Chapter 13 The Health Care Interview

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Chapter Summary Changing Views on the Health Care Interview Creating a Collaborative Relationship Opening the Interview Getting Information Giving Information Counseling and Persuading Closing the Interview Summary

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Changing Views on the Health Care Interview The Provider’s View Views of health care continue to evolve Task orientation fosters relational distance

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Changing Views on the Health Care Interview The Patient’s View Patients feel vulnerable The setting is threatening and demeaning

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Changing Views on the Health Care Interview The Emerging View Collaboration is critical in health care The goal of health care interaction is to “develop a reciprocal relationship, where the exchange of information, identification of problems, and development of solutions is an interactive process.”

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Creating a Collaborative Relationship Appreciating Diversity Age and sex influence 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.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Creating a Collaborative Relationship Creating and Maintaining Trust Confidentiality and trust go hand-in-hand. Providers and patients cocreate trust.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Opening the Interview Enhancing the Climate The opening sets the tone for the entire interview Location and setting promote collaborative interactions.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Opening the Interview Being Sensitive and Personal Use the opening to reduce apprehension Neither rush nor drag out the opening Politeness breeds politeness

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Opening the Interview Adapting the Opening The opening must fit the situation Get the whole story Orient the patient

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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…

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Giving Information Causes for Loss and Distortion of Information Attitudes of Providers Problems with Patients Ineffective Methods

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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...

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Counseling and Persuading Effective Counseling and Persuading Five Critical Relational Factors 1. Empathy 2. Trust 3. Honesty 4. Mutual Respect 5. Caring Continued…

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Counseling and Persuading Effective Counseling and Persuading Selecting an appropriate interview approach. Providing an appropriate climate. Encouraging interaction. Considering solutions.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. Closing the Interview The closing must be a collaborative effort Important questions and revelations occur during the closing

© 2009 The McGraw-Hill Companies, Inc. All rights reserved. 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.