the Patient: The Sequence of
the Interview
• Building the Relationship: The Techniques of
Skilled Interviewing
• Adapting Your Interview to Specific Situations
• Sensitive Topics that Call for Special Skills
• Societal Aspects of Interviewing
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Post RN semester 1

GETTING READY
THE APPROACH TO THE INTERVIEW
• Take time for self-reflection.
• Review the medical record.
• Review your clinical behavior and appearance.
• Adjust the environment.
• Take notes.
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Post RN semester 1

LEARNING ABOUT THE PATIENT
THE SEQUENCE OF THE INTERVIEW
• Greet the patient and establishing rapport
• Invite the patient's story
• Set the agenda for the interview
• Expand and clarify the patient's story
• Create a shared understanding of the patient's
concerns
• Negotiate a plan
• Follow up and closing of the interview
6/6/2023 11
Post RN semester 1

BUILDING THE RELATIONSHIP
The Techniques of Skilled Interviewing
• Active listening
• Guided questioning
• Nonverbal-
communication
• Empathetic responses
• Reassurance
• Summarization
• Empowering the patient
6/6/2023 12
Post RN semester 1

ADAPTING YOUR INTERVIEW TO SPECIFIC
SITUATIONS
• The silent patient
• The confusing patient
• The patient with
impaired capacity
• The talkative patient
The angry or
disruptive patient
• Interviewing across a
language barrier
• The patient with low
literacy
• The deaf or hard-of-
hearing patient
• The blind patient
• The patient with
limited intelligence
• The patient seeking
personal advice
6/6/2023 13
Post RN semester 1

SENSITIVE TOPICS THAT CALL FOR
SPECIAL SKILLS
• The sexual history
• Mental health
• Alcohol and drug use
• Family violence
• Death and dying
6/6/2023 14
Post RN semester 1

THE TECHNIQUES OF SKILLED
INTERVIEWING
• Active listening
• Adaptive questioning
• Nonverbal
communication
• Facilitation
• Empathetic responses
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Post RN semester 1
• Validation
• Reassurance
• Summarization
• Empowering the patient.

PURPOSES OF HEALTH HISTORY
• Provide the subjective database
• Identify patient strengths
• Identify patient health problems, both actual and
potential
• Identify supports (financial, social)
• Identify teaching needs
• Identify discharge needs
• Identify referral needs
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Post RN semester 1

TYPES OF HEALTH HISTORY
• Complete (comprehensive) health history
• Focused health history
6/6/2023 17
Post RN semester 1

6/6/2023 Post RN semester 1 18

COMPONENTS OF HEALTH HISTORY
Biographical Data
Reason for Seeking Healthcare
Current Health Status
Past Health History
Family History
Review of Systems
Developmental Considerations
Psychosocial Profile
6/6/2023 19
Post RN semester 1

BIOGRAPHICAL DATA
 Patient’s name
 Address
 Phone number
 Contact person
 Age/birth date
 Place of birth
 Gender
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Post RN semester 1
Race
 Religion
Marital status
Educational level
Occupation
 Social security
number/health insurance

REASON FOR SEEKING HEALTHCARE
• Ask your patient why he or she is seeking healthcare
• The patient’s reason for seeking care is usually related
to the level of preventive healthcare (general
checkups or screening)
• In an acute-care setting, the reason for seeking care is
called the chief complaint.
6/6/2023 21
Post RN semester 1

CURRENT HEALTH STATUS
– The current health status should include the
following:
• Usual state of health.
• Any major health problems.
• Usual patterns of healthcare.
• Any health concerns.
6/6/2023 22
Post RN semester 1

PAST HEALTH HISTORY
• The past health history assesses
– Childhood illnesses and hospitalizations
– Surgeries and serious injuries
– Adult medical problems (including serious
or chronic illnesses)
– Immunizations
– Medications and allergies
– Recent travel
6/6/2023 23
Post RN semester 1

FAMILY HISTORY
Ask about the health status and ages of your
patient’s family members.
•Family members include the patient’s spouse,
children, parents, siblings, aunts and uncles, and
grandparents.
• Ask about genetically linked or common
diseases, such as heart disease, high blood
pressure, stroke, diabetes, cancer, obesity, bleeding
disorders, tuberculosis, renal disease, seizures, or
mental disease.
• If the patient’s family members are deceased,
record the age and cause of death.
6/6/2023 24
Post RN semester 1

REVIEW OF SYSTEMS (ROS)
Ask questions that are specific to each body
system.
• The questions are usually about the most
frequently occurring symptoms related to a
specific system.
6/6/2023 25
Post RN semester 1

DEVELOPMENTAL CONSIDERATIONS
• Developmental assessments are often
performed on children
• Illness and hospitalization can have a major
impact on a child’s growth and development
6/6/2023 26
Post RN semester 1

PSYCHOSOCIAL PROFILE
• It includes questions about;
– Healthcare practices and beliefs
– A description of a typical day
– A nutritional assessment
– Activity and exercise patterns
– Recreational activities
– Sleep/rest patterns
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Post RN semester 1

PSYCHOSOCIAL PROFILE
– Personal habits
– Occupational risks
– Environmental risks
– Socioeconomic Status
– Family roles and relationships
– Stress and coping mechanisms.
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Post RN semester 1

References
1. Dillon PM., Nursing Health Assessment; A Critical Thinking, Case
Studies Approach, 2nd ed. Copyright © 2007 by F. A. Davis.
2. Lynn SB., Szilagyi PG., Bates' Guide to Physical Examination and
History Taking, 10th ed. Copyright ©2009 Lippincott Williams &
Wilkins.
3. SHEILA L.VIDEBECK Psychiatric Mental Health Nursing Fifth
edition.
4. Santosh Malik psychiatric nursing first edition October , 2012.
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Post RN semester 1

Assignment
• Pre reading of chapter iii “INTRODUCTION TO
PHYSICAL EXAMINATION AND GENERAL
SURVEY”
6/6/2023 Post RN semester 1 30

6/6/2023 31
Post RN semester 1

Interviewing Skills and Health History (2).pdf

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