You're right, the patient's response raises concerns that require follow up from a healthcare professional. Sensitively expressing care and concern for the patient's wellbeing is important in this situation.

1. Guide to Interviewing
Muhammad Suliman
(Post RN BScN)

2. Outline
• Types of interviews
• Process for successful interviewing
• The interview schedule
• The interview guide
• Conducting the interview
• Rapport
• Questioning
• Interview review
• The interviewee
• Dos and don’ts
• six Cs for writing an accurate patient history.
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3. 3
Interviewing
Is a planned communication or a conversation
with a purpose, for example to get or give
information, identify problems of mutual
concern, evaluate change, teach, provide
support. There are two approaches to
interviewing, directive and nondirective.

4. 4
The directive interview is highly structured and
elicits specific information. The nurse
establishes the purpose of the interview and
controls the interview. The client responds to
questions but may have limited opportunities
to ask questions or discuss concerns. The
nondirective interview or rapport-building
interview, by contrast the nurse allows the
client to control the purpose, subject matter,
and pacing.

5. The Patient Interview and History
5
• Patient interview
– First step in examination
process
– Establish a relationship with
the patient
• Chief complaint
– Subjective statement by
patient describing the most
significant symptoms or signs
of illness

6. 6
Interview
schedule
Interview
Interview
guides
Interview
notes format
Who you are going
to interview, why,
when and where?
What questions are
you going to ask?
What results were
obtained?
• Information found
• Decisions
• Actions
• Structure
• Rapport
• Listen
•Clarify
An interview guide should be created prior to all
interviews to ensure the interviews are focused and
efficient and enable comparison and summarisation.
Interview process
Preparation Execution Review

7. Name Position Rationale Date
John Smith R&D Manager To understand R&D strategy
and get future R&D
expenditures
25/4
Roy Wilkinson Head of metalurgical
research
To get facts on competitor
Xs latest development.
In particular:
 Potential customers
 Our position
27/4
Bob Johnson Lab assistant
7
The interview schedule
An interview schedule is helpful, to track who is going
to be interviewed, when and why.

8. Preparing the interview schedule
• Identify what the objectives of the interviews are,
what information you need to find out.
• Identify who needs to be interviewed to obtain this
information.
• Create an interview schedule, allowing time to review and
record notes between interviews.
• Book the interviews and record them in the schedule.
8

9. To make the most out of an interview, a well thought through
interview guide is extremely helpful.
Section Question Sub Question
Introduction 1.Personal background
2.Key mission of the department
3. ……………..
 Education
 Work experience
 Major activities
 Major interfaces

Body 4.Recent development in area x
5.Customer reactions
6. ……………….
7. ……………….
8. ……………….
 Major products
 Competitor activities
 Switching costs
 Timing of change

Wrap up 9.Future trends
10.Restate key points
 Next S - curve
 Timing

9
The interview guide

10. Preparing the interview guide
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• Determine the objectives of the interview.
• Plan the structure of the interview.
• Prepare interview questions.
• Prepare additional notes if they assist.
The interview guide enables standardisation of
interviews for effective comparison and summarisation

11. 11
Interview execution
Interviews are exceptionally rich sources of information.
However, no two interviewees are alike: some will need
only the slightest encouragement to speak their minds,
while others will have to be guided along.
The interviewer‟s job is to conduct the interview to
gather the information required, which takes skill,
practice and structure.
Once you have concluded your interviews, they must be
summarised to yield the „big picture‟.
Your questions should therefore allow for valid
comparison and summarisation of your interviewee‟s
viewpoints.

12. 12
Eight steps to a successful interview
1. Do research before the interview
– Review patient records
– Be sure test and lab results are on the chart
2. Plan the interview
– Be organized before starting the interview
– Follow office policy
The Patient Interview

13. 13
3. Make the patient feel at ease
– Icebreakers
– Appear relaxed
– Eye contact
4. Ask the patient for an interview
– Makes the patient feel more comfortable
– Emphasizes the importance of the process

14. 14
5. Ensure privacy / no interruptions
– Close door
– Do not use “pet” names
6. Be respectful with sensitive topics
– Watch for nonverbal cues
– Watch your own nonverbal cues

15. 15
7. Do not diagnose or give an opinion
– Refer questions to physician
– Do not go beyond your scope of practice
8. Formulate a general picture
– Summarize key points
– Ask if patient has questions or needs to add
additional information

16. How to conduct the interview
Listen to the answers and request clarification if necessary
Avoid making criticisms or taking sides
Keep control of the interview: refocus the interviewee if they are
rambling or clarify if they misunderstood the question
Stay focused and follow your interview guide
Allow the interviewee to ask questions
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Introduction
Body
Wrap-up
Always state the reason for the interview and how it will be conducted
Put the interviewee at ease
Ask the interviewee if they agree to you taking notes
Thank the interviewee
Advise them what the next steps are and the timeframe

17. Build rapport
17
Your interview needs to balance the building of rapport and collecting of required
information.
Introduction
Gain rapport first. Explain the context, set the tone, and make the interviewee feel
at ease. The introduction serves to:
• Introduce yourself
• Gauge the interviewee‟s style, expectations and concerns
• Confirm the timeframe
Sequence the interview items
Items should be ordered by importance and sensitivity. The more sensitive your
interviewee, the more important it is to avoid an „inquisitorial‟ interview tone. A
non-threatening format for interviews involves the careful arrangement of
interview topics:
• General before specific
• External before internal
• Historic before current

18. Listen and question
18
Listen
To reassure the interviewee you are listening and to gain information:
• use non-verbal cues such as head nods to show you are listening.
• wait until the current question is answered before preparing the next one
• listen for emotions and attitudes as well as facts
• interrupt only if you sense avoidance of answering the question or if the
interviewee has drifted too far from the topic
• request clarification and ask follow on questions
Ask open questions
To initiate discussion on a broad subject and to encourage a comprehensive
explanation:
• use clear, direct phrasing that asks a single question
• ask how, what or when but avoid the intimidating why question
Ask closed questions
To elicit a specific reply:
• use this type of question sparingly to avoid appearing as an
interrogator
• ask in order to understand rather than impress
• be concise

19. Open questioning
19
Advantages Disadvantages
• Puts interviewee at ease
• Interesting for interviewee
• Provides depth of detail
• Reveals other areas of
enquiry
• You may lose control
• May use up too much time
• Interviewer may appear unprepared
• Harder to analyse later
• Lower reliability of data
Examples:
“Are there any other issues I should be aware of?”

20. Closed questioning
20
Advantages Disadvantages
• Efficient use of time
• Easy to compare interviews
• Higher reliability of data
• Less interviewing skill needed
• Focuses interviewee
• Can be boring for interviewees
• Doesn‟t provide the
opportunity to qualify answers
• You may miss other areas
Examples:
“Did you sleep well last night?”

21. Probe questioning
21
Advantages Disadvantages
• Provides data on new aspects
• Supplies detail in context
• Shows interest in conversation
• Can appear threatening
Examples:
“How does that happen?”
Probe questioning is honing in on a particular area of interest and drilling
down to obtain more detail. It includes asking for more information to clarify
a vague phrase or statement made by the interviewee such as „quite high‟ or
„often late‟. Probe questioning needs to be balanced with open and closed
questioning to avoid the interview seeming like an interrogation.

22. Paraphrasing
22
Paraphrasing is a technique used to confirm or clarify something the
interviewee has said or implied. There are three levels of
paraphrasing:
1. The first level confirms or clarifies expressed thoughts and
feelings, for example: “so there are three factors that
determine the present situation”
2. The second confirms implied thoughts or feelings, for example:
“so you would really like to change this situation”
3. The third surfaces core thoughts or feelings, for example: “you
are afraid that it might make things worse for you” or “so you
think the strategy is wrong”
(Note that with paraphrasing of feelings you can trigger a
strong emotional response particularly with this third option )

23. 23
Apply Your Knowledge
ANSWER: An open-ended question which will allow the
patient to explain the situation more clearly.
1. What type of question is the following: “How have
you been managing your diabetes?”
2. How would you use mirroring if the patient made the
following statement during an interview? “I just cannot
seem to stay on a diet no matter how hard I try.”
ANSWER: The Nurse should restate what the patient says in
his or her own words. For example, the nurse might say, “You
are finding it difficult to stay on a diet.”
Correct!

24. Interview notes are valuable when sharing information with
other team members. 24
• Write interview notes
as soon as possible
after the interview
• Outline key findings,
note emerging
hypotheses
• Consider how findings fit
with earlier evidence
• Identify gaps to be
filled in subsequent
interviews
Key Steps
Interview Notes
Interviewees:
Interviewers:
Location:
Date:
KEY FINDINGS
BACKGROUND AND
SITUATION
DISCUSSION NOTES
NEXT STEPS
Format
Interview review
A standard interview note format is useful in orienting interviews to results:

25. The interviewee can be
Inarticulate
A jargoneer
A familiarist
An obstructionist
Too familiar with the job
25
Shy
Loud
A deceiver
A hypochondriac
An empire builder

26. 26
The nervous interviewee
Be very explicit in setting the scene, tell why you are there and what they can
expect. Establish rapport and make sure you are relaxed and confident
The non-talker
Make a special effort to build rapport and find common language and
experiences. Avoid closed questions, use open questions to draw them out
The angry/hostile interviewee
Do not tolerate threatening behaviour.
If anger is directed at you:
• admit your mistake if you are wrong
• stay calm, avoid getting angry in return
If anger is directed at others:
• do not get involved and do not taking sides
• correct misinformation tactfully
ie do not challenge honestly held opinions
Adjust your style to suit the interviewee

27. Poor interviewing behaviour
×Did not make an appointment
×Arrived late
×Was rude
×Did not explain the purpose of the
interview
×Did not explain the scope of interview
×Used jargon
×Became confrontational
×Was inconsiderate
×Talked down to the interviewee
×Abruptly ended the interview
×Did not explain what happens next
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Examples:

28. Do not
× Forget interviewee’s name or role
× Criticise
× Interrupt
× Be impatient
× appear bored
× Fail to thank the interviewee for their time
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29. Do
 Create rapport
 Make notes
 Be sincere
 Be objective
 Be courteous
 Verify your findings
 Separate fact from fiction
 Pitch the interview at the right level
 Keep within the scope of the interview
 Establish the option to ask follow up questions
 Wrap up the interview and thank the interviewee for their
time.
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30. 30
Apply Your Knowledge
While interviewing a female patient, you notice bruises on her
forearms and face. You ask her how she got the bruises, and
she says she cannot remember, but she must have fallen down.
What should you do?
ANSWER: The patient’s answer is vague and evasive. Since
multiple bruises may be a sign of abuse, you should tell the
physician of your suspicions.