How would your communication and interview techniques for building a health history differ with each patient?
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
· By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
Case C 38-year-old Native American pregnant female living on a reservation
· How would your communication and interview techniques for building a health history differ with each patient?
· How might you target your questions for building a health history based on the patient’s social determinants of health?
· What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks.
· Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
· Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
· Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
EXPERT ANSWER AND EXPLATION:
Building A Health History
A Brief Summary of the Interview
This interview involved a 38-year-old Native American pregnant woman residing on a reservation. The woman had come to the health facility to check up on health during the pregnancy period. The interview found that this woman was four weeks pregnant, and this pregnancy was her third one. The interview also revealed that her second birth was in the form of a cesarean section. During the interview, it was found that the patient’s family has a history of twins. She has brothers who are identical twins. When asked if she has ever suffered any chronic condition, she said no. In terms of financial capability, it was found that the patient’s income was 100% above the federal poverty level. She is working as a librarian assistant in one of the state libraries in her region. She also has an insurance package from Indian health programs. Through the interview, it was found that she has never had a blood transfusion, no history of tuberculosis, and it allergic to penicillin medication. She also said that after this child, she would like to undergo family planning program that can take her to her menopause period because she does not want to conceive again.
Communication Techniques to be used by Assigned Patient
The first technique that I would use with my assigned patient is offering her a genuine smile. Arnold and Boggs (2019) mention that a genuine smile can immediately convey openness and warmth. I would use this technique to lobby the patient to be open with me and to know that I will be real with her. Also, a genuine smile will help be build trust with the patient. The second technique is asking the right questions. This technique will be used to understand the thoughts of the patients and to learn new things about her. Open-ended questions will better fit this patient and allow her to express herself clearly (Brooks, Ballinger, Nutbeam, Mander and Adams (2018). Another technique I will use with the patient is active listening. This technique will help me understand what the patient is saying. Janssen, Ruiter and Waters (2018) argue that active listening can also show that the communicator is empathetic. The last technique that will be used to connect with the patient is to provide feedback when needed and receive the one given diligently (Turkelson, Aebersold, Redman & Tschannen, 2017). When one provides feedback, it can show that he or she takes the other person seriously.
The Risk Assessment Instrument Selected
The instrument selected to assess risk in this scenario is the Historical, Clinical, Risk Management-20 (HCR-20). This tool is often used by psychological professionals to assess the level of violence and psychological problems the patients are undergoing. Cheng, Haag and Olver (2019) mention that marital violence is reported more in native American nations more compared to other parts of the country. This tool will be applicable to this patient because it will be used to assess if the patient is stressed about the type of birth she had previously. Also, the tool will be used to assess if the patient is undergoing any violence, either physically or mentally (Shepherd, Campbell & Ogloff, 2018).
The Targeted Questions
- When last did you see your menstrual cycle?
- Is this your first pregnancy?
- Have you ever suffered any chronic condition?
- Have you ever had any major surgery?
- Does your family have any history of twins?
Arnold, E. C., & Boggs, K. U. (2019). Interpersonal Relationships E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.
Brooks, C., Ballinger, C., Nutbeam, D., Mander, C., & Adams, J. (2018). Nursing and allied health professionals’ views about using health literacy screening tools and a universal precautions approach to communication with older adults: a qualitative study. Disability and rehabilitation, 1-7. https://doi.org/10.1080/09638288.2018.1538392
Cheng, J., Haag, A. M., & Olver, M. E. (2019). Predictors of Historical Clinical Risk Management-20 Version 3 (HCR–20: V3) summary risk ratings. Psychiatry, Psychology and Law, 26(4), 682-692. DOI: 10.1080/13218719.2019.1618753
Janssen, E., Ruiter, R. A., & Waters, E. A. (2018). Combining risk communication strategies to simultaneously convey the risks of four diseases associated with physical inactivity to socio-demographically diverse populations. Journal of behavioral medicine, 41(3), 318-332. https://link.springer.com/article/10.1007/s10865-017-9894-3
Shepherd, S. M., Campbell, R. E., & Ogloff, J. R. (2018). The Utility of the HCR–20 in an Australian sample of forensic psychiatric patients. Psychiatry, Psychology and Law, 25(2), 273-282. https://doi.org/10.1080/13218719.2017.1364676
Turkelson, C., Aebersold, M., Redman, R., & Tschannen, D. (2017). Improving nursing communication skills in an intensive care unit using simulation and nursing crew resource management strategies. Journal of nursing care quality, 32(4), 331-339. DOI: https://doi.org/10.1097/NCQ.0000000000000241
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