Chapter 13
The Health Care Interview
McGraw-Hill/Irwin
Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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Chapter Summary
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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
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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
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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
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Empathy
Trust
Honesty
Mutual Respect
Caring
Continued…
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Counseling and Persuading
• Effective Counseling and Persuading
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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.