Chapter 13The Health Care

Interview

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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

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Changing Views on the Health Care Interview

• The Provider’s View

• Views of health care continue to evolve

• Task orientation fosters relational distance

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Changing Views on the Health Care Interview

• The Patient’s View

• Patients feel vulnerable

• The setting is threatening and demeaning

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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.”

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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. 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 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.

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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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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 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

1. Empathy

2. Trust

3. Honesty

4. Mutual Respect

5. Caring

Continued…

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Counseling and Persuading

Effective Counseling and Persuading 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.