Patient Centered Interview
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This document outlines a 5-step process for conducting a patient-centered medical interview: 1) Setting the stage, 2) Obtaining the patient's agenda, 3) Opening with a patient-centered history of present illness, 4) Continuing the history of present illness using open-ended questions and empathy skills, and 5) Transitioning to the middle portion of the interview. The first 4 steps emphasize understanding the patient's full context and story through open-ended inquiry, empathy, and building rapport. This approach aims to improve outcomes by ensuring the patient's concerns are addressed, empowering them, and establishing trust in the patient-clinician relationship.
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Medical interview.pptx
The medical interview document outlines the structure and goals of a medical interview between a doctor and patient. The interview includes gathering information about the patient's complaints, medical history, and life history to make an accurate diagnosis and treatment plan. It discusses the importance of establishing rapport, actively listening to understand the patient's perspective, and providing information to the patient in an understandable way. The doctor aims to understand the patient's health concerns and ensure informed consent during the medical interview process.
History taking in general FACT and ART
Here are the key points to cover in a systems review:
- Briefly ask about symptoms related to major organ systems: cardiovascular, respiratory, gastrointestinal, genitourinary, neurological, musculoskeletal, skin, ears/nose/throat, eyes.
- Ask focused questions about symptoms related to the presenting complaint and related systems.
- Note any pertinent positives or negatives. No need to record if all negatives unless related to presenting complaint.
- Aim to be thorough but brief. Focus on symptoms not covered elsewhere in history.
- Document any significant findings to follow up in detail in HPI or PMH as needed.
Aac hptcint forum10-10
This document presents a model for integrated patient-centered and clinician-centered interviewing. It describes the model, which combines patient-centered interview skills that elicit psychosocial information with clinician-centered processes to obtain physical symptom data. The model is demonstrated in five steps: setting the stage, establishing the chief concern and agenda, opening the patient-centered history of present illness, continuing the patient-centered story, and transitioning to the clinician-centered portion.
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This document discusses the importance of communication skills in medical practice. It outlines seven competencies for effective doctor-patient communication: building a relationship, opening the discussion, gathering information, understanding the patient's perspective, sharing information, reaching agreement, and providing closure. For each competency, it provides tips and guidelines on how to demonstrate care, show respect, ask open-ended questions, actively listen, explain diagnoses and plans, and ensure mutual understanding. The overall message is that strong interpersonal communication is integral to quality patient care.
Qualitative Research Methods
The document discusses various qualitative research methods used in interviews and observations. It describes structured, semi-structured, and unstructured interviews, providing examples of questions for each type. It also covers focus groups, problem-centered interviews, expert interviews, and methods of observation like participant and non-participant observation. The purpose of these qualitative research methods is to get an in-depth understanding of experiences, beliefs, and social phenomena.
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- The document discusses surgical management techniques for problematic hip conditions in adolescent and young adult patients. These include femoro-acetabular impingement, hip instability, slipped capital femoral epiphysis, Legg-Calvé-Perthes disease, and advanced osteoarthritis.
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Tuberculosis of the spine, also known as Pott's disease, was first described in 1799. It is caused by the bacterium Mycobacterium tuberculosis which spreads hematogenously from a primary infection site to the spine. India has a high prevalence of spinal tuberculosis, accounting for around 1-3% of all TB cases. The disease most commonly affects the lower thoracic and upper lumbar spine. Clinical features include back pain, stiffness, deformity, and neurological deficits in advanced cases. Diagnosis involves imaging like X-rays and MRI to identify vertebral body destruction, as well as tests to detect M. tuberculosis from biopsy or aspirate samples. Advanced disease can compress the spinal cord, potentially causing parapleg
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1. The functional outcomes of shoulder fracture surgery can be unpredictable due to the complex anatomy of the shoulder.
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Bone tumors.pptx
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Patient Centered Interview
- 2. • A user-friendly step-by-step method for the beginning of the medical interview • It is followed by clinician centred interview • Benefits: a)improved patient satisfaction, b)decreased risk of malpractice law suits, c)improved health outcomes. d)after this investment, you will find the rest of the interview to be fairly easy and routine, e)the data you generate will be easily understood and usually describe the primary symptoms and their personal context. f)the mind–body connection will be established g)the patient will feel listened-to, understood, and cared-for.
- 4. Steps • Setting the stage for the interview • Obtaining agenda • Opening the pt. centered HOPI • Continuing the pt. centered HOPI • Transition to middle part of the interview
- 5. Step 1: SETTING THE STAGE FOR THE INTERVIEW “ Mr. George Brown? Hello, I am Mark Burn. I am the medical student on the team that will be looking after you. How do you prefer to be called” - eye contact, smiling, attentive& calm, friendly, respectful demeanour is time convenient for the interview?, Patient circumstances, pressing needs that might delay interview draw full attention & show your caring & concern ‘is that a comfortable chair for you?’, ‘is that light bothering your eyes’
- 6. Step 2: OBTAINING AGENDA • It orients and empower the patient and ensure that his/her concerns are properly prioritised and addressed • Benefits: completes interview in short time ,empower patients, increased yield of data “ we have got about 40 minutes together today and I need to ask a lot of questions and do an examination but lets start bay making a list of things you want to discuss”
- 7. Step 3: OPENING THE HOPI • HOPI most important component of interview • Encourage continuous flow of information ( knowing pt. symptom story) • If pt. not talking, focussing open ende skills are used( echoing, requesting, summary) • Mentally active: think what the information means
- 8. Step 4; CONTINUING PATIENT CENTERED HOPI • student will be verbally more active • Focussing open ended skills, emotion seeking skills, empathy skills • Understanding patient as a person • Enhance clinician patient relationship -echoing, request, summarising -psychological and social context ( how is that affecting your life? )
- 9. Step 4 • Emotional context; Emotional focus (emotion seeking skills) : direct or indirect • Empathy skills; To address emotion & feeling, convey the patient that you have recognized it by naming it, you understand it and you are available in any anyway possible • Empathy skills may make patient introduce new personal information- you can work on that • Do this until you are satisfied with depth of the story
- 10. Step 5: TRANSITION TO MIDDLE PART OF INTERVIEW
- 11. SUMMARY • The beginning of the medical interview consists of two preparatory steps during which we set the stage (Step 1) and the agenda (Step 2) followed by an open- ended beginning of the HPI (step 3), continuation of the HPI (Step 4), and transition to the middle of the interview (Step 5). • The transition (Step 5) prepares the patient for the more direct clinician-centered style of the middle of the interview. • In Steps 3 and 4, you use the following patient-centered skills to “build the patient’s history”: non focusing and focusing open-ended inquiry, occasional closed-ended questions, emotion-seeking and empathy skills, and hypothesis testing. • The cyclic, integrated use of these patient centered skills occupies all of the longest and most important Step 4. • These are the tools that will allow you to begin to understand the richness and complexity of the human condition
- 12. THANK YOU